Diagnosis of Partial Retrograde Ejaculation in Non-Azoospermic Infertile Men with Low Semen Volume

نویسندگان

  • Roger Mieusset
  • Marie Walschaerts
  • François Isus
  • Thierry Almont
  • Myriam Daudin
  • Safouane M Hamdi
چکیده

In non-azoospermic patients with low semen volume (LSV), looking for partial retrograde ejaculation (PRE) by searching sperm in the postejaculatory urine (PEU) is required. The use of a retro-ejaculatory index (R-ratio) was suggested to define PRE, but none of the studies indicated a specific threshold above which PRE must be considered. Our objective was to propose a threshold value for the R-ratio as indicative of PRE in patients with LSV selected to be devoid of any known causes or risk factors for retrograde ejaculation or LSV. Among our data base (2000-2009) including 632 patients with PEU, 245 male patients from infertile couples who had had a first semen analysis with LSV (< 2mL) and a second semen analysis associated with PEU, were selected on the previous criteria. A prospective control group was randomly constituted (2007-2008) of 162 first consulting male patients from infertile couples, with a normal semen volume (≥ 2mL) on a first semen analysis and who accepted to collect PEU with their usual second semen analysis, selected on the previous criteria. To define an R-ratio threshold indicative of PRE, we used a ROC curve analysis and a regression tree based on a classification and regression tree (CART) algorithm. Of the 245 LSV patients, 146 still presented low semen volume (< 2 mL) on the second semen analysis. From the use of the CART algorithm, two low (1.5% and 2.8%) and two high R-values (7.1% and 8.3%) were defined, according to the lower reference limit for semen volume of 2.0 mL (WHO 1999) or 1.5 mL (WHO 2010) respectively. As only one or no patient with normal semen volume was observed above the two high R-values, we suggest an R-value higher than the range of [7.1-8.3]% as indicative of PRE until confirmation by a prospective multicenter study.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

AB068. Practical diagnosis and treatment algorithm for azoospermia

A male factor i s sole ly responsible in approximately 20% of cases of infertility and contributory in another 30-40%. Azoospermia is present in 1520% of infertile males. Although the main goal of the evaluation of the infertile men is to identify the reversible conditions, to identify the irreversible causes that can or cannot be managed by assisted reproductive techniques (ART) is also import...

متن کامل

AB069. The observation on affection of TURED on obstructive azoospermia

A male factor i s sole ly responsible in approximately 20% of cases of infertility and contributory in another 30-40%. Azoospermia is present in 1520% of infertile males. Although the main goal of the evaluation of the infertile men is to identify the reversible conditions, to identify the irreversible causes that can or cannot be managed by assisted reproductive techniques (ART) is also import...

متن کامل

I-2: Current Evaluation and Treatment of The Infertile Men

Background Fifty percent of infertility involves a male factor. The evaluation begins with a history, physical exam and semen analysis x 2. The history should include questions about exposure to gonad toxins. The differential diagnosis of no ejaculate includes; retrograde ejaculation, failure of ejaculation (rare), failure of emission and psychogenic. Evaluation of absence of the vas deferens w...

متن کامل

Ifferential Diagnosis of the Azoospermic Atient

I T c a t m h 3 4 d t a p s m b a e d s s NTRODUCTION pproximately 15 percent of couples are unable to conceive fter one year of unprotected intercourse. A male factor is olely responsible in about 20 percent of infertile couples nd contributory in another 30–40 percent (1). Azoosperia, defined as complete absence of sperm from the ejacuate, is present in about 1 percent of all men (2) and in 1...

متن کامل

Study into the iron content of seminal plasma in normal and infertile subjects.

The iron content in seminal plasma of normal (n19), oligozoospermic (n11), azoospermic (n12), oligoasthenozoospermic (n19), and asthenozoospermic (n17) subjects was estimated by using atomic absorption spectrophotometer. The concentration of iron in normal seminal plasma varied from 265 to 365 mg%. The source of iron in seminal plasma seems to be the adnexal glands and not spermatozoa, as azoos...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:

دوره 12  شماره 

صفحات  -

تاریخ انتشار 2017