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Query: UMLS:C0002895 (sickle cell disease)
 11,747 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The causes of infertility in 504 men were studied prospectively. The major causes were varicocele (28.8%), infection (20.8%), bilateral testicular failure (15%), idiopathic oligospermia (6.6%), multifactorial (5.6%), cryptorchidism (4%), sexual problems (3.8%) and surgical injury (1.6%). Unilateral testicular torsion and sickle cell disease though of less frequent occurrence were of particular interest because their roles are only now beginning to be realized. Gonadotrophin deficiency was an insignificant cause of subfertility. In spite of the high incidence of infection and past history of urethritis Neisseria gonorrheae was surprisingly not isolated from any patient. Compared with Caucasian studies, the high incidence of infection, and the low incidence of gonadotrophin deficiency are major points of difference.
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PMID:The causes of male infertility in 504 consecutive Nigerian patients. 287 82

40 male patients aged 17 years and older and attending the routine sickle cell outpatient clinic at Lagos University Teaching Hospital, Nigeria, were studied to evaluate the fertility potential of men with sickle cell disease. Their hemoglobin types were determined by cellulose acetate electrophoresis at pH 8.9. They were in the stable phase of their disease during the study. The history taken included information on age, marital status, sexual experience, and whether the patient had fathered a child. During the physical examination a note was made of the presence of varicocele and prostatic infection. Semen produced by masturbation after 4-5 days of sexual continence was collected in the laboratory in wide-necked bottles. It was tested as soon as it liquefied for semen volume, viscosity, pH, liquefaction time, sperm density, motility, and morphology. Sperm morphology was examined after supravital staining. Evaluation of sperm quality and quantity was based on the guidelines suggested by Eliasson and Freud. Semen analysis was repeated after 2 weeks or more and the mean of the 2 results was taken for analysis. The patients' mean age was 20.56 years. None of the subjects had a varicocele or clinical evidence of urinary tract infection. 4 patients were married. All had barren marriages, but 3 claimed to have had children extramaritally. Of the 36 unmarried patients, 10 had had coitus before, and 1 claimed to have a child. 23 patients provided semen for analysis. The ejaculate volume ranged from 0.2-6 ml. The sperm density varied from 0-98 million/ml. The mean total sperm count was 52.67 millions/ejaculate. The seminal fluid profiles were compared with those of 25 fertile male controls whose wives were 3 months pregnant and attending antenatal clinics in the same hospital. No semen sample from the sickle cell subjects met the generally accepted minimum requirement for fertility, i.e., 20 million sperms per ml, of which at least 40% should be alive and at least 60% should be well formed. Comparison between the fertile male controls and the sickle cell subjects showed no significant difference in enjaculate volumes, but there were striking differences in sperm concentration, total sperm count, motility, and morphology. Infertility seems to be a greater problem among males than females with sickle cell disease, because such men rarely have fathered children, whereas many women with sickle cell disease have had sucessful pregnancies.
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PMID:Fertility in males with sickle cell disease. 611 23

Male reproductive function has been poorly studied in sickle cell disease. Low sperm count, impaired motility of spermatozoa and spermatogenic arrest during testicular biopsies have been described in this situation. In the present series of patients, the main seminal changes found were reduced forward progression of spermatozoa and high incidence of the stress pattern during morphologic analysis. Since these findings closely resemble that seminal picture observed during varicocele, testicular hypoxia has been expected by the authors to be a possible stressing factor both common to falcemic and varicocele patients.
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PMID:Semen analysis in sickle cell disease. 746 46

Varicocele is one of the most common causes of low semen quality, which is reflected in high percentages of sperm cells with fragmented DNA. While varicocelectomy is usually performed to ameliorate a patient's fertility, its impact on sperm DNA integrity in the case of subclinical varicocele is poorly documented. In this study, multiple DNA fragmentation analyses (TUNEL, SCD, and SCSA) were performed on semen samples from sixty infertile patients with varicocele (15 clinical varicoceles, 19 clinical varicoceles after surgical treatment, 16 subclinical varicoceles, and 10 subclinical varicoceles after surgical treatment). TUNEL, SCD, and SCSA assays all showed substantial sperm DNA fragmentation levels that were comparable between subclinical and clinical varicocele patients. Importantly, varicocelectomy did improve sperm quality in patients with clinical varicocele; however, this was not the case in patients with subclinical varicocele. In summary, although infertile patients with clinical and subclinical varicocele have similar sperm DNA quality, varicocelectomy should only be advised for patients with clinical varicocele.
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PMID:Multiple determinations of sperm DNA fragmentation show that varicocelectomy is not indicated for infertile patients with subclinical varicocele. 2496 35