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PD07-08 CHANGES IN TESTICULAR VOLUME AND FUNCTION AFTER TESTOSTERONE REPLACEMENT VS. RESTORATION: ANALYSIS OF A RANDOMIZED, DOUBLE BLIND, PLACEBO-CONTROLLED TRIAL OF ENCLOMIPHENE CITRATE VS. ANDROGEL™ 1.62% IN MEN WITH SECONDARY HYPOGONADISM
Author(s) -
Igor Sorokin,
Charles Welliver,
Paul J. Feustel,
Adam Parker,
Jaye Thompson,
Greg Fontenot,
Ronald D. Wiehle,
Andrew McCullough
Publication year - 2016
Publication title -
the journal of urology
Language(s) - English
Resource type - Journals
eISSN - 1527-3792
pISSN - 0022-5347
DOI - 10.1016/j.juro.2016.02.2811
Subject(s) - medicine , placebo , testosterone (patch) , randomization , urology , double blind , hormone replacement therapy (female to male) , randomized controlled trial , gynecology , selective estrogen receptor modulator , estrogen receptor , pathology , breast cancer , alternative medicine , cancer
AND OBJECTIVES: It is generally accepted that semen quality, as judged by the volume, motility, and morphology of spermatozoa, predicts both in vitro and in vivo fertilization. Kruger et al. demonstrated that microscopic assessment of sperm morphology plays an integral role in evaluating the male. This study aims to determine whether there is a correlation between specimens with extremely low percentages of structurally normal sperm and embryonic aneuploidy in couples that pursue IVF with Comprehensive Chromosomal Screening (CCS). METHODS: Couples who underwent IVF and utilized aneuploidy screening (preimplantation genetic screening (PGS)) from July 2010 e October 2015 were included. At least 100 sperm in four different areas of the slide were evaluated according to Kruger’s strict criteria (Kruger et al: 1⁄44%: normal; >4%: abnormal). Female and male partner ages were binned (A: 1⁄435; B: (35-38]; C: (38-41]; D: (41-43]; and E: >43). Male age group E was subbinned (a: 1⁄443; b: (43-50]; c: (50-55]; d: (55-60]; and e: >60). Aneuploidy rate for each female age group was calculated, with 95% confidence intervals calculated by Clopper-Pearson method. Chi-square and ANOVA were used to test significance, established at p<0.05. RESULTS: Subjects (n1⁄4268) consisted of females (24.6-43.9 yo) with male partners (23.8-62.9 yo) who underwent 288 autologous fresh IVF cycles with PGS. CCS was performed on 1836 embryos, of which 656 were found to be aneuploid. The percentage of male patients with a morphology count >4% was similar between all five male age groups (A: 61.7%, B: 66.2%, C: 59.7%, D: 75.2%, E: 59.7%). When male age group E was subdivided, the proportion of patients with an abnormal morphology count increased with age (a: 36.2%, b: 44.1%, c: 70.4%, d: n/a, e: 100%). Aneuploidy rate was similar between normal and abnormal sperm morphology groups in all five age female groups (Table 1). Additionally, PR, clinical PR and early pregnancy loss rate were similar between groups in each female age group (Table 1). CONCLUSIONS: No correlation was identified between teratozoospermic specimens and increased incidence of embryonic aneuploidy. Male partners with specimens found to have abnormal Kruger morphology should be reassured that they do not have an increased incidence of producing chromosomally abnormal embryos.

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