Difficulties in differential diagnosis between obstructive and non-obstructive azoospermia

Introduction. The difference between obstructive and non-obstructive azoospermia (OA and NOA) is important for the choice of treatment tactics and adequate counseling of a married couple.Objective. To describe, analyze, and classify possible challenges in differentiating between two types of azoospermiaMaterials and methods. The retrospective review of database on surgical sperm retrieval attempts performed our hospital (n = 754). A subpopulation of 216 patients who were preliminary diagnosed with OA, was selected for further analysis. All patients had testicular pathology data following sperm retrieval attempt. Rate of reclassification was assessed as a primary outcome. Reclassified cases were further analyzed to find a possible reason for incorrect differential diagnosis.Results. Among 216 patients with initially suspected OA, 131 (60.6%) had evidence of spermatogenic dysfunction on pathological examination of seminiferous tubules. Multivariate regression analysis showed that only regular exposure to high temperatures was an independent predictor of NOA detection in patients with normal endocrine and clinical parameters (OR = 1.989; 95% CI = 1.101 – 3.595). Analysis of the decision tree showed that patients with inhibin B levels below 93 pg/ml had the highest risk of an incorrect initial diagnosis (82.6%).Conclusions. Differential diagnosis of OA and NOA is not such a simple task. Any case of azoospermia against the background of normal semen volume by default should be considered as a case of NOA if there is no anamnestic or clinical data clearly indicating obstruction. Regular exposure to high temperature is likely to cause azoospermia in men with initially severe disorders of spermatogenesis. Finally, the reference values of inhibin B offered by most laboratories are not intended to assess reproductive function

An IMDAF approach to annellated 1,4:5,8-diepoxynaphthalenes and their metathesis reaction leading to novel scaffolds displaying an antiproliferative activity toward cancer cells

A series of 1,4:5,8-diepoxynaphthalenes, annellated with six-membered carbo- A nd heterocycles, was obtained via the intramolecular Diels-Alder furan (IMDAF) cycloaddition approach from bis-furyl dienes and acetylenic dienophiles (dialkyl acetylenedicarboxylates and hexafluoro-2-butyne). To achieve a wide variety of different products for subsequent biotesting, ethylene-promoted ring-opening cross-metathesis (ROCM) reactions, Prilezhaev epoxidation, catalytic hydrogenation, and N-or O-deprotection reactions of pentacycles were performed. The polyfunctional scaffolds of the resulting diverse heterocycles were tested on cancer lines (PC3, DU-145, MDA-MB-231, HT-1080, and HCT116) and normal lung fibroblasts (WI-26 VA4), and it was found that some of the obtained compounds exerted a concentration-dependent antiproliferative action toward MDA-MB-231 human triple-negative breast cancer and especially PC3 human prostate cancer cell lines. It was demonstrated that compound 16f (hydrogenated 7-(tert-butyl)-4,5-dimethyl-2,8a-divinyl-3,5a-epoxyfuro[2,3,4-de]isoquinoline-4,5,7-tricarboxylate) possessed a time-dependent apoptosis induction activity associated with caspase 3/7 activation in prostate cancer cells, which clearly represents a viable lead for the further development of new-generation anticancer agents. © 2021 The Royal Society of Chemistry and the Centre National de la Recherche Scientifique