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  • TITLE
  • DECLARATION
  • CERTIFICATE 1
  • CERTIFICATE-2
  • ACKNOWLEDGEMENT
  • CONTENTS
  • 1 INTRODUCTION
  • I. ENVIRONMENTAL FACTORS
  • Cigarette Smoke
  • Alcohol
  • Occupational Exposures
  • Heat Exposure
  • Organic Solvents
  • Heavy Metals
  • Environmental Contaminants
  • II. IATROGENIC FACTORS
  • Herniorrahaphy
  • Radiation
  • Chemotherapy
  • Drugs
  • Ill. ACQUIRED DEFECTS OF THE TESTIS, PROSTRATE ANDSPERM
  • Orchitis
  • Syphilis
  • Epididymal infections (epididymitis)
  • Immunologic causes: Antisperm antibodies
  • Varicocele
  • IV. DEVELOPMENTAL AND STRUCTURAL DEFECTS OF THETESTIS AND SPERM.
  • Cryptorchidism
  • Genetic causes
  • Sertolicell only syndrome
  • Spermatogenic arrest
  • Anomalies of sperm structure (Immotile cilia syndrome or., Kartageners syndrome)
  • Globozoospermia
  • V. HORMONAL CAUSES AND ANDROGEN RESISTANCE
  • Hypogonadotropic hypogonadism
  • Hyper prolactinaemia
  • VI. SYSTEMIC DISEASES
  • VII. IMPAIRMENT OF SPERM TRANSPORT (OBSTRUCTIVEAZOOSPERMIA)
  • VIII. PROBLEMS OF EJACULATION
  • Retrograde ejaculation
  • Anejaculation
  • IX. SEXUAL DYSFUNCTlON
  • Male erectile dysfunction
  • INTRAUTERINE INSEMINATION
  • 2 MALE REPRODUCTIVE SYSTEM: BACKGROUND
  • Hormonal Regulation
  • 3 REVIEW OF LITERATURE
  • I. ENVIRONMENTAL FACTORS
  • Cigarette smoke
  • Alcohol
  • Occupational Exposures
  • Heat exposure
  • Organic solvents
  • Heavy metals
  • Environmental contaminants
  • II. IATROGENIC FACTORS
  • Ill. ACQUIRED DEFECTS OF THE TESTIS, PROSTRATE ORSPERM
  • Antisperm antibody
  • Varicocele
  • IV. DEVELOPMENTAL AND STRUCTURAL DEFECTS OF THETESTIS OR SPERM
  • Genetic Causes
  • V. HORMONAL CAUSES AND ANDROGEN RESISTANCE
  • INTRAUTERINE INSEMINATION
  • 4 MATERIALS AND METHODS
  • I. STUDY POPULATION
  • II. QUESTIONNAIRES
  • Ill. SEMEN ANALYSIS
  • Initial macroscopic examination
  • Liquefaction
  • Appearance
  • Volume
  • Viscosity
  • pH
  • Initial microscopic investigation
  • Assessment of Sperm motility
  • Agglutination
  • Assessment of Sperm Concentration
  • Assessment of sperm morphology.
  • Preparation of smears
  • 1.Staining method
  • Staining procedure
  • Assessment of sperm morphology
  • 2. Test simplets R Prestained slides
  • Immature germinal cells and mature sperm.
  • IV. SPERM PREPARATION FOR INTRA UTERINE INSEMlNATlON
  • 1. The Swim - up technique
  • Sperm proparation media
  • Components
  • Procedure
  • 2. Two step discontinuous buoyant density gradient centrifugation
  • Reagents
  • Procedure
  • V. CHROMOSOME ANALYSIS
  • Culture Requirements
  • Preparation of solutions for Harvesting
  • Harvesting and slide Preparation
  • G Banding
  • I. Phosphate buffer for trypsin
  • II. Trypsin Solution
  • VI HORMONAL ASSAY
  • VII STATISTICAL ANALYSIS
  • 5 RESULTS AND DISCUSSION
  • Fig. 1. Percentage of infertility type among three age groups
  • Fig. 2. Distribution of sperm count among 319 patients
  • Fig. 3. Distribution of percentage morphology among 319 patients
  • PLATE I
  • a, b Normal Spermatozoa
  • c, d.& e. Spermatozoa with double head
  • f, g Small headed spermatozoa
  • h Spermatozoon with tapered head
  • PLATE II
  • a, b, c, d, e & f: Head defects - amorphous pattern
  • g Round spermatid
  • h Spermatozoon with amorphous headand thin mid piece
  • PLATE III
  • a Spermatozoa with thick mid piece
  • b. Assymetrical insertion of mid piece
  • c. Spermatozoon with bent neck
  • d Spermatozoon with pyriform head and double tail
  • e A spermatozoon with normal head and double tail
  • f Spermatozoon with tail defect (Coiled tail)
  • g Spermatozoa with double tail and vacuolated head
  • h Spermatozoa with amorphous head
  • PLATE IV
  • a, b: Spermatozoa with amorphous head and cytoplasmicdroplets in mid piece region.
  • c. Pin head
  • d: Multiple defects of spermatozoa observed in a singleinfertile patient.
  • e Tapered head
  • f, e: 2 Neutrophils (leucocytes)
  • h Immature germ cell
  • Fig. 4. Distribution of motility percentage among 319 patients
  • Monomorphic pattern of sperm abnormalities
  • PLATE V
  • a, b&c: Macrocephalic spermatozoa with double tail
  • d, e, f Decapitated spermatozoa
  • g&h Globozoospermia
  • Symbols commonly used in pedigree charts
  • PLATE VI
  • a Normal Male Karyotype
  • b. G- Banded karyotype showing 47, XXY patternobserved in Klinefelter syndrome patients
  • PLATE VII
  • c. G banded karyotype showing reciprocal translocationinvolving chromosome 5 & 13 observed in severeoligoastheno teratozoospermic cases.
  • d: G banded karyotype showing Robertsonian translocationbetween chromosome 21 and 13 in severe oligospermicmales.
  • Fig. 13. Percentage of cases and distribution of diagnosisinvestigated m the present study
  • INTRAUTERINE INSEMINATION
  • 6 CONCLUSION
  • REFERENCES