Determining an optimal cut-off value for follicle-stimulating hormone to predict microsurgical testicular sperm extraction outcome in patients with non-obstructive azoospermia

ABSTRACT Objective To determine the optimal cut-off value for follicle stimulating hormone (FSH) to predict the outcome of microsurgical testicular sperm extraction (micro-TESE) in patients with nonobstructive azoospermia (NOA). Subjects and methods We included a total number of 180 patients with NOA. The serum level of FSH was determined and all the subjects underwent micro-TESE. We determined the optimal cut-off value for FSH and assessed whether the test could be effectively used as a successful predictor of sperm retrieval by calculating the Receiver Operating Characteristic (ROC) area under the curve. Results Overall we included a total number of 171 patients with mean age of 34.3 ± 8.6 years. The micro-TESE was considered to be successful in 79 (43.8%) while it failed in 92 (56.2%) patients. We found that the mean level of serum FSH was significantly higher in group those with failed micro-TEST compared to successful group (p < 0.001). The cut-off value for FSH was calculated to be 14.6 mIU/mL to predictive the outcome of micro-TESE with a sensitivity of 83.5% [73.5%-90.9%] and a specificity of 80.3% [69.5%-88.5%]. At this value, the other parameters were calculated to be PPV, 81.5%; NPV, 82.4; LR+, 4.23; and LR-, 0.21. Conclusions The results of the current study indicate that FSH plasma levels above 14.6 mIU/mL can be considered to be the failure predictor of the micro-TESE in NOA patients.

Age and education influence the performance of elderly women on the dual-task Timed Up and Go test / Idade e educação influenciam o desempenho de mulheres idosas no teste Timed Up and Go com dupla tarefa

Gait variability is related to functional decline in the elderly. The dual-task Timed Up and Go Test (TUG-DT) reflects the performance in daily activities. Objective To evaluate the differences in time to perform the TUG with and without DT in elderly women with different ages and levels of education and physical activity. Method Ninety-two elderly women perfomed the TUG at usual and fast speeds, with and without motor and cognitive DT. Results Increases in the time to perform the TUG-DT were observed at older ages and lower educational levels, but not at different levels of physical activity. More educated women performed the test faster with and without DT at both speeds. When age was considered, significant differences were found only for the TUG-DT at both speeds. Conclusion Younger women with higher education levels demonstrated better performances on the TUG-DT. .

Alterações da marcha são indícios de declínio funcional em idosos. O TUG com dupla tarefa (TUG-DT) reflete o desempenho das atividades do cotidiano. Objetivo Avaliar as diferenças no tempo de execução do TUG com e sem DT em idosas com diferentes faixas etárias, e níveis de escolaridade e atividade física. Método Noventa e duas idosas foram avaliadas pelo TUG nas velocidades usual e máxima, sem e com DT cognitiva e motora. Resultados Houve aumento no tempo de execução do TUG-DT em idosas com maior faixa etária e menor escolaridade, mas não para diferentes níveis de atividade física. Aquelas com maior escolaridade realizaram o teste mais rápido com e sem DT nas duas velocidades. Com relação à faixa etária, foram obervadas diferenças apenas nos testes com DT nas duas velocidades. Conclusão Idosas mais jovens com maior escolaridade demonstraram um melhor desempenho no TUG com DT. .

Early successful orchidopexy does not prevent from developing azoospermia

INTRODUCTION: The incidence of Ad spermatogonia (stem cells for fertility) was assessed in 20 cryptorchid patients, all of whom had a successful orchidopexy in childhood but developed azoospermia following puberty. MATERIALS AND METHODS: From a cohort of 231 patients who had a semen analysis following successful orchidopexy 20 patients (9 percent) had azoospermia. The patients were classified into 2 groups according to the time of surgery: A = < 21 months of age (n = 5, mean = 10.7 ± 8.6 months) and B = during childhood (n = 15, mean = 10.1 ± 3 years). Nine of the 20 patients (45 percent) had bilateral cryptorchidism: A = 1 and B = 8. Testicular biopsies were performed during orchidopexy and analyzed with semi-thin technique. The number of Ad spermatogonia and entire number of germ cells was determined. The patients' semen analyses were evaluated at least twice; FSH and testosterone plasma values were estimated. RESULTS: In group A, all patients had germ cells at the time of surgery (mean = 1.04 ± 1.4 germ cells per tubular cross section); only 6 patients in group B (40 percent) had no germ cells (mean = 0.17 ± 0.4); A vs. B, p = 0.0133. Importantly, Ad spermatogonia were absent in the entire study population. The plasma FSH of 16 patients (80 percent) was abnormal [median = 16.35 IU/L (Interquartile range of sample - IQR 9.075-27.85 95 percent CI, 3-53)] while the plasma testosterone of all the patients was normal. CONCLUSIONS: The most severe cause of infertility in cryptorchid patients cannot be mitigated by an early successful surgery alone.

Hormonal abnormalities in azoospermic men in Kano, Northern Nigeria.

BACKGROUND & OBJECTIVES: We undertook this study to observe the pattern of hormonal abnormalities and testicular pathology in azoospermic male Africans in Kano, Northern Nigeria. METHODS: Eighty consecutive azoospermic infertile males attending fertility clinic in Aminu Kano Teaching Hospital, Kano, were selected for the study. Their semen were analyzed three times at eight weeks interval, after which serum follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone and prolactin were assayed in serum samples, and histological examination of testicular biopsies done. RESULTS: Of the 80 subjects studied, 32 (40%) had abnormal hormonal levels, 48 (60%) had normal hormonal values and 36 (45%) had testicular pathology. INTERPRETATION & CONCLUSION: Endocrinopathies are common in azoospermia. Their contribution to male factor infertility cannot be overemphasized. The main reason for the endocrinopathies is not known but environmental factors, endocrine disruptors and genetic polymorphism have been suggested to be contributory.