BRUNO CAMARGO TISEO
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
LIM/55 - Laboratório de Urologia, Hospital das Clínicas, Faculdade de Medicina
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- Evaluation of men with unexplained infertility(2015) COCUZZA, M.; TISEO, B. C.Infertility affects approximately 15 % of couples desiring conception and male infertility underlies nearly half of the cases. However, despite the diagnostic advances in male infertility field, approximately 30 % of patients still have no apparent cause for their infertility problem. Although it is anticipated that future developments will allow identification of the etiology for subfertility in these patients, at present they are considered unexplained disorders that challenge specific treatment recommendations. The use of assisted reproductive techniques (ART) to overcome male infertility is increasing, and due to its effectiveness, this treatment modality has been suggested by some to be used as the treatment of choice in the majority of the cases of male factor infertility regardless of etiology. Although the use of ART may allow infertile couples to achieve pregnancy rapidly, the fear of transferring the unnecessary burden of invasive treatment on healthy female partners weigh down this treatment option heavily. The true litmus test for male fertility remains the ability to generate pregnancy in vivo. Although seminal parameters are used as a surrogate measure of a man’s fertility potential, it is definitely not a direct measure by any means. Seminal parameters between the reference ranges not reflect defects in sperm function. Thus, the assessment of sperm structure and function has gained interest and resulted in the development of the new techniques that are presented in this chapter. © Springer Science+Business Media, LLC 2015.
- Bariatric Surgery Impact on Reproductive Hormones, Semen Analysis, and Sperm DNA Fragmentation in Men with Severe Obesity: Prospective Study(2020) WOOD, Guilherme Jacom Abdulmassih; TISEO, Bruno C.; PALUELLO, Davi V.; MARTIN, Hamilton de; SANTO, Marco Aurelio; NAHAS, William; SROUGI, Miguel; COCUZZA, MarcelloPurpose Growing evidence in the literature suggests that obesity is capable of altering reproductive hormone levels and male fertility. Effects on classic semen parameters and sperm DNA fragmentation (SDF), however, have not been properly established. Additionally, the impact of bariatric surgery (BS) on those parameters is still controversial. Materials and Methods In Phase 1, 42 patients with obesity and 32 fertile controls were submitted to reproductive hormone evaluation, semen analysis, and SDF testing. In Phase 2, patients with obesity were submitted to BS or clinical follow-up and were invited to 6-month revaluation. Results Phase 1: Men with obesity have higher levels of estradiol, LH, and FSH and lower levels of total testosterone (TT) when compared with eutrophic fertile men. Additionally, they present worse semen parameters, with reduction in ejaculated volume and sperm concentration, worse sperm motility and morphology, and higher SDF. Phase 2: 32 patients returned to revaluation. Eighteen were submitted to BS (group S) and 14 were not submitted to any specific therapeutic regimen (group NS). In group S, TT more than doubled after surgery (294.5 to 604 ng/dL,p < 0.0001). Worsening of sperm concentration and total ejaculated sperm count were also noticed, and 2 patients became azoospermic after BS. SDF, however, improved after the procedure. No changes in the variables studied were observed in non-operated patients. Conclusion In this prospective study, we have found that BS results in improvements in reproductive hormone levels and SDF after 6-month follow-up. Sperm concentration, however, reduced after the procedure.
- Surgical management of nonobstructive azoospermia(2015) TISEO, Bruno Camargo; HAYDEN, Russell Paul; TANRIKUT, CigdemNonobstructive azoospermia (NOA) is characterized by the complete absence of sperm in the ejaculate due to testicular failure. The evaluation and management of patients with NOA offer a challenge to the reproductive urologist. In the era of in vitro fertilization with intracytoplasmic sperm injection, surgical sperm extraction techniques can afford men with NOA biologic paternity. To provide a comprehensive review of surgical sperm retrieval approaches in the patient with NOA emphasizing complications, success rates and outcome optimization, a Medline search was conducted querying surgical approaches used to manage NOA. Four sperm extraction techniques are described including: testicular sperm aspiration, testicular sperm extraction, fine needle aspiration mapping and microdissection testicular sperm extraction. In addition, the roles for pre-extraction varicocelectomy and sperm cryopreservation are discussed. The management of NOA continues to evolve as newer tools become available. Several modalities of sperm acquisition exist. An understanding of their complications and success rates is fundamental to the treatment of NOA. (C) 2015 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier (Singapore) Pte Ltd. This is an open access article under the CC BY-NC-ND license