Relation between serum hormones and semen parameters in sub-fertile males: is 17-hydroxyprogesterone really a game changer?

Background: Semen analysis and serum hormone assessment remains an integral part of assessment of infertile males. 17-OHP has recently been demonstrated as a very good marker of intratesticular testosterone environment. Our study was designed to find relationship between individual serum hormone levels and semen parameters in sub fertile men, and to find whether 17-OHP fares better or worse in predicting baseline semen parameters compared to other routinely tested hormones. Methods: A retrospective analytical study was conducted on 74 patients, after matching inclusion and exclusion criteria, from July 2022 to December 2023. All included patients were investigated with Semen analysis and Serum biomarker levels (FSH, total testosterone, estradiol, total testosterone/estradiol (T/E2) ratio, and 17-hydroxyprogesterone). Results: Only 10 patients (13.51%) had normal semen analysis, while rest 64 (86.49%) had abnormality in at least 1 semen parameter. Serum testosterone and T/E2 ratio had significant difference (p<0.05) between the two groups. Comparing individual semen parameters against all hormones, FSH and total testosterone had significant association with sperm count, concentration and total motility. Total testosterone also had a significant relation with progressive motility, morphology and semen volume (p<0.05). T/E2 ratio had significant association with Sperm count, motility and morphology, and semen volume (p<0.05). But, 17-OHP and estradiol were not found to have any significant association with any baseline semen parameters in our study (p>0.05). But, serum 17OHP was found to be significantly associated with sexual dysfunction in males (p<0.05). Conclusions: Our study inferred that serum FSH, testosterone level and T/E2 ratio can be used to predict baseline semen parameters, but 17OHP did not have any association with baseline semen parameters. However, serum 17OHP can serve as a novel marker for male sexual dysfunction.

A tenacious trio of retropharyngeal emphysema, pneumomediastinum and subcutaneous emphysema secondary to pulmonary tuberculosis: a case report

Retropharyngeal emphysema (RPE) is the presence of air in the retropharyngeal area. It may occur due to various etiologies or sometimes spontaneously due to an underlying lung pathology. This report describes a case of a 26-year-old gentleman with pulmonary tuberculosis on treatment who presented with acute breathlessness and dysphagia. His neck and chest radiograph showed retropharyngeal emphysema with pneumomediastinum and subcutaneous emphysema. This was further confirmed by a CT neck and thorax. The patient was managed conservatively with analgesia, antibiotics, IV corticosteroids and oxygen supplementation. Repeat chest radiograph after 17 days showed resolution of retropharyngeal emphysema. Clinicians should have a high index of suspicion for RPE in patients who present with unexplained acute breathlessness and dysphagia of a diseased lung

Impact of post-thaw incubation time of frozen embryos on clinical pregnancy rate

Background: Vitrification of embryos following a single-controlled ovarian stimulation has been the strategy practised now in many in vitro fertilisation clinics to minimise the risk of early ovarian hyper stimulation syndrome, to reduce multiple pregnancy rates and to improve cumulative pregnancy rates. In recent years, advances in vitrification techniques and improved culture conditions have led to good post-thaw embryo survival rates, thereby increasing pregnancy rates of frozen embryo transfer (FET) cycles. Aim: The aim of this study was to analyse the effect of post-thaw incubation time of frozen embryos on the clinical pregnancy rates (CPRs) of frozen embryo transfer (FET) cycles. Settings and Design: This was a retrospective, comparative study done at a teaching hospital in assisted reproductive treatment. Materials and Methods: Three hundred and ten FET cycles were analysed, of which 125 had day 2 freezing and 185 had day 3 freezing. Depending upon the day of thawing and day of transfer, FET cycles were divided into six groups: Group 1 (day 2 thawing and day 3 transfer), Group 2 (day 2 thawing and day 4 transfer), Group 3 (day 2 thawing and day 5 transfer), Group 4 (day 3 thawing and day 3 transfer), Group 5 (day 3 thawing and day 4 transfer) and Group 6 (day 3 thawing and day 5 transfer). Statistical Analysis Used: Statistical analysis was performed using version 14 R software version 4.0.1 (2020-06-06) (R foundation for Statistical Computing, Vienna, Austria). A P < 0.05 is taken as significant. Results: The CPR of Group 4 was 42.4% which was more than that of the other groups but it did not reach statistical significance. Conclusions: Short incubation time of 2–4 h is as effective as an extended incubation time in terms of CPRs of FET cycles

Seasonal variation of human semen parameters: a retrospective study in Chennai, Tamil Nadu

Background: Infertility in humans is a prevalent disorder that arises from several primary or secondary reasons. Regarding the latter, many seasonal and meteorological trends have been proposed as potential contributors. This study set out to determine whether the functional properties of semen samples kept in a secondary centre database showed any signs of a potential seasonal trend. Methods: Retrospective analysis was performed on the 1830 consecutive sperm analysis reports that were gathered at the Institute of Reproductive Medicine and Women's Health over the course of a year (2020-2024). Microscopic, macroscopic examinations were included in the reports. Season of sample collection was used to examine data for various parameters. The assessment of continuous variables should be done using the ANOVA test. Additionally, a regression analysis and chi-squared will be carried out to determine the significant variation caused by season on semen parameter. Results: Seasonal variations significantly impact sperm concentration and total sperm count, with temperature changes across seasons being a key factor. However, motility, morphology, and defect parameters remain stable and unaffected by temperature. Environmental factors like temperature should be considered in fertility assessments and treatments. Conclusions: In conclusion, this thesis demonstrates that semen quality is significantly influenced by seasonal variations, with cooler temperatures associated with improved sperm concentration and total count, as indicated by statistically significant p values (p&lt;0.05) for these parameters. The p values for sperm concentration (p=0.0280) and total sperm count (p=0.0363) confirm a significant relationship with seasonal temperature changes. In contrast, parameters such as motility and morphology remain relatively stable across seasons, as evidenced by non-significant p values (p&gt;0.05)