Keywords
prevalence
antibiotic resistance
resistance mechanisms
empirical treatment
How to Cite
Abstract
Introduction: The starting point to address male infertility is the semen analysis (spermogram). Objective: To report the case of a patient consulting for infertility. Materials and Methods: Semen analyses (WHO 2021), sperm search in urine, swim-up tests, hormone assays, and microbiological analyses were performed. Results: The number and vitality of spermatozoa varied, with leukospermia and hypospermia persisting. Infectious and hormonal factors were ruled out. The retrograde ejaculation index of 98.8% (RV < 2.16%) confirmed retrograde ejaculation. The patient reported being shot in the abdomino-pelvic área and undergoing a failed surgery to remove the bullet, a fact that explained the condition. The response to the swim-up was unsatisfactory for Low Complexity Assisted Fertilization Techniques. Conclusions: Multidisciplinary work allowed for a definitive diagnosis and addressed the patient’s demand, who was included in a High Complexity Assisted Fertilization plan.
References
1. Vásquez RF, Vásquez ED. Espermograma y su utilidad clínica. Revista Salud Uninorte. 2007; 23(2), 220-230, http://www.scielo.org.co/pdf/sun/v23n2/v23n2a09.pdf
2. Zambrano Serrano CA, Carvajal Obando A. Diagnosis and hormonal treatment of male infertility. Actas Urol Esp (Engl Ed). 2020;44(5):321-327, https://doi.org/10.1016/j.acuro.2019.10.013
3. Pugliese, N. Fertilización asistida de baja complejidad. En: Palaoro L, Mendeluk G, editors. Citología exfoliativa y de la reproducción. ed: Eudeba; 2019. p. 207-231.
4. Palermo GD, Neri QV, Schlegel PN, Rosenwaks Z. Intracytoplasmic sperm injection (ICSI) in extreme cases of male infertility. PLoS One. 2014;9(12):e113671, https://doi.org/10.1371/journal.pone.0113671
5. Ariagno JI, Mendeluk GR, Pugliese MN, Sardi SL, Acuña C, Repetto HE, et al. The only presence of sperm in urine does not imply retrograde ejaculation. Arch Androl. 2005;51(6):431-6, https://doi.org/10.1080/014850190953294
6. Ariagno J, Curi S, Mendeluk G, Grinspon D, Repetto H, Chenlo P, et al. Shedding of immature germ cells. Arch Androl. 2002;48(2):127-31, https://doi.org/10.1080/014850102317267436
7. Paira DA, Olivera C, Tissera AD, Molina RI, Olmedo JJ, Rivero VE, et al. Ureaplasmaurealyticum and Mycoplasma hominis urogenital infections associate with semen inflammation and decreased sperm quality. J Leukoc Biol. 2023;113(1):18-26, https://doi.org/10.1093/jleuko/qiac006
8. EzzEl-Din AM, Gaber HD, Kamal DT. Chlamydia trachomatis Infection: its relation to semen parameters and sperm DNA integrity. Egypt J Immunol. 2021;28(4):290-298,
9. Sardi M, Repetto H,Chenlo P, Ariagno J, Mendeluk G. Seminal Extracellular Traps in SARS-CoV-2 Infection. J Clin Nephrol. 2024; 8(2): 095-099. https://dx.doi.org/10.29328/journal.jcn.1001134
10. Rodin DM, Larone D, Goldstein M. Relationship between semen cultures, leukospermia, and semen analysis in men undergoing fertility evaluation. Fertil Steril. 2003;79(3):1555-8, https://doi.org/10.1016/s0015-0282(03)00340-6
11. Bassas Arnau L. Exploración de la función testicular. Endocrinol Nutr. 2009;56(1):18-31, https://doi.org/10.1016/S1575-0922(09)70190-1
12. Hershlag A, Schiff SF, DeCherney AH. Retrograde ejaculation. Hum Reprod. 1991;6(2):255-8, https://doi.org/10.1093/oxfordjournals.humrep.a137317
13. Sarquella J, Vilches R, Palma Cristian. Trastornos de la eyaculación. Rev Med Clin Condes. 2024; 25 (1) 129-137, https://www.clinicalascondes.cl/Dev_CLC/media/Imagenes/PDF%20revista%20m%C3%A9dica/2014/1%20Enero/17-Dr.Sarquella.pdf
14. Gade J, Brasso K. Spermagranulomer. UgeskrLaeger. 1990 Aug 6;152(32):2282-4.
15. Bisht S, Faiq M, Tolahunase M, Dada R. Oxidative stress and male infertility. Nat Rev Urol. 2017;14(8):470-485, https://doi.org/ 10.1038/nrurol.2017.69