ABSTRACT
Background: Sperm retrieval from men with azoospermia has evolved in recent times, providing patient hope for fulfilling their dream of having their own genetic child through testicular sperm extraction followed by intracytoplasmic sperm injection (TESE-ICSI). In the present study, we are correlating the serum follicle stimulating hormone (FSH) levels and the rate of testicular sperm retrieval. Aim: To correlate the serum FSH levels with surgically retrieved sperms from testes in non-obstructive azoospermia. Method: Sixty-six men presenting with male infertility, diagnosed with non-obstructive azoospermia based on standard guidelines were included in the study. The surgically retrieved tissue was washed in 4-(2-hydroxyethyl)-1-piperazineethanesulfonic acid (HEPES) gamete buffer media and scanned under an inverted microscope at ×400. Outcome analysis was assessed through sperm retrieval rate. Result: Testicular sperms were successfully retrieved in 62% (41/66) of men. Sperm retrieval rate (SRR) with FSH values (Group A <10, Group B 10-20 and Group C >20) mIU/mL were 84% (26/31), 75% (12/16) and 15% (3/19), respectively. Conclusion: Chances of sperm retrieval in non-obstructive azoospermia using surgically retrieved sperm are as common for men with FSH levels <10 mIU/mL with 84% (26/31) retrieval as for the borderline 10-20 mIU/mL FSH levels with 75% (12/16) retrieval. We do have retrieved sperms with >20 IU/mL serum FSH also which is not a contradiction for TESE for such patients; however, such patient's need to be counselled about the chances of successful sperm retrieval and the consequent pregnancy outcomes.
ABSTRACT
Background: Infertility is a world-wide problem and one third females. Over the years, anti-mullerian hormone (AMH) has emerged as a major marker of ovarian reserve. There is also increasing interest in determining the factors which can impact AMH levels. Aims: To correlate the association of reproductive and lifestyle factors on AMH levels in women of Indian origin. Settings and Design: Multicentric cross sectional study. Materials and Methods: The study was conducted using data extracted from the patient records of seven private fertility practices located in North India. Women who were attending these clinics for fertility treatment were requested to fill the questionnaire related to reproductive and lifestyle factors. Statistical Analysis used: Our outcome variable was level of AMH measured in the past 3 months, and was assessed as normal or low. All analyses were conducted using STATA 17. Results: We found a direct association of low AMH with increasing age, short cycles, amenorrhea and women with family history of premature menopause. We found a direct correlation of high AMH and women with polycystic ovary syndrome and those whose partners had Oligoasthenoteratozoospermia (OATS) or azoospermia. There was no correlation with smoking, sleep, diet, body mass index, cell phone or laptop use in our study. Conclusion: Reproductive and lifestyle factors may affect ovarian reserve and but there was a dearth of human studies in this area. To the best of our knowledge this is the first human study on the effect of AMH on Laptop and Cell phone use. We urgently need more studies to confirm or refute our findings so that we can counsel our patients well.
