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as 1.17. Male ratio was similar atroups (group 1-58.2%; group 2-56.7%;roup 3-53.9%). There was no statisticalifference among groups accordingumber of female (p�0.122) and malep�0.091) offspring. Comparing the to-al number of offspring, groups 1 and 2ere not homogeneous (p�0.05), and

o weren’t groups 2 and 3 (p�0.01). Atroup 1, the numbers of female andale offspring were compared accord-

ng to duration of exposure (this dataeing the period working as traffic oper-tor), and they were statistically similarp�0.546 and p�0.713, respectively).onclusions: Associations between traf-c pollution and total number of offspringere observed in general population, and

n a group exposed to high air pollution.ex ratio was preserved in all the groups,nd so was the male ratio. In the groupxposed to high levels of air pollution,he time of exposure did not influencepon the number of female and male off-pring.

P-2.051zoospermia: Is Sperm Pellet Analysisy Simple Centrifugation Enough toetect Rare Spermatozoa?ndrietta J, S Athayde K, F Rejowski R,allak Jivision of Urology, Hospital das Clıni-

as, University of Sao Paulo, Sao Paulo,razil

ntroduction and Objectives: Ten tofteen percent of male cases are due tozoospermia (absence of spermatozoa inresh ejaculated). Azoospermia is classifieds: Obstructive, if spermatogenesis is nor-al but there is a block in the epididymis

r vas deferens or Non-Obstructive, if ori-in is unknown or spermatogenesis is im-aired, by testicular failure or due to aormonal failure to stimulate spermato-enesis. The aim of this study was to eval-ate two methods used to concentrateemen, Simple Centrifugation and Cyto-entrifugation, in azoospermic patients.aterials and Methods: Azoospermic pa-

ients at routine semen analysis were ana-yzed. Complete semen analysis accordingo World Health Organization guidelinesas accomplished. Samples were centri-

uged and pellets were examined for theresence of spermatozoa. If no spermatozoaere found in the pellet, Cytocentrifugationas then performed (smears were stainedith NF-PICS staining).esults: A total of 237 samples were in-luded in the study. Simple Centrifugation

ad positive results in 37.6% (n�89) of i

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ases and Cytocentrifugation in 20.3%n�30).onclusions: Rare spermatozoa may beresent in the ejaculates of men previ-usly azoospermic by routine analysis.hese techniques should be performed inll azoospermic samples, since any sper-atozoa found in the semen confirm theresence of spermatogenesis in the testes,ainly if there is a possibility of IVF.

P-2.052ssessment of Infertility in theelatives of Infertile Men Referred toatemmieh Hospital Infertility Center,amedan, Iran, 2007-2008abolhavaeji H, Farimani M, Rabiee S,miri I, Bahmanzadeh Mamedan Medical University, Infertilityenter of Fatemieh Hospital, Hamedan,ran

ntroduction and Objective: Infertility iseen in approximately 15% of young cou-les, and in 40% of cases, male factor isesponsible. One of the important factorsn assessment of these patients is atten-ion to family history of infertile men. Theim of this study is assessment of infertil-ty in the relatives of infertile men re-erred to Fatemmieh Hospital of Hamedann 2006-2007.

aterials and Methods: In a case-seriestudy, 280 infertile men referred to Fatem-ieh Hospital of Hamedan in one year,

ntered the study. For each patient, dataelated to infertility status in first and sec-nd degree relatives were gathered by ahecklist. Data were analyzed by SPSSoftware (v:13).esults: In our study the mean age of

nfertile men was 33.2�6.39 (23-56y). Therevalence of infertility in the relatives of

nfertile men was 13.93%. The infertilityrevalence in brothers, sisters, father’selatives and mother’s relatives was 3.57%,.22%, 3.92% and 3.22%, respectively. The

nfertility prevalence in first degree andecond degree relatives were 48.72% and7.28%. The results of semen analysis inatients with positive family historyhowed that the majority of them51.28%) had asthenospermia. In ourtudy, 5.71% of infertile men had historyf transient infertility in their parents.onclusions: Regarding high prevalencef infertility in the family of infertile men

n our study, paying attention to familyistory is necessary and genetic consulta-ion before marriage can prevent many

nfertility problems in family. C

URO

P-2.053he Index Finger and Ring Fingeratio (2D:4D): Is This a Reliableredictor of Semen Quality?ang Y, Rho J, Seo H, Park K, Kim K,im D, Kim Chosun University Hospital, Gwang-ju,orea

ntroduction and Objectives: The hy-othesis that the index finger and ringnger ratio (2D:4D) related with men’semen quality was suggested. It is basedn the HOXA and HOXD gene take a role

n finger development and differentiationf urogenital system during embryogene-is. After the assumption reported that ifhe 2D:4D ratio is higher, the semen qual-ty is probably poorer, many investigatorsave tried to prove it by experiment.aterials and Methods: We set the two

roups of healthy young men (mean age1.4) with different 2D:4D ratio from col-

ege of medicine in Chosun University.ne group was comprised of 26 menhose 2D:4D was higher than 1 (mean

.09), and the other group contained 28en whose 2D:4D was lower than 1

mean 0.95). Demen was collected byasturbation and examination of semen

uality was done.esults: After comparison of these data,e cannot detect the relation of 2D:4D

atio with semen quality. Our findingshow that there was no difference be-ween the two groups in sperm count andotility (p�0.87, p�0.92).onclusions: This statistical significance

hows that the 2D:4D ratio has little asso-iation with semen quality in normaloung men. Thus, the measurement ofnger length cannot be a reliable indica-or of semen quality and testicular func-ion.

P-2.054esticular Adrenal Rest Tumor innfertile Patient with Congenitaldrenal Hyperplasiaarchini G1, Wagner B2, Ortega F1,ocuzza M1, Srougi M1, Hallak J1

Department of Urology; 2Department ofndocrinology, University of Sao Paulo,ao Paulo, Brazil

ntroduction and Objective: Men withongenital adrenal hyperplasia (CAH) haveow fertility rates compared with the nor-

al population, being related to testiculardrenal rest tumors (TART). We presenthe case of a male patient with CAH dueo 21-hydroxylase deficiency who pre-ented with testicular tumor and infertil-ty.

ase Report: A male patient had been

LOGY 74 (Supplment 4A), October 2009

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valuated by the Endocrinology Depart-ent with diagnosis of simple virilizing

on-salt-wasting form of CAH. Treatmentith low-dose was initiated at 4 years old

nd he needed no mineralocorticoid re-lacement. The patient evolved normallyntil 22 years old when he interrupted hisreatment and lost follow-up consulta-ions. He searched medical counsellingfteen years latter because of infertility.he patient was 37 years old, healthy and

aking no medications at that time. Heas trying to achieve pregnancy for two

ears without success. At physical exami-ation he had low stature and small soft-ned topic testicles. Semen analyses re-ealed azoospermia. Serum hormonalcreening showed increased levels of Folli-le-Stimulating Hormone (FSH) and Lutein-zing Hormone (LH) and low levels of tes-osterone, suggesting testicular failure.reatment with low-dose daily glucocorti-oid had been initiated by the endocrinol-gist before our first visit but after twelveonths no great changes in sperm countere found. Testicular ultrassonographic

xamination confirmed small bilateral het-rogenous testicles. It also revealed a hy-erecogenic hypervascularized mosaicrea of 1.5 � 1.5 cm in the projection ofestis network in both testicles, suggestinguct oclusion at this point. Further evalua-ion with magnetic ressonance image re-ealed bilateral solid elongated serpigi-ous lesions in the mediastinum testisith low sign at T2 image, being adrenal

est tumor a differential diagnosis. Theatient was submitted to bilateral testicu-

ar biopsy witch revealed preserved sper-atogenesis and spermiogenesis in 20% of

ight testicle seminiferous tubules and leftesticular. The patient and his wife werencluded in the intracitoplasmatic spermnjection program.onclusions: The prevalence of testicu-

ar tumors in male CAH patients is high.iagnosis can be done with ultrasonogra-hy or MRI and early treatment of TARTith glucocorticoid should be of primary

oncern. Although testis-sparing surgery iseasible, it may not result in testicularunction improvement. Alternative fertilityechniques and genetic counselling shoulde offered for these patients.

P-2.055actors Influencing the Outcome ofCSI in Azoospermic Patientsourmand G, Hashemian E, Salsabili N,araji A, Mehrsai A, Akbari Frology Research Center, Sina Hospital,ehran University of Medical Sciences,

ehran, Iran t

ROLOGY 74 (Supplment 4A), October 2009

ntroduction and Objective: Sperm re-rieval for ICSI has revolutionized thereatment of azoospermic men; it, how-ver, is associated with a low successate. We decided to study the effects ofactors, such as the sperm retrieval site,he age and hormonal status of the cou-le, the number of retrieved oocytes, theumber of transferred embryos, testicularistology and the cause of azoospermia,n the outcome of ICSI.aterials and Methods: Two hundred

orty-six azoospemic patients (52 ofhom had obstructive azoospermia [OA]

nd the other 194 cases had non-obstruc-ive azoospermia [NOA]) who underwentperm retrieval using PESA or TESE be-ween April 2004 and March 2008 werenrolled in this cohort study. All femaleartners received HMG for ovulation stim-lation and oocytes were retrieved 36hrsfter the administration of HCG. 48hrsfter the ICSI procedure, the cleaved em-ryos were placed in the uterine cavity.esults: The occurrence of clinical preg-ancy was significantly correlated withhe underlying cause of azoospermia (23%n OA versus 10.8% in NOA, P�0.05).

oreover, the age of the female partnernd FSH serum levels significantly alteredhe pregnancy rate in both groups (p�0/01). In NOA group, the number of re-rieved oocytes and the transferred em-ryos significantly influenced the outcomef the pregnancy (p�0.05). Testicular bi-psy along with the age and FSH serum

evels of the male partner, however, hado effect on the success rate of the ICSIrocedure.onclusions: Compared to NOA suffer-rs, ICSI provides a significantly higherregnancy rate in OA patients. Female

actors including age and the ovarian re-erve, however, influence the success ofhis process in both groups.

P-2.056valuation of Causes of Semen Examisorders in Men Who Came Becausef Male Infertility to Imam Rezarology Clinicaghavi Razavizade SR, Mahdavi R, DarabiR, Tavakoli Kashhad University of Medical Sciences,ashhad, Iran

ntroduction: About 10 to 15 percent ofoung couples one year after marriageith tendency to have a child do not have

he power of fertility; in whom have inter-ering diseases of male partner. Knowing

hese diseases and their prevalence gives s

s the ability to have better treatment andlanning in future. So, in a 3 year periode assessed the causes of semen examisorders in infertile men.aterials and Method: In this study 164

atients came to Imam Reza urology clinicecause of male infertility from 2004/3ntil 2007/3 and were selected acciden-ally. Their data was entered in question-aire and analyzed by SPSS.esults: Among patients, 82/3% had pri-ary and 17/7% had secondary infertility.he average age of total patients was9/51 years old. The most common dis-ase was varicocele with 81 patients (49/%), idiopathic infertility 57 patients (34/%), history of varicocele surgery 8atients (4.9%), atrophic testis 3 patients1.8%), cryptorchidism or orchiopexy 6atients (3.7%), hernia 4 patients (2.4%),ertoli cell only syndrome 2 patients1.2%), vas deferens agenesis 1 patient0.6%), arrest at spermatocyte phase 1atient (0.6%) and usage of anti-convuls-

ng drugs 1 patient (0.6%).onclusion: Because of relatively highrevalence of varicocele in men whoame because of infertility, early evalua-ion of varicocele in young men and itsffects on semen should be considered.

P-2.057n Evaluation for Coincidence ofubclinical Varicocele (Detected byoppler Venous Reflux) withontralateral Grade III Varicocelend Effects of Subclinicalaricocelectomy on Spermarametersaghavi Razavizade SR, Tavakkoliabassi K, Mahdavi Zafarghandi R, DarabiRashhad University of Medical Sciences,ashhad, Iran

ntroduction: Male factor is the caus-tive agent in half the cases of infertil-ty, and 40% of infertile men have vari-ocele. Varicocele has been shown toave dysfunctional effects on sperm pa-ameters. Up to now, it has been provedhat definition, diagnosis and treatmentf varicocele was based on clinical find-

ngs. Attention to high prevalence ofubclinical varicocele and curable poten-ial in infertility, diagnosis and treatmentf subclinical varicocele may have usefulffects on infertile couples.aterials and Methods: Patients with

nilateral clinical varicocele grade IIInd abnormal spermogram were exam-ned with color Doppler ultrasound forubclinical varicocele on contralateral

ide. Based on ultrasound results, pa-

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