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8th SEEM in Sofia: prospects and issues in male infertility

26-10-2012      2095 views

by Joel Vega

Issues in male infertility were discussed in the first plenary session of the EAU 8th South Easterrn European Meeting (SEEM) which opened today in Sofia, Bulgaria. “We are happy to host this meeting for the first time. The region has seen developments in the last few years and to have the support of the European Association of Urology (EAU) in organizing this event means support for urology in this region,” said meeting chairman Prof. Dimitar Mladenov in his welcome remarks.

Around 250 participants registered for the annual event which, aside from lectures and debates, will also present the latest research and clinical studies by young and promising urologists in the region. A total of 174 abstracts were accepted for presentations out of the 287 abstracts submitted for the event.

“We have to encourage young urologists during meetings like these because here we can look at their work. You can only make urology in the region better if we ourselves provide opportunities to young urologists,” Regional Office Chairman Prof. Bob Djavan told the audience in his opening remarks.

Mohammed Ali Sadighi Gilani (Tehran) gave an overview of male risk factors for infertility and said that census data in the US indicated a growing prevalence of infertility among males in the last three decades.

“The incidence of male infertility has increased from 7% -8% in the 1960s to 20%- 35% in recent years,” Gilani said.

Regarding Europe, Gilani said there is “cogent evidence of an increase in the prevalence of infertility” as he cited the environment, hazardous occupations, life style, systemic disease and genetics, among others, as some of the risk factors. He also mentioned that there are some studies on the use of mobile phones that could lead to the probable poor quality of sperm counts. Exposure to pesticides was also identified in some studies as a probable cause for impairing sperm quality.

Nikolaos Sofikitis (Ioannina)  discussed the pharmacological treatment of oligo-astheno-teratospermia (OAT) and examined several assisted reproductive techniques (ART) aimed to assist natural conception. Among the hormonal treatment he mentioned were gonadotrophins/GnRH analogues, testosterone, ant estrogens (such as clomiphene and tamoxifine), aromatase inhibitors and bromociptine.

Bulent Alici (Istanbul) lectured on new aspects regarding in vitro fertilisation (IVF) and examined the surgical techniques that have been developed  for sperm retrieval such as testicular sperm aspiration (TESA), percutaneous epididymal sperm aspiration (PESA), microscopic epididymal sperm aspiration (MESA), testicular sperm extraction (TESE) and microTESE.

“TESA, PESA, MESA, TESE and mTESE have similar retrieval outcomes in obstructive zoosperm (OA), but microTESE is more beneficial in non-obstructive zoosperm,” Alici said.

He added that there are advances in sperm extraction such as the  confocal fluorescence microscopy but there are limitations such as the safety of antibody injection in humans, the potential damage to spermatozoa or testes and the suitability of labeled sperm for ICSI (intra-cytoplasmic sperm injection). Regarding genetics, Alici said he expects that the success of ART will be on genetics in the future.

.Sava Micic (Belgrade) spoke on  vasovasostomy and examined the factors that physicians should consider in assessing the chances of a successful sperm retrieval and delivery. “Vasectomy reversal restores sperm production in about 80% to 90% of men,” Micic said, adding: “On average, around 50% of couples achieve a pregnancy when  there is a one to two years (lapse) after reversal surgery.”

He added that the chance for fertilisation is poorer after eight years have lapsed since reversal surgery.

“Sperm removed during vasvasostomy can be frozen and used for assisted reproductive technologies in case of unsuccessful reversal surgery,” Micic noted.

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