Oestrogen receptors beta genotype in infertile Egyptian men with nonobstructive azoospermia.

In a prospective study, the polymorphism of oestrogen receptor ß gene was investigated in nonobstructive azoospermia patients. Ninety infertile patients with nonobstructive azoospermia diagnosed after two semen analysis, 2 weeks apart and negative testicular sperm extraction during intracytoplasmic sperm injection, and 60 fertile men as controls were enrolled in the study. Semen analysis, hormonal profile and allele-specific PCR reaction were performed to detect variants of the RsaI polymorphism of the oestrogen receptor ß gene for all patients and controls. The mean patient's age was significantly lower than the mean age of the controls (P < 0.05). There was a significant increase in the mean serum levels of FSH, LH, free testosterone and E2 and significant decrease in total testosterone in patients than controls (P < 0.05). In the patients, the frequency of the homozygous GG, heterozygous AG and homozygous AA genotype was 83.3%, 14.3% and 3.3% respectively, whereas their frequencies in the controls were 95%, 5% and 0% respectively (odds ratio 3.8). There is no significant correlation between ERß polymorphisms and patient's age or pituitary and sex hormones (P > 0.05). Our findings suggested that in Egyptian population, genetic mutation in ERß is associated with the risk of nonobstructive azoospermia.

Improvement of sexual activity, pregnancy rate, and low plasma testosterone after bilateral varicocelectomy in impotence and male infertility patients.

To evaluate the effects of bilateral varicocelectomy on sexual activity, testicular volumes, semen quality, and serum hormone levels in impotence and male infertility patients, 48 patients were studied from an outpatient clinic from May 1998 to March 2001. The mean age was 37+/-5.9; 16 patients were complaining of erectile dysfunction and 32 patients were complaining of male infertility. The mean duration of impotence was 3.3+/-2.4 years and for male infertility was 3.8+/-3.2 years. Sexual and reproductive history was taken for erectile dysfunction and male infertility patients. General, local examination, and laboratory investigations were done for all patients. Preoperative and postoperative testicular volumes; semen parameters, including semen volume, sperm count, and motility; and morphology and hormonal parameters, including LH and FSH, and testosterone levels were measured. All patients were followed up for 3-36 months after varicocele repair. Left and right testicular volume was improved in impotence and male infertility patients and fertility groups, but this improvement was not statistically significant (p>.25). The semen volume was significantly increased in male infertility patients and fertility group (p<.05), but there was no statistical significant difference in impotent patients (p>.25). The sperm count was improved in male infertility patients and fertility group, but this improvement was not statistically significant (p>.25), and in impotent patients there was no significant difference (p>.40). The sperm motility was very significantly increased in male infertility patients and the fertility group (p<.0005), and highly significantly increased in impotent patients (p<.005). The abnormal forms were not statistically significant in impotence and male infertility patients (p>.40), but significantly decreased in the fertility group (p<.05). Serum testosterone was very significantly increased in impotence and male infertility patients (p<.0005) and was highly significantly increased in fertility groups (p<.005). Serum FSH was improved in impotence and male infertility patients, but this improvement was not statistically significant (p>.10), and in fertility groups of male infertility patients, the results showed a statistically significant increase (p<.05). Serum LH was not statistically significant in impotence and male infertility patients (p>.10), and was significantly increased in fertility groups (p<.05). The improvement of sexual activity was 50-75%, the pregnancy rate for their partners was 37% and increased plasma testosterone levels over a period of 3 years of follow-up after varicocele repair.