Saaduldeen Ghali Abdulkadim Al-Esawi

Abstract: Objective: To evaluate the Doppler ultrasound in prediction the success of sperm retrieval in Iraqi azoospermic patient using the resistive inde x(RI). Methodology: This cross sectional study conducted in the Doppler unite and the Fertility centre in the AL- Sadder Medical City in a period between April 2013 and January 2014 .The study included 72 patients with azoospermia, their age ranging from 20 to 50 years , US and Doppler study were done for them prior to testicular sperm extraction (TESE) . Statistical analysis was done by using SPSS version 20 in which use two by two tables to compute different accuracy measures. Results: There were 33 patients with positive post surgical results and 39 patients with negative results. The accuracy of RI in predicting post surgical result was (76.4%). The study shows that when the size of the testis was normal and the RI was < 0.7, the accuracy of the successful rate of sperm retrieval will be higher (82.2%) and when the size of the testis was small and the RI ≥ 0.7, the accuracy was lower (66.7%). Conclusion: This study concludes that Doppler ultrasound using RI parameter can be use as a predictor of sperm retrieval in azoospermic patients and this will be increase if taken with testicular size parameter. Recommendations: This study recommends the use of RI parameter of Doppler ultrasound and testicular size as a predictor of sperm retrieval in azoospermic patients . Keywords: Doppler US, azoospermia, testicular sperm retrieval. ـــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــــ

Conclusion:-Although the combination of surgical sperm retrieval (SSR) and ICSI may be the sole treatment available for male factor infertility with uncorrectable azoospermia, the overall success rate is limited particularly in NOA and ongoing pregnancies are obtained in <25% of ICSI cycles. However every azoospermic patients should offer such option of treatment and for those patients who had succeed sperm retrieval, multiple ICSI cycle trials may increase the chance of pregnancy without the need for repeated surgery. Open surgical methods of SSR, has been shown to increase the options available to the embryologist to use , select and cryopreserved sperms, however it will increase the surgical trauma to the testicles and increase the tissue extracted , the effects of these factors on the future testicular function needs to be investigated by further studies.

The study was aimed to find the relationship between semen volume and follicle stimulating hormone(FSH),lutiniezing hormone(LH),prolactin(PRL),and testosterone(T) in blood serum for Azoospermic patients. This study was included azoospermia(n=25) and normozoospermia (n=25) .semen volume and reproductive hormones(FSH,LH,Prolactin and testosterone) were assessed in both two groups .The results were showed a significant positive correlation between semen volume and testosterone hormone(r= 0.90 ) while it was revealed a significant negative correlation between semen volume and follicle stimulating hormone(r= - 0.93 ),lutiniezing hormone(r= - 0.95 ),and prolactin hormone(r= - 0.95 ) in azoospermic group . in Conclusion , The disturbance of reproductive hormones in azoospermic group

Hypospadias is a relatively common congenital anomaly of the penis that arises in 2 to 8 of 1000 live births, often as an isolated anomaly. This anomaly is repaired surgically in the first year of life to improve the cosmetic appearance and establish a glanular position of the urinary meatus for voiding and deposition of semen later in life. The aim of this study is to evaluate the effectiveness of HCG hormonal manipulation in inducing penile growth in hypospadias boys before surgical repair , and the pattern of this growth and response , in addition to that this thesis try to add more knowledge to the etiology and pathogensis of one of these relatively common urogenital disorder.

Comparative study between the usage of transurethral diversion and suprapubic cystostomy after distal hypospadias repair by tubulerized incised urethroplasty