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Varicocele and Spermogram Abnormality: About 264 Cases at the Fertilia Medical Clinic in Bamako

Open Journal of Medical Imaging 2023年第3期13卷 84-91页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré youssouf yalcouyé Adama Diaman Keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Aims: To determine the impact of varicocele on the result of the spermogram in a group of hypo-fertile or infertile men. Patients and Method: This was a cross-sectional, descriptive study concerning 264 men collected between February 2020 and March 2022 at the Fertilia medical clinic in Bamako. The study population consisted of consenting male subjects presenting for infertility. All of our patients had already done a spermogram, they then benefited from a scrotal Doppler ultrasound. The scrotal echo-doppler was completed by an abdominal and pelvic echography in search of a possible etiology, in particular a renal cancer, a thrombosis of the renal or spermatic vein, a retroperitoneal mass or a nutcraker syndrome. Testicular volume was measured on ultrasound according to Lambert’s formula (length × width × height × 0.71). A volume = 16 ml was considered normal. Results: 264 patients were recruited in ours. The average age was 33 years with extremes ranging from 25 to 65 years. 149 patients or 56.44% were between 30 and 45 years old. 213 patients or 80.68% had primary infertility. All the patients, i.e. 100%, had a sperm anomaly and dilation of the pampiniform plexus veins. The most common sperm abnormalities were oligoasthenoteratozoospermia, which concerned 214 patients, or 81%, followed by azoospermia (40 patients, or 15%) and oligospermia (10 patients, or 4%). 213 patients or 80.68% had a Hirshen grade II varicocele, 45 patients or 17% had grade I and 06 patients or 2.27% had grade III. Among the 6 patients, 04 had left testicular atrophy and 2 bilateral atrophy. The venous reflux was more accentuated on the left than on the right. Conclusion: Varicocele is significantly found in men with infertility. Sperm alterations concern both the concentration of spermatozoa, their mobility and their vitality. Even if the mechanism of alteration of the sperm parameters is not well elucidated, our study made it possible to make the link between the dilation of the veins of th

关键词： Ultrasound Male Infertility Varicocele Oligoasthenoteratozoospermia

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Endometrial Status and Embryonic Implantation about 150 Cases at the Medically Assisted Procreation Laboratory “Le Diafounou”

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Open Journal of Medical Imaging 2023年第3期13卷 92-100页

作者： Mamadou Dembélé Alassane Kouma Ilias Guindo Souleymane Sanogo Zoumana Cheick Berete Ousmane Traoré Mamadou N’Diaye Brahima Doumbia Oncoumba Diarra Issa Cissé Aboubacar Sidiki N’diaye Bandiougou Doucouré youssouf yalcouyé Adama Diaman Keita Siaka Sidibe Faculty of Medicine and Odonto-Stomatology of Bamako (FMOS) Bamako Mali Medical Imaging Department Kati University Hospital Kati Mali Department of Education and Research in Public Health (DERSP) Bamako Mali

Background: The endometrium is the tissue that lines the inside of the uterus. It undergoes multiple changes during the menstrual cycle and prepares to welcome the fertilized egg. Endovaginal ultrasound is a first-line examination in the assessment of female infertility. Objective: We aimed to determine the impact of endometrial status by endovaginal ultrasound on the outcome of embryo transfers. Subjects and Methods: This was a prospective cross-sectional study of 150 women collected between January and October 2020 at the “Le Diafounou” medically assisted procreation laboratory. Were included in the study, women presenting for desire of pregnancy and having continued the treatment until the transfer of fresh or frozen embryos. An uterine score was used. This score took into account the thickness of endometrium, it is coffee bean aspect, the presence of the notch, the echogenicity of the endometrium, the pulsatility index, the presence of the flow at the end of diastole and sub-endometrial flow. Ultrasounds were performed using a General Electric logic 500, logic 9 and Voluson E8 device. The data was entered into Excel and then analyzed using SPSS version 21. Results: 150 women were selected for the study. 83 women or 55.3% were between 17 and 35 years old and 44.7% were over 35 years old with an upper limit of 50 years old. The number of women who became pregnant was 69% or 46%. The average thickness of the endometrium was 11.40 mm with extremes of 4.65 mm and 18.6 mm. There was a correlation between the thickness of the endometrium and obtaining a pregnancy (p i.e. 88.7%. The pulsatility index was relatively low for those who started a pregnancy, i.e. 90%. The high pulsatility index is one of the reasons for the failure of embryo implantation. The correlation was significant (p = 0.009). 141 women had no notch in the uterine arteries, i.e. 94%. 94 women or 62.7% had a triple line endometrium or typical coffee bean appearance. End-diastolic flow was observed in 12

关键词： Endometrial Status Embryonic Implantation Medically Assisted Procreation

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