Ahmad Majzoub

Hamad Medical Corporation | HMC · Urology

Non-obstructive azoospermia (NOA) is found in up to 15% of infertile men. While several causes for NOA have been identified, the exact etiology remains unknown in many patients. Advances in assisted reproductive technology, including intracytoplasmic sperm injection (ICSI) and testicular sperm retrieval, have provided hope for these patients. This...

Study question Can varicocelectomy be indicated for the treatment of hypogonadism in men above 40 years of age? Summary answer Varicocelectomy improves serum testosterone (T) levels in men with preoperative hypogonadism. This improvement can be anticipated in men above the age of 40 years. What is known already Varicocele ligation is a common int...

Study question What is the clinical presentation of adolescent varicocele and the impact of its repair on semen quality? Summary answer Adolescent varicocele usually presents as testicular pain and does not influence semen quality. Varicocele ligation does not impact postoperative semen results in this patient population. What is known already Va...

Study question What is the prevalence of patients with high oxidation-reduction potential (ORP) and high sperm DNA fragmentation (SDF) in different patient groups with and without varicocele? Summary answer A large percentage of normozoospermic patients and patients who are normally considered of manageable in assisted reproduction show high SDF a...

Study question Does varicocelectomy improve semen parameters, hormones & pregnancy outcomes in infertile men with clinical varicocele? Summary answer In infertile men with clinical varicocele, sperm count, motility, and DNA fragmentation improved significantly after varicocelectomy. Pregnancy outcomes improved for both spontaneous and assisted rep...

Objectives To evaluate and compare the clinical outcomes associated with early versus delayed PP implantation in individuals with priapism-induced erectile dysfunction (ED). Methods We included studies that focused on refractory priapism leading to ED and its management with PP implantation. We assessed cohort study bias with the risk of bias tool...

Background Studies exploring the effect of COVID-19 on male reproductive system suggest a detrimental association, however with conflicting results. The aim of this study was to assess the association between COVID-19 infection and male reproductive potential including hormone profiles and semen parameters. Methods This prospective cohort study in...

Introduction Premature ejaculation (PE) is one of the most common sexual disorders that negatively impacts couple’s satisfaction. Varicocele on the other hand is a highly prevalent condition affecting men population. A higher incidence of PE is observed among patients with varicocele, which incited several authors to evaluate the possible correlati...

Introduction Infection is a devastating complication of penile prosthesis implantation ranging from 0.33 to 11.4%. 1 Although a salvage procedure is an option in case of infection, the rule of thumb is to remove all device components. 2 Special considerations and pre-operative planning are essential for better outcome in the management of such cond...

Introduction Premature ejaculation (PE) is one of the most common sexual disorders that negatively impacts couple’s satisfaction. Varicocele on the other hand is a highly prevalent condition affecting men population. A higher incidence of PE is observed among patients with varicocele, which incited several authors to evaluate the possible correlati...

In recent years, there has been a growing interest in identifying subcellular causes of male infertility, and sperm DNA fragmentation (SDF) research has been at the forefront of this focus. DNA damage can occur during spermatogenesis due to faulty chromatin compaction or excessive abortive apoptosis. It can also happen as sperm transit through the...

Study question Is varicocelectomy effective in improving the semen quality of patients with isolated oligozoospermia (IO)? Summary answer Varicocelectomy is a valid option for infertile men with clinical varicocele and documented IO considering the significant improvement in semen concentration. What is known already Varicocele is the leading cor...

Study question Does microsurgical varicocelectomy impact normal semen parameters in fertile patients undergoing the procedure for indications other than infertility? Summary answer Micro surgical varicocelectomy does not alter the fertility potential of men with normal semen. What is known already Varicocele repair results in improvement in semen...

Study question Does microsurgical varicocelectomy improve semen parameters and fertility potential in patients with low sperm vitality? Summary answer Micro surgical varicocelectomy in patients with low sperm vitality is beneficial as it results in significant improvement in sperm count and progressive motility. What is known already Low sperm vi...

Purpose: To systematically review the evidence on the association between sexually transmitted infections (STIs) and male infertility. We sought to answer two questions: Are STIs significantly associated with detrimental changes in semen parameters?; and, is the prevalence of STIs significantly higher in infertile than fertile men? Materials and m...

Abstract Background: No study appraised the knowledge gaps and factors impacting men's sexual and reproductive health (SRH) in MENA (Middle East and North Africa). The current scoping review undertook this task. Methods: We searched PubMed and WoS electronic databases for original articles on men's SRH published from MENA. Data was extracted from...

Background: Few studies assessed the relationships between BMI and post varicocelectomy semen quality and fertility potential and reported inconsistent findings. Objective: To assess the association of BMI with semen parameters and reproductive hormones before and after microsurgical varicocelectomy. Materials and Methods: Retrospective chart revie...

Ejaculatory duct obstruction (EDO) is rare and is associated with infertility due to obstructive azoospermia. Hemospermia, infertility and painful ejaculation are commonly seen in EDO patients. EDO can be congenital or acquired, yet it is usually associated with a mid-line cyst (MDC). We present a rare case of acquired EDO in a fertile man presenti...

Objective We appraised the reporting quality of abstracts of systematic reviews/meta-analyses (SR/MAs) published in one urology journal and explored associations between abstract characteristics and completeness of reporting. Methods The Arab Journal of Urology (AJU) was searched for SR/MAs published between January 2011 and 31 May 2022. SR/MAs wi...

Introduction Metabolic Age (MetAge) and body composition analysis may reflect an individual’s metabolic status, which is believed to influence male sexual and gonadal functions. Although erectile dysfunction (ED) and hypogonadism are increasingly prevalent with age, they are also detected among younger men. This study aims to assess the impact of M...

Varicocele and premature ejaculation: systematic review Introduction and objective: Premature ejaculation (PE) is a highly prevalent condition that significantly impacts couple’s satisfaction. Varicocele is a common disease with negative consequences on testicular function. A higher incidence of PE is observed among patients with varicocele, which...

ABSTRACT Background: To date, no previous research assessed the bibliometrics of men’s sexual and reproductive healthcare (SRHC) across Arab countries. This study appraised the current stand- ing of men’s SRHC research in the MENA (Middle East and North Africa) region. Methods: We performed a bibliometric analysis to assess qualitatively and quanti...

Genitourinary anomalies constitute a large proportion of congenital malformations. However seminal tract anomalies, particularly ejaculatory duct (ED) anomalies are very rare and little information exists on the topic. We are reporting a very rare case of bilateral ectopic EDs opening in the bladder trigone in a 33-year-old gentleman presenting for...

Purpose COVID-19 frequently affects the kidneys with symptoms ranging from mild proteinuria to progressive acute kidney injury. This prospective study aimed to assess the short- and long-term impact of asymptomatic and mild COVID-19 on the renal function of healthy young adults, and to determine the correlation between viral load and kidney functio...

Recurrence following varicocelectomy is an important cause of treatment failure and persistence of subnormal semen parameters. This original study was combined with a systemic review and meta‐analysis aiming to evaluate the efficacy of redo varicocelectomy on male fertility potential and pregnancy outcome. The retrospective study included 32 patien...

Study question Does varicocele lead to progressive testicular dysfunction If not corrected and Can patients with long history of varicocele benefit from varicocelectomy? Summary answer Varicocele in older patients have more pronounced effect. Correction at a younger age leads to more significant improvement in testicular function and semen paramet...

Study question Is there a difference between unilateral and bilateral varicocele on clinical presentation and postsurgical outcome of infertile men undergoing microsurgical subinguinal varicocelectomy? Summary answer Patients with bilateral varicocele have significantly worse clinical presentation than unilateral disease. Significantly greater imp...

Study question Does Body Mass Index (BMI) affect the semen parameter outcome after microsurgical varicocelectomy in infertile men? Summary answer BMI significantly affects the quality of semen parameters of infertile men with varicocele. However, it does not influence the outcome of varicocele repair. What is known already Varicocele is the most...

Objective to evaluate the effectiveness of UPOINT based multimodal treatment on patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS), and determine factors that could be associated with clinical improvement. Methods A retrospective study was conducted in Doha, Qatar including patients with CP/CPPS from the Middle East and North...

American Center for Reproductive Medicine Reasearch Collaborators-2018

To identify the most prevalent chromosomal abnormalities in patients with non‐obstructive azoospermia (NOA), consolidate their surgical sperm retrieval (SSR) rates and determine the significant predictors of positive SSR in this patient population. A systematic review and meta‐analysis were performed following the Preferred Reporting Items for Syst...

Background : The use of herbal medicine and alternative medicine is reported to be in up to 50% of prescriptions for benign prostate hyperplasia (BPH) in Europe, along with an increased global interest for holistic medicinal approaches. This study aimed to systematically review the published evidence investigating the use of herbal medicines as a t...

Study question Does the sperm DNA fragmentation (SDF) level impact the clinical outcome of couples undergoing intracytoplasmic sperm injection (ICSI)? Summary answer No significant effect was observed for SDF on the reproductive outcome of couples undergoing ICSI. What is known already Sperm DNA Fragmentation (SDF) has emerged as an important bio...

Study question Does microsurgical subinguinal varicocelectomy (MSV) improve semen parameters and fertility outcomes of patients with severe oligozoospermia (SO) and clinical varicocele? Summary answer MSV significantly improves semen parameters of patients with SO and can broaden their fertility treatment options. What is known already: Varicocele...

To analyse the current therapeutic options for patients with premature ejaculation (PE) and highlight their mechanism(s) of action, effectiveness, advantages and limitations. A literature search was conducted using the PubMed database searching for articles exploring different PE treatment modalities. A Preferred Reporting Items for Systemic Review...

Objective: : To review the outcomes of various therapeutic modalities that can be offered to patients with chronic orchialgia (CO) after failed conservative treatment. Methods: : A literature search was conducted using the PubMed and MEDLINE databases searching for articles exploring different CO treatment modalities. A Preferred Reporting Items...

Our study objective was to assess the effect of various sperm DNA fragmentation levels on clinical intracytoplasmic sperm injection outcome. This retrospective study included 392 patients who underwent ICSI and performed sperm DNA fragmentation testing before the procedure. Based on sperm DNA fragmentation cut-off values, the patients were differen...

The advent of intracytoplasmic sperm injection (ICSI) has changed the human reproduction landscape by overcoming several limitations related to both male and female infertility factors. However, despite the development of new technologies, the live-birth rate with ICSI has not exceeded 30%. In order to improve assisted reproductive technology outco...

Purpose: The use of antioxidants is common practice in the management of infertile patients. However, there are no established guidelines by professional societies on antioxidant use for male infertility. Materials and methods: Using an online survey, this study aimed to evaluate the practice pattern of reproductive specialists to determine the...

Semen analysis is the first, and frequently, the only step in the evaluation of male fertility. Although the laboratory procedures are conducted according to the World Health Organization (WHO) guidelines, semen analysis and especially sperm morphology assessment is very difficult to standardize and obtain reproducible results. This is mainly due t...

In this study, we investigated the prevalence of sexual dysfunction among males with advanced chronic kidney disease and the effect of treating hyperprolactinemia among these patients. In this prospective study, patients were assessed with history, physical examination, hormonal assessment, and two questionnaires, IIEF and AIPE. Patients with hyper...

The development of surgical sperm retrieval procedures can be considered as the single most important breakthrough in the field of male infertility. Various testicular sperm retrieval procedures exist and are indicated in patients with obstructive and nonobstructive azoospermia, as well as patients with high levels of sperm DNA fragmentation and se...

Obtaining good quality sperm for in-vitro fertilization, ICSI, or for cryopreservation can be a major problem if a man suffers from medical conditions that preclude normal collection. Major advances in sperm retrieval and preparation techniques have been witnessed in recent years, allowing a better understanding of the contribution of the sperm to...

Obtaining good quality sperm for in-vitro fertilization, ICSI, or for cryopreservation can be a major problem if a man suffers from medical conditions that preclude normal collection. Major advances in sperm retrieval and preparation techniques have been witnessed in recent years, allowing a better understanding of the contribution of the sperm to...

Semen analysis is a basic test for evaluating male fertility potential, as it plays an essential role in driving the future management and treatment of infertility in couples. Manual semen analysis includes the evaluation of both macroscopic and microscopic parameters, whereas automated semen analysis is conducted through a computer-aided sperm ana...

Selecting good-quality sperm for use in in-vitro fertilization is a key step in assisted reproduction. For many years purely morphological attributes have been used to assess suitability, but increasingly biochemical and molecular biological techniques are now identifying sperm with the best chances of producing viable and healthy embryos. Focusing...

It is widely accepted that oxidative stress plays an important role in the pathophysiology of male infertility and that antioxidants could have a significant role in the treatment of male infertility. The main objectives of this study are: 1) to systematically review the current evidence for the utility of antioxidants in the treatment of male infe...

Varicocele ligation has been proven to restore semen parameters and improve pregnancy rates in men with clinical disease. However, its effect in men with severe oligozoospermia (SO) is less clearly elucidated. This original report and meta‐analysis examined the impact of subinguinal microsurgical varicocelectomy on semen parameters and fertility ou...

In 2020, the COVID‐19 pandemic led to the suspension of the annual Summer Internship at the American Center for Reproductive Medicine (ACRM). To transit it into an online format, an inaugural 6‐week 2020 ACRM Online Mentorship Program was developed focusing on five core pillars of andrology research: scientific writing, scientific methodology, plag...

The prolonged lockdown of health facilities providing non‐urgent gamete cryopreservation –as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS‐CoV‐2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and pr...

Informed consent is considered an essential component of medical ethics and it revolves around the principle of autonomy. Previously, a doctor used to make decisions on behalf of his/her patient, an approach better known as ‘paternalistic’. Nowadays, every patient has the right to freely express his/her acceptance or refusal to undergo any proposed...

Intracytoplasmic sperm injection (ICSI), combined with surgical sperm retrieval (SR) techniques, is the sole option for patients with non-obstructive azoospermia to achieve fertility; however, with suboptimal results. Given the variability in clinical presentation, the potential role of factors that can predict the likelihood of successful testicul...

Sperm DNA integrity is crucial for fertilization and development of healthy offspring. The spermatozoon undergoes extensive molecular remodeling of its nucleus during later phases of spermatogenesis, which imparts compaction and protects the genetic content. Testicular (defective maturation and abortive apoptosis) and post-testicular (oxidative str...

Objective To explore predictors of successful sperm retrieval (SR) and to identify potentially suitable candidates for testicular sperm aspiration (TESA), a more straightforward, less traumatic, and less costly procedure than open surgical SR methods. Design Retrospective chart review. Setting Academic tertiary medical center. Patients A total o...

Objective Erectile dysfunction is increasingly prevalent with age. Metabolic Age (metAge) refers to the number calculated by comparing Basal Metabolic Rate (BMR) of an individual to BMR average of his chronological age (chAge) group. It hence serves to reflect the metabolic status which is believed to influence sexual function. The aim of this stu...

Objective The spermatozoa nuclear component especially it’s DNA integrity is essential for normal fertilization, pregnancy & embryo development. Currently sperm DNA fragmentation (SDF) testing is one advanced sperm function test used along other conventional tests to evaluate male infertility.We aim to assess the impact of SDF on pre- & post-wash...

Purpose: Since its discovery in December 2019, the novel coronavirus SARS-CoV-2 has spread globally, causing the current COVID-19 (coronavirus disease-19) pandemic. As there is an increase of infections in the male population, concerns have emerged about the potential impact of COVID-19 on male reproductive organs and male fertility. Therefore, th...

Conventional semen analysis is considered the cornerstone investigation for infertile men. Nonetheless, this routine test does not provide information on important sperm functions like sperm DNA fragmentation (SDF). Abnormalities of human spermatozoal nucleus and chromatin have a detrimental impact on both natural and assisted reproductive outcomes...

Study question: Are there any clinical predictors that could help in selecting non-obstructive azoospermia (NOA) candidates for testicular sperm aspiration (TESA)? Summary answer: TESA may be offered for patients with a serum FSH level <7.5IU/L and average testicular size >7.75ml What is known already: Microsurgical testicular sperm extraction (...

Study question: Does unilateral microsurgical subinguinal varicocelectomy have a favorable effect on the fertility potential of patients with severe oligospermia? Summary answer: Microsurgical sub inguinal varicocelectomy improves semen parameters of patients with severe oligospermia improving their fertility outcome. What is known already: Seve...

Study question: Can the outcome of sperm retrieval in patients with non-obstructive azoospermia be affected by an untreated clinical varicocele? Summary answer: The presence of clinical varicocele did not influence the sperm retrieval rate in this population of NOA patients. What is known already: Varicocele is prevalent in approximately 5% of me...

Study question: Does the duration of abstinence period affect seminal oxidative stress in infertile men? Summary answer: Shorter abstinence period significantly decreases seminal oxidative stress with subsequent improvement of motility, progressive motility and normal morphology. What is known already: The duration of abstinence may affect the sem...

Study question: Does hormonal disturbance in end stage renal disease patients affect their sexual function ? Summary answer: Endstage renal disease is commonly associated with sexual dysfunction that is more likely to be attributed to organic causes rather than solely to endocrine disturbances What is known already: Male sexual dysfunction is co...

Background and Aims Male sexual dysfunction is commonly prevalent in patients with end stage renal disease (ESRD) and has been partly attributed to the concurrent state of hyperprolactinemia and hypogonadism, often observed in this patient population. The aim of this study was to evaluate the hormone profile and sexual function of ESRD patient, usi...