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Article
Diagnostic laparoscopy in female infertility

Authors: Entessar Abdel Jabbar انتصار عبد الجبار --- Raida M. Al-Wazzan رائدة محمد الوزان
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2009 Volume: 35 Issue: 1 Pages: 58-64
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACT
Objective: To highlight the importance of laparoscopic evaluation in the etiology of infertility and to evaluate the etiology in primary and secondary infertility.
Methods: This retrospective study included 1233 patients complaining of infertility, 919 patients had primary infertility and 314 patients had secondary infertility. All had been subjected to diagnostic laparoscopy at the Infertility Center in Al-Batool Teaching Hospital, Mosul.
Results: Laparoscopy diagnosed pelvic abnormality in 87.27% of infertile patients which was statistically significant difference comparing to no abnormality detected in 12.73%. The ratio of positive findings in secondary infertility was significant in comparison with the positive findings in primary infertility. Single pelvic abnormality detected during laparoscopy among infertility patients was seen in 75.09% of cases and it was statistically different from multiple pelvic abnormality: 24.91%, and it was highly significant among primary infertility patients (77.24%) and among secondary infertility patients (30.87%). Among all infertile patients, ovarian factor was the most common (66.83%) followed by tubal factor (22.03%), endometriosis (4.46%), pelvic inflammatory disease (2.85%), pelvic adhesion (2.10%) and uterine fibroid (1.73%). Ovarian factor was highly significant in primary infertility while tubal factor and pelvic inflammatory disease were the highly significant in secondary infertility.
Multiple pelvic pathology identified by laparoscopy showed the tubal factors associated with poly cystic ovary in 29.49% of cases (31.66% in primary infertility and 25% in secondary infertility with no significant statistical difference). Pelvic inflammatory disease associated with other pelvic abnormality 34.09% was highly significant among secondary infertility patients. Congenital uterine abnormalities was not seen alone, it was seen associated with other causes among primary infertility patients (9 cases 0.72%).
Conclusion: Diagnostic laparoscopy is a valuable technique and is a mandatory invasive investigation for complete assessment of female infertility before the couple progresses to infertility treatment especially where assisted reproductive techniques were not available.
Keywords: Infertility; primary infertility; secondary infertility; diagnostic laparoscopy.

الخلاصةالهــدف: لتبيان أهمية الناظور التشخيصي في معرفة سبب العقم عند النساء في حالات العقم الأولي والثانوي.الطريقة: دراسة أستعادية لـ 1233 مريضة لديها حالة عقم من اللواتي راجعن مركز العقم في مستشفى البتول التعليمي في الموصل. 919 مريضة تعاني من العقم الأولي و 314 مريضة تعاني من العقم الثانوي.النتائـج: أظهرت النتائج بان الناظور شخّص وجود سبب في الحوض في 87,27% من الحالات وان وجود سبب واحد في الحوض هو الأكثر في حالات العقم الأولي 75,09% بينما وجود عدة أسباب في الحوض كانت الأكثر بين حالات العقم الثانوي. المبيض ومشاكله السبب الرئيسي في حالات العقم وهو السبب الأكبر في العقم الأولي بينما مشكلة الأنابيب والتهابات الحوض كان السبب الأكبر في حالات العقم الثانوي. وفي حالات العقم عامة التي وجد فيها أكثر من سبب وجد مشكلة الأنابيب وحالة تكيس المبيض في 29,49% ووجد أن مشكلة التهاب الحوض مع أسباب أخرى أكثر حدوثا في حالات العقم الثانوي. الاستنتاج: الناظور التشخيصي فحص له قيمة لإكمال فحوصات النساء اللواتي لديهم حالة عقم قبل العلاج المتقدم خاصة في حالة عدم توفر وسائل العلاج .


Article
The impact of proteins, glycoproteins and fructose in blood and seminal plasma on sperms concentrationIn infertile men

Authors: Zina A. Marrow --- Nassir M. Al-Rubae --- Nahla M. Al-Sakkal
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2009 Volume: 51 Issue: 1 Pages: 62-66
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: proteins, glycoproteins and fructose as parameters used to assess infertility in men.
Objective: To determine and correlate serum and seminal plasma of total proteins, glycoproteins and fructose with infertility in men.
Patients and Methods: The study was performed on 154 subjects; 109 infertile men (oligospermic and azoospermic) and 45 normal volunteers (normospermic men). All sera and seminal plasma were submitted for total proteins, glycoproteins and fructose levels measurment.
Results: No significant difference was noted in serum and seminal plasma of total proteins in oligospermic and azoospermic and that of normospermic men (P>0.05) compared to normospermic men.
Statistical significant reduction (P<0.05) was noted in seminal plasma glycoproteins in oligospermic as compared to normospermic and azoospermic men.
A significant elevation (P<0.05) of fructose levels were observed in seminal plasma of azoospermic when compared to others.
Conclusion: This study may indicate that the higher concentration of glycoprotein in seminal plasma the better quality of semen and a significant negative correlation (r=&#8722;0.749: P<0.05) were observed between seminal plasma fructose and sperm count of infertile men.


Article
Effect of infection on semen parameters in a sample of Iraqi infertile males.

Authors: Jawad K. Al-Diwan --- Eman Al-Kaseer --- Ali A. Lazem
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 3 Pages: 272-274
Publisher: Baghdad University جامعة بغداد

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Background: Several studies were carried out on association of infection with male infertility, which revealed great variations in the prevalence of genital infection in different parts of the world. This work was designed to study the effect of infection on semen parameters in a sample of Iraqi infertile males.Methods: A sample of 400 infertile male patients attending the High Institute for Embryo Research and Infertility Treatment for laboratory investigations and treatment were selected. This study was carried out during the period Nov. 2002 to April 2003, inclusive. Seminal fluid analysis was performed on samples obtained by masturbation into a glass container after 48 to 72 hours from of abstinence from sexual intercourse. Analysis (examination of volume, liquifaction, sperm count, motility percent, normal morphology percent and presence of pus cells) was performed within an hour after ejaculation. Results: Clinical infection was detected in 14% of infertile males and 29% had subclinical infection. Liquifcation time and leukocyte had significant variation between infected and non infected patients. Conclusion: Early diagnosis and treatment of genitourinary infection in necessary to reduce complication and infertility in future.

Keywords

Infertility --- semen --- infection --- Iraq


Article
Prevalence of bacterial infection and their sensitivity in patients undergoing an infertility eval

Author: Wafaa Hazim Saleh وفاء حازم صالح
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2010 Volume: 6 Issue: 1 Pages: 33-38
Publisher: Baghdad University جامعة بغداد

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Background: Infection with sexually transmitted diseases is broad and includes bacterial, viral and protozoa infection. Large number of infected people goes untreated because of symptomatic or unrecognized infections.Patients and methods: Forty five patients was complaining from infertility (primary or secondary), consulting Kammal El-Sammari Hospital for infertility from May - 2008 to February - 2009. Control group consisted of twenty fertile women that consulting private clinic for checking. Four swabs were taken from each woman in two groups. Two swabs were taken from posterior fornix of the vagina (High vaginal swab) and the last two were taken from endocervical canal. First swab (vagina and cervix) was examined directly under light microscope (wet mount) and stained by Gram stain. The other swab was cultured on Blood and Chocolate agar.Results: The patients group consisted from forty-five female patients, their aged ranged from (22-45 years), (X= 32.9). Direct examination (wet mount) and Gram staining of high vaginal swab showed significant increased in leukocyte (pus cells) and epithelial cells in infertile group than normal one. The isolated bacteria from culture of high vaginal swab were Streptococcus agalactiae (group B streptococci) which was significantly increased than fertile group. This bacteria was sensitive to Cephaloxtin and Cephotaxime and resistant to PenicillinConclusions: The isolated bacteria from culture of high vaginal swab were Streptococcus agalactiae (group B streptococci). This bacteria was sensitive to Cephaloxtin and Cephotaxime and resistant to Penicillin .

Keywords

:Infertility --- bacteria --- antibiotic


Article
Association Between Testicular Microlithiasis and Infertility

Author: Waleed Nassar Jaffal
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2012 Volume: 11 Issue: 2 Pages: 280-283
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:Testicular microlithiasis (TM) is an uncommon condition, usually brought to attention when some other condition is being investigated. There have been reports suggesting a link between testicular microlithiasis and testicular dysfunction and tumors.OBJECTIVE:To study the association between testicular microlithiasis and male infertility.MATERIALS AND METHODS:From January 2010 to January 2011, 140 patients with different scrotal lesions presented to urologic consultation department at Al-Ramadi teaching hospital were included in this prospective study, all patients were examined by gray scale and doppler ultrasonograghy, their age ranges from 15 to 55 years. All cases of microlithiasis were recorded and complete information obtained from each patient. Seminal fluid analysis (SFA) was done for each patient with microlithiasis.RESULTS:The age of patients ranges from 15 to 55 years (mean 34.6). Of 140 patients, 6 patients had microlithiasis (4.28%). Of 6 patients with microlithiasis, 5 patients were married and infertile and one of them had varicocele and one patient had testicular atrophy. One patient was unmarried but has varicocele and abnormal seminal fluid analysis.CONCLUSION:There is strong association between testicular microlithiasis and infertility. Hypospermatogenesis in patients with TM may relate to both the degree of testicular dysgenesis and the presence or absence of concomitant scrotal pathology (eg, scrotal varicocele and testicular atrophy


Article
Laparoscopic Varicocelectomy for Bilateral Varicoceles in Infertile Males

Authors: Saad D. Farhan --- Muayed Abass Fadhel**
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2011 Volume: 10 Issue: 3 Pages: 317-322
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND :Varicoceles, present in 15% to 20% of men, are the most common abnormal finding among men presenting with infertility.Despite the very long history of the disease and many records on different surgical and radiological solutions, the ideal method of spermatic vein ligation for varicocele is still a matter of controversy. The perfect technique would be one that preserves testicular function and eliminates the varicocele with a low rate of recurrence, hydrocele formation and any other complications.OBJECTIVE:To assess the efficacy of laparoscopic Varicocelectomy for management of bilateral palpable varicoceles in infertile males.METHODS:We analysed the result of 25 patients presented with history of infertility and diagnosed to have bilateral palpable varicoceles treated in our department with Bilateral laparoscopic ligation of the spermatic vessels between January 2009 and November 2010.RESULTS:The average operative (Bilateral Laparoscopic Varicocelectomy) time was 34 minutes. There were no intra operative complications in the study group. Hydrocele formation was seen in 3 (6%) patients recurrence was seen in one (2%) patient .The average hospital stay was 18 hours. postoperative analgesics (1-2) doses , daily activities initiation usually started after 48 hrs and physical exercise 72 hrs . non of the patient has developed an atrophic testis as a result of the laparoscopic procedure. eighteen patients (72% )of the patients had improvement of the seminal fluid parameters During follow up period (6 months),with seminal fluid analysis, clinical and ultrasonic examination.CONCLUSION:Laparoscopic varicocele ligation is a simple and safe technique, causing minimal morbidity and enabling rapid return to normal activity


Article
Effect of Royal Jelly on male Infertility

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Abstract Male infertility may occur due to different causes, therefore , different therapeutic approaches have been applied in order to improve the ability of men to get children . Semen analysis is used to determine the fertility potential in males, but the occurrence of pregnancy is the evidence of sperm ability for fertilization. Although male fertility is affected by food and nutrients, but little attention is paid for the use of Royal Jelly and no previous studies on the use of Royal Jelly in the treatment of male infertility. Eighty – three infertile men were treated with Royal Jelly, twenty – two with 100mg Royal Jelly, twenty –one with 50mg Royal Jelly, twenty with 25mg Royal Jelly and twenty with pure honey. Our study showed that, the treatments were safe and there were no side effects. After three months of treatment , the sperm active motility , testosterone level , Lutelizing hormones level , sluggishly motile sperm and intercourse / week increased significantly in infertile men treated with Royal Jelly , while sperm count and FSH level increased not significantly . On the basis of results, Royal Jelly is safe and effective in the treatment of male infertility.

يحدث العقم لدى الذكور لأسباب عديدة ولذلك فأن مناهج علاجية عديدة تستخدم لتحسين قدرة الرجال على إنجاب الأطفال , إن تحليل المني يجري لتحديد القدرة على الإخصاب في الذكور ولكن حصول الحمل هو الدليل على قدرة الحيامن على الإخصاب ، وبالرغم من ان خصوبة الذكور تتأثر بالغذاء ولكن هناك اهتمام قليل بدراسة تأثير الغذاء الملكي ولا توجد دراسات سابقة على استخدام الغذاء الملكي في علاج العقم عند الرجال لهذا فأن الدراسة الحالية تضمنت علاج الذكور المصابين بالعقم الذين يراجعون عيادة العقم في تكريت 83 ذكر عقيم عولجوا بالغذاء الملكي منهم 22 ذكر عقيم عولج بجرعة 100 ملغم غذاء ملكي ، 21 ذكر عقيم عولج بجرعة 50 ملغم غذاء ملكي ، 20 ذكر عقيم بجرعة 25 ملغم غذاء ملكي و 20 ذكر عقيم عولج بجرعة 10 غم عسل نقي لقد أظهرت دراستنا ان العلاجات كانت أمينة ولم تسجل أي أعراض جانبية مهمة بعد ثلاثة أشهر ، كانت نسبة النطف ذات الحركة الفعالة ومستوى هرمون التستوستيرون الخصوي ومستوى هرمون LH والنطف ذات الحركة البطيئة وعدد مرات الجماع الأسبوعية زادت بشكل ملحوظ إحصائيا في المرضى المعالجين بالغذاء الملكي بينما عدد النطف ومستوى هرمونFSH لم تزيد بشكل ملحوظ إحصائيا وبناءاً على النتائج فأن الغذاء الملكي أمين وفعال في علاج العقم لدى الرجال


Article
Semen Quality of Infertile Couples--Comparison Between Smokers and Non-Smokers

Author: Ammar Fadil Abid
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2010 Volume: 9 Issue: 3 Pages: 293-296
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT:BACKGROUND:The effect of cigarette smoking on spermatogenesis is unclear. Previous studies suggest a deleterious effect of cigarette smoking on semen on semen quality ,but their results have not been consistent.OBJECTIVE:To compare the various semen parameters of infertile cigarette smokers with infertile non-smokers, to study the effect of cigarette smoking on semen quality.METHODS:Semen samples of 66 cigarette smokers and 70 non-smokers infertile patients were included in the study. As far as possible; other factors which might influence semen quality were eliminated. Seminal parameters, when taken together, indicated the presence or absence of the three main semen variables: asthenospermia (A), oligospermia (O), and normospermia (N). Smokers were categorized as light, moderate and heavy smokers. Semen samples were examined for Asthenospermia and oligospermia, according to World Health Organization guidelines.RESULTS:In our study, 25 non-smokers had normospermia (N) with their semen parameters falling within the normal ranges. In contrast, samples from 16 smokers qualified as N. This finding underscores the fact that smoking certainly has an adverse influence on the semen quality, as concluded in several other studies.Asthenospermia (A) was the most dominant semen variable contributing to the semen quality of smokers (n = 34) as well as non-smokers (n = 31). Statistical analysis using Pearson chi-squared and t-test found no statistically significant effect of cigarette smoking on sperm density; motility or morphologic features of sperm were detected.CONCLUSION:Our study shows a limited effect of smoking on conventional sperm parameters.


Article
Social Consequences of Infertility upon Women in Mosul City
النتائج الاجتماعية للعقم على النساء في الموصل

Author: Maha A. Al-Neami د. مها ألنعيمي
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2008 Volume: 21 Issue: 4 Pages: 291-298
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: infertility is a dilemma of global properties. It's a devastating experience. Especially in oriental societies, where the infertility is seen as the problem of woman not for man, thus the childbearing and the male offspring are of the highest valued factors in stabilizing marriage and expected to bring happiness and family harmony. Otherwise these women will subjected to a tremendous social sequels and emotional sufferings.Objective: to explore the wide array of conditions women may endure and the sociological context of infertility consequences experienced by women suffering from primary, secondary, and those have daughters only within their marital home in Mosul. Methods: a retrospective cohort study conducted in Al-Batool Teaching Maternity Hospital in Mosul City. A sample of 200 infertile women has been sociologically compared with other 200 fertile women according to questionnaire form filled through direct interviews with each woman.Results: 7.5% of infertile women threatened for divorce, 40% were threatened for husband's remarrying, exposure to physical, verbal and psychological violence, and Emotional, financial and personality negligence all were significantly higher in the respondent group. Additionally the inter-spousal relationship and family milieu have been affected negatively, also the inability to reproduce is a life-size problem in more than three quarters of the sample causing various emotional conflicts as sorrow, jealousy, psychological strain, frustration, feeling with inferiority and low self-esteem. Minority of the infertile women depend on medical treatment alone as fertility seeking behavior, whereas majority sought traditional and faith healers options. Conclusion: infertility is a stressful experience, and it become devastating in traditional societies like our culture, where infertility is seen as the problem of woman not the man. This may subject her to stigmatization, exploitation and other social consequences apparent in terms of threats, marital disruption, physical abuse, emotional negligence, economic dispossession and social ostracism distressing her emotional and social health that necessitate the setting up of the new reproductive technologies with couples education and sympathetic marital counseling. Keywords: infertility, women, Mosul

خلفية البحث: يعتبر العُقُم معضلة عالميةِ الأبعاد. كونه تجربةً قد تكون مدمرة خصوصا في المجتمعات الشرقية حيث ينظر للعقم كمشكلة تخص النساء وليس الرجال. هكذا فالحمل والنسل الذكر مِنْ العناصر الأساسية في استقرار الزواجِ والانسجام العائليِ. وخلاف ذلك فمن المتوقع أن يكون هناك عواقب اجتماعية ومعاناة كبيرة. الهدف: للوقوف على المشاكل المترتبة على العقم ضمن السياقُ الاجتماعي عند النِساءِ العقيمات(عقم أولي وثانوي)، وأمهات البنات في مدينة الموصل.طريقة البحث: أجريت دراسة المجموعةِ ذات الأثر الرجعيِ في مستشفى البتول التعليمي/ الموصل. بأخذ عيّنة مِنْ 400 امرأة, نصفهم (200) امرأة عقيمة قُورنوا ضمن النطاق الاجتماعي مَع (200) امرأة خصبة باستعمال ورقة استبيان خاصة لهذا الغرض ملأت من خلال المقابلاتِ المباشرةِ مَع كلّ امرأة.النَتائِج: كان هناك تهديد بالطلاقِ في 7.5 % مِنْ النِساءِ العقيماتِ، 40% تهديد بزواج الرجل ثانية، كما كان التعرّض إلى العنفِ النفسيِ والكلامي والجسدي، والإهمال المالي والعاطفي بالإضافة إلى إهمال الرأي والشخصيةِ موجود وبشكل واضحً في المجموعةِ العقيمةِ. إضافة إلى ذلك كان تأثير العقم سلبياً على العلاقة الزوجية والجو العام للعائلة، كما كانتً عدم القابلية للحمل أو ولادة النسل الذكرتعتبر مشكلة حقيقية في أكثر مِنْ ثلاثة أرباع العيّنةِ مما أفرزت صراعات ومشاكل عاطفيةَ مُخْتَلِفةَ في نفسية المرأة العقيمة ترجمت على شكل حُزن، غيرة، إجهاد نفسي، إحباط، والشعور بالنقص. كما أظهرت الدراسة اعتماد غالبية النِساءِ العقيماتِ على الممارسات التقليديةَ والطب الشعبي والروحانيات لعلاج العقم إلى جانب المعالجةِ الطبيةِ. الخاتمة: العُقُم هو تجربة مرهقة، وقد تُصبحُ مُدَمّرةً في مجتمعاتنا الشرقية، التي تعتبر العقم بمثابة وصمة للمرأة العقيمة, قَدْ تخضعُها إلى الاستغلال وتهديداتِ اجتماعية مختلفة تظهر على شكل مشاكل زوجية واعتداءات متنوعة مع إهمال عاطفي و اقتصادي وجفاء عائلي قد يهدد توازنها الاجتماعي و العاطفي مما يستلزمُ بَدْء التقنياتِ الجديدةِ لعلاج العقم محليا و تثقيف المجتمع و الأزواجِ بتقديم المشورة والمعلومات الكافية والكفيلة لدرئ مثل هذه المشاكل.

Keywords

infertility --- women --- Mosul


Article
Assessment of spermatogenesis by fine needle aspiration of testes in patients with azoospermia
تقييم تكوين النطف بواسطة الرشف بالإبرة الدقيقة في المرضى المصابين بانعدام النطف

Author: Ibrahim K. S. قاسم سعيد ابراهيم
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2013 Volume: 39 Issue: 2 Pages: 143-146
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTBackground and objectives: Recent advances of Invitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI) combined with the progress in sperm retrieval from testes have provided a hope for azoospermic patients to become fathers. The aim of this study is to describe the cytological features of the cells aspirated from testes of patients with azoospermia and to select those who have mature spermatozoa in their aspirate for assisted fertilization.Design and setting: A descriptive study (case series) conducted in private clinic from Jan. 2007 to Sept. 2012.Patients and methods: Under local anasthesia Fine Needle Aspiration Cytology (FNAC) was performed on 250 patients whose sperm count was zero in at least three consecutive semen samples.The size of the testes was measured and recorded for each case. The cytological features of the aspirated cells were described and the patients who have mature spermatozoa were identified for assisted fertilization.Results: Normal spermatogenesis was found in 54 patients (21.6%), complete maturation arrest at primary spermatocytes in 95 patients (38%), complete maturation arrest at secondary spermatocytes in 32 patients (12.8%), germ cell aplasia in 62 patients (24.8%), and atrophic testis in 7 patients (2.8%). The mean age of the patients was 29.8 years. Regarding the greatest dimension of the testes, there was a significant difference in the greatest dimension of atrophic testes and in testes with germ cell aplasia, from the other groups. The procedure was well tolerated by the patients and no complications were encountered. Conclusions: The technique can differentiate obstructive from intrinsic causes of azoospermia. It is simple, quick, cost effective and free from complications.Keywords: FNAC, testis, infertility azoospermia.

الخلاصةالخلفية والأهداف: التطور الحاصل في الإخصاب في المختبر وزرق النطف داخل السايتوبلام بالإضافة إلى التطور في الحصول على النطف من الخصية وفر فرصة لمرضى إنعدام النطف لكي يصبحوا آباء. والهدف من هذه الدراسة هو وصف الخلايا الناتجة عن الرشف بالإبرة الدقيقة وإختيار من لديهم نطف ناضجة للإخصاب المساعد. التصميم والمكان: دراسة وصفية أجريت قي مختبر الباحث الخاص من كانون الثاني 2007 لغاية أيلول 2012.المرضى والطرق: تحت التخدير الموضعي تمت عملية الرشف بواسطة الإبرة الدقيقة لــ 250 مريض يعانون من عدم وجود نطف في السائل المنوي لثلاث فحوصات على الأقل بواسطة السرنج والإبرة الدقيقة23 G ، ثم سحب الخلايا من الخصية وعمل مسحة، ثم ثتبيت المسحة في كحول أثيلي تركيز 95%، ثم صبغها بصبغة هيماتوكسلين أيوسين. وتم وصف الخلايا المسحوبة وتم تشخيص المرضى الذين لديهم نطف ناضجة لغرض إجراء تخصيب مساعد. النتائج: كانت عملية تكوين النطف كاملة في 54 مريض 21,6%، وتوقف كامل لإنتاج النطف في مرحلة الخلايا النطفية الأولية في 95 مريضا 38%. التوقف الكامل لإنتاج النطف في مرحلة الخلايا النطفية الثانوية في 32 مريضا 12,8 %. عدم وجود خلايا بزرات النطاف في 62 مريضا 24,8 %، خصية ضامرة في 7 مرضى 2,8%. وكان المعدل العمري للمرضى 29,8 سنة. بالنسبة للأبعاد القصوى للخصية في حالة ضمور الخصبة وإنعدام الخلايا النطفية كانت تختلف إحصائيا" من المجاميع الأخرى. كانت عملية السحب متحملة من قبل المرضى ولا يوجد مضاعفات. الاستنتاج: بواسطة هذه الطريقة يمكن معرفة أسباب إنعدام النطف (الإنسداد أو أسباب في الخصية). كانت الطريقة سهلة وسريعة ولم تكلف كثيرا". وكانت خالية من المضاعفات.

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