بسم الله الرحمن الرحیم Sudan University of Science and Technology Collage of Graduate Studies

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1 بسم الله الرحمن الرحیم Sudan University of Science and Technology Collage of Graduate Studies Serum Gondotropins Levels Among Sudanese Men with Infertility مستویات الجونادوتروبین في مصل دم یعانون من العقم الرجال السودانیین الذین A dissertation submitted for partial fulfillment for the requirement of M.Sc Degree in Medical Laboratory science- Clinical chemistry By: Salma Mohamed Osman Mohamed Ali B.Sc in Medical Laboratory Sciences Clinical Chemistry Khartoum University 2013 Supervisor: Dr.Ghada Abdelrahman Alfadil Assistant professor of clinical chemistry January, 2018

2 بسم االله الرحمن الرحيم تعالى: قال ي ر ف ع الل ه ال ذ ين آم ن وا م نك م و ال ذ ين أ وت وا ال ع ل م د ر ج ات و الل ه ب م ا ت ع م ل ون خ ب ير ١١ المجادلة سورة الا یة 11

3 Dedication To The soul of my mother To my Father To my sisters and grandmother To my Teatchers and friends I

4 Acknowledgments First, I thank the Almighty Allah, for enabling me to reach this level of the academic ladder. It is all because of His power mercy and grace. This thesis would not have been possible without the guidance and the help of several individuals who in one way or another contributed and extended their valuable assistance in the preparation and completion of this theisis. therefore it is with immense gratitude that I acknowledge the support and help of those individuals. Firstly I would like to thank my supervisor Dr. Ghada Abdelrahman Alfadel for her unlimited support, invaluable guidance and comment during the study. And grateful thanks for my friends and my colleague,also I would like to thank all workers at Banoon center specialy lab workers for their help in collection of samples,the patients who agreed to give me their samples to encourage reach. II

5 Abstract Background: Infertility is the inability of a sexually active, noncontracepting couple to achieve pregnancy in one year.the causes for a male infertility include :Congenital factors, Acquired urogenital abnormalities, Urogenital tract infections, Increased scrotal temperature Endocrine disturbances, Systemic diseases. Materials and Methods: In a cross-sectional study population 150 males randomly were enrolled in this study, (75 males as control and 75 males As cases. Semen fluid was collected to measure sperm by (CASA) and serum was collected to measure gonadotropins (FSH, LH) by ELISA technique. Results: In both Azoospermia and oligospermia groups the means concentrations of ( FSH ) was significantly increased compared to control group (18.1 ± 9.1m Iu\mL) (14.4 ± 7.08 m Iu\mL) vs (6.4 ± 7.03 m Iu\mL) with p.value (0.00) (0.00) respectively. Also the means concentrations of (LH) in Oligospermia and Azoospermia groups Was significantly increased compered to control group(14.1± 9.4 m Iu\mL) (11.1 ± 7.1 m Iu\mL) vs (6.4 ± 7.03 m Iu\mL) with p.value (0.02) (0.03) respectively. Conclusion:The study concluded that there is inverse association between serum level of( FSH,LH ) and low sperm count this could contribute the pathogenesis of male infertility. III

6 المستخلص خلیفھ الدراسھ :العقم ھو عدم القدره علي النشاط الجنسي للزوجین غیر المستخدمین لموانع الحمل لتحقیق الحمل في سنھ واحده واسباب العقم عند الذكور :عوامل خلقیھ التھابات الجھاز البولي التناسلي المكتسبھ زیادة درجھ حراره الصفن اضطرابات الغدد الصماء والامراض المزمنھ. الطرق والمواد: اجریت دراسھ مستعرضھ ل 150 ذكر عشواي یا تم تسجیلھم في ھذه الدراسھ وصنفوا اعتمادا علي نتیجھ الساي ل المنوي الي مجموعتین مجموعھ طبیعیھ تحلیل الساي ل المنوي 75 ومجموعھ غیر طبیعیھ الساي ل المنوي 75 مع قیاس الھرمون المنبھ للجریب والھرمون اللوتیني. النتاي ج : مستویات الھرمون المنبھ للجریب والھرمون اللوتیني في زیاده عند الذكور الذین لدیھم قلھ في الحیوانات المنویھ والذكور الذین لیس لدیھم حیوانات منویھ بالمقارنھ مع الذكور الذین لدیھم الساي ل المنوي طبیعي (0.05 >p) قیمھ احتمالیھ اوضحت بین مستویات عكسیھ علاقھ ھنالك ان الدراسھ عدد مع للجریب المنبھ الھرمون ومجموع الحیوانات المنویھ مع قیم احتمالیھ (0.00) (0.00 ( علي التوالي. كما اوضحت ایضا ان ھنالك علاقھ عكسیھ بین مستویات الھرمون اللوتیني مع عدد ومجموع الحیوانات المنویھ مع قیم احتمالیھ (0.02) (0.03) علي التوالي. الناتج النھاي ي :خلصت الدراسھ ان ھناك علاقھ عكسیھ اللوتیني مع عدد الحیوانات المنویھ وتركیزھا. بین الھرمون المنبھ للجریب, والھرمون IV

7 Content I الایھ Dedication Acknowledgements List of contents List of tables and figures Abstract II III IV V VI المستخلص VII Chapter one 1 Introduction,Rationale and Objectives Rationale General objectives Specific objectives 2 V

8 Chapter two literature Review Anatomy of Male Reproductive track Phisology of Testicles Hormonogenesis Cellular mechanism of testosterone Action Physiological Action of Testosterone Postnatal Deveolpment Seminal fluid Semen composition Semen Analysis Apperance of semen Liquefactionof semen Volume of semen Viscosity of semen VI

9 3 Chapter three 23 3 materials and methods Study area Study design period Study population Inclusion criteria Exclusion criteria Ethical considerations Collection of samples Estimation of sperm count Procedure of sperm count Method of hormone estimation Principle of the test Procedure of the test Quality control 24

10 Chapter four 4.1 Results 27 Chapter five 5 discussion, conclusion and recommendation disscusion conclusion recommendation Refrances Appendices Questionaire VIII

11 List of figuers figure Figure name Page no 4-1 Disterbution of age of study group Disterbution of age of study group according to residence 30 List of tables Table Table name Page no 4-1 Serum FSH levels in different sub group of sperm 28 count 4-2 Serum LH levels in different sub group of sperm 28 count 4-3 Frequency of occupation of study group Frequency of married duration of study group Relationship between gonadotropins and age group Relationship between gonadotropins and residence 36 IX