Andor teratozoospermia

Any of the following combination * 1 factor A + 1 factor B 1 factor A + 1 factor C

2 factors C

Prostate, seminal vesicles, and/or epididymis ultrasound abnormalities (by scrotal and transrectal ultrasound scans)

Prostate

Seminal vesicles

Epididymis

Prostatitis alone

>2

0

0

Prostate-vesiculitis

>2

>2

0

Prostate-vesiculo-epididymitis

>2

>2

>2

In case of prostatitis alone, examine the prostatic fluid Abnormal prostatic expression fluid and/or abnormal urine after prostatic massage

Clinical history

Positive history for urinary infection, epididymitis, and/or sexual transmitted diseases

Physical signs

Thickened or tender epididymis, tender vas deferens, and/or abnormal digital rectal examination

Ejaculate signs Leukocytes > 1x106/ml (measured by immunocytochemistry) Culture with significant growth of pathogenic bacteria (>105 CFU/ml) Chlamydia trachomatis or Ureaplasma urealyticum detected in the urethral swabs after prostate massage Abnormal appearance, increased viscosity and pH, and/or abnormal biochemistry of the seminal plasma

Fig. 25.3 Proposed new criteria to diagnose MAGI integrating those proposed by the WHO [10]

performed by immunocytochemistry rather than peroxidase staining to evaluate all leukocyte subpopulations.

The new proposed guidelines for MAGI should be applied to infertile patients to gain more careful information about sex gland-related OS production and to establish a more appropriate therapeutic strategy.

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