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Id: lil-796895
Autor: Miller, Sarah; Couture, Sophie; James, Gareth; Plourde, Simon; Rioux, Jacky; Labrecque, Michel.
Título: Unilateral absence of vas deferens: prevalence among 23, 013 men seeking vasectomy
Fonte: Int. braz. j. urol;42(5):1010-1017, Sept.-Oct. 2016. tab, graf.
Idioma: en.
Resumo: ABSTRACT Purpose: To determine the prevalence of unilateral absence of vas deferens (UAVD) in men with both testes seeking vasectomy. Materials and Methods: Computerized charts of 23,013 patients encountered between January 1994 and December 2013 in one university hospital and two community clinics of Quebec City, Canada, were searched. Pre-vasectomy consultation, operative reports and semen analysis results were reviewed to identify cases of UAVD. Cases were categorized as confirmed (unilateral vasectomy and success confirmed by semen analysis) or possible congenital UAVD further sub-categorized according to whether or not a scrotal anomaly was present. Results: Among 159 men identified as potentially having UAVD, chart review revealed that 47 had only one testicle, 26 had bilateral vasa, and four were misdiagnosed (post-vasectomy semen analysis [PVSA] showing motile sperm after unilateral vasectomy) leaving 82 men deemed cases of UAVD (0.36%, 95% confidence interval 0.28% to 0.43%). These were classified as confirmed (n=48, 0.21%) and possible (n=34, 0.15%; 22 without and 12 with scrotal anomalies) congenital UAVD. The misdiagnosis ratio of UAVD was low when scrotal content was otherwise normal (1:48), but higher if anomalies were present (3:12). Conclusions: Most surgeons who perform vasectomy will encounter cases of UAVD. In most suspected cases, it is safe and effective to proceed with unilateral vasectomy under local anesthesia while stressing the need for PVSA. Further studies or scrotal exploration may be considered in patient with prior scrotal surgery.
Descritores: Anormalidades Urogenitais/epidemiologia
Ducto Deferente/anormalidades
Vasectomia/estatística & dados numéricos
-Fatores de Tempo
Canadá/epidemiologia
Registros Médicos
Prevalência
Estudos Retrospectivos
Análise do Sêmen
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Adulto
Responsável: BR1.1 - BIREME


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Cedenho, Agnaldo Pereira
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Id: biblio-892875
Autor: Sposito, Camila; Camargo, Mariana; Tibaldi, Danielle Spinola; Barradas, Valéria; Cedenho, Agnaldo Pereira; Nichi, Marcílio; Bertolla, Ricardo Pimenta; Spaine, Deborah Montagnini.
Título: Antioxidant enzyme profile and lipid peroxidation products in semen samples of testicular germ cell tumor patients submitted to orchiectomy
Fonte: Int. braz. j. urol;43(4):644-651, July-Aug. 2017. tab.
Idioma: en.
Resumo: ABSTRACT Purpose To determine enzymatic antioxidant and lipid peroxidation levels in seminal plasma of patients orchiectomized for testicular tumors. Materials and Methods The study included 52 patients: 26 control men and 26 orchiectomized patients for testicular tumor, of which 12 men had seminoma tumor and 14 men non-seminoma tumor. After semen analysis performed according to the WHO guidelines, an aliquot of semen was centrifuged and the seminal plasma was collected. Lipid peroxidation was performed by thiobarbituric acid reactive substances (TBARS) assay and antioxidant profile was assessed by analyzing catalase, glutathione peroxidase (GPx) and superoxide anion (SOD) activities using colorimetric assays with a standard spectrophotometer. Data were tested for normality and compared using one-way ANOVA (p<0.05). Results Seminoma and non-seminoma groups presented lower sperm concentration and morphology when compared to control group (p=0.0001). Both study groups (seminoma and non-seminoma) presented higher TBARS levels when compared to control group (p=0.0000013). No differences were observed for SOD (p=0.646) andGPx (p=0.328). It was not possible to access the enzymatic activity of catalase in any group. Conclusion Patients with testicular tumor present increased semen oxidative stress, but no differences were observed in antioxidant levels, even after orchiectomy. This indicates that most likely an increased generation of oxidative products takes place in these patients.
Descritores: Sêmen/enzimologia
Neoplasias Testiculares/metabolismo
Peroxidação de Lipídeos/fisiologia
Seminoma/metabolismo
Antioxidantes/metabolismo
-Oligospermia
Contagem de Espermatozoides
Superóxido Dismutase/metabolismo
Neoplasias Testiculares/cirurgia
Orquiectomia
Catalase/metabolismo
Estudos de Casos e Controles
Estudos Transversais
Estresse Oxidativo/fisiologia
Análise do Sêmen
Glutationa Peroxidase/metabolismo
Pessoa de Meia-Idade
Limites: Humanos
Masculino
Adolescente
Adulto
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-975645
Autor: Bernstein, Ari P; Fram, Ethan B; North, Amanda; Casale, Anthony; Drzewiecki, Beth A.
Título: Does total testicular volume predict testicular volume difference in adolescent males with varicocele?
Fonte: Int. braz. j. urol;44(5):981-986, Sept.-Oct. 2018. tab, graf.
Idioma: en.
Resumo: ABSTRACT Introduction: We evaluated the relationship between total testicular volume (TTV) and testicular volume differential (TVD) in adolescent males with varicocele. Both low TTV and high TVD have been independently associated with higher incidences of infertility later in life, but a predictive relationship between TTV and TVD directly has yet to be described. Materials and Methods: We retrospectively analyzed a database of Tanner 5 boys ages 16-21 who presented with varicocele at a single institution between 2009 and 2017. All patients had a scrotal sonogram prior to surgical intervention. TTV and TVD were calculated for each individual and four non-exclusive groupings of patients were created for statistical analysis. We chose 30 cc as a cut off value for low TTV based on prior studies. Results: 209 patients met our inclusion criteria. Mean age was 18.3 years (16-21, SD 1.7) with a mean total testicular volume of 36 cc (13.5-78.2, SD 11.1). Cut off points of TVD of 20% and TTV of 30 cc were used to separate patients. There were 65 boys (31%) with TTV < 30 cc and 58 boys (28%) with TVD ≥ 20%. Among males with TTV < 30 cc, 23 (35%) had a TVD ≥ 20%. Among males with TTV ≥ 30 cc, 35 (24%) had a TVD ≥ 20%. The relationship between TVD and TTV was found to be non-significant (p > 0.05). Discussion: Adolescent varicoceles continue to pose a challenge to pediatric urologists. The dilemma of over-aggressive treatment has proven difficult to balance with the risk of infertility. We hoped that elucidating the relationship between TTV and TVD could be useful in identifying patients who are at greater risk for infertility while decreasing the need for more intrusive testing, such as semen analysis, in an adolescent population. We looked at the direct relationship between low TTV and high TVD. In our population, there was a non-significant relationship between TTV < 30 cc and TVD ≥ 20% (p > 0.05) indicating that in adolescents with varicocele, TTV and TVD are independent variables. Our study limitations include the inherent user dependent bias of ultrasound measurements and data collection at a single institution with high ethnic diversity, possibly not comparable to all patient populations. Conclusions: Low TTV (< 30 cc) itself is not predictive of high TVD (≥ 20%) in adolescent boys with varicocele, despite their reported independent associations with impaired fertility in other studies.
Descritores: Motilidade Espermática/fisiologia
Testículo/patologia
Varicocele/patologia
-Tamanho do Órgão
Testículo/fisiopatologia
Testículo/diagnóstico por imagem
Varicocele/fisiopatologia
Índice de Gravidade de Doença
Estudos Retrospectivos
Análise do Sêmen
Limites: Humanos
Masculino
Adolescente
Adulto Jovem
Responsável: BR1.1 - BIREME


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Id: biblio-954068
Autor: Zhang, Xinyue; Zhang, Hongguo; Hu, Cong; Wang, Ruixue; Xi, Qi; Liu, Ruizhi.
Título: Clinical features of carriers of reciprocal chromosomal translocations involving chromosome 2: report of nine cases and review of the literature
Fonte: Int. braz. j. urol;44(4):785-793, July-Aug. 2018. tab.
Idioma: en.
Projeto: National Natural Science Foundation of China.
Resumo: ABSTRACT Objective: To explore the clinical features of carriers of chromosome 2 translocations, enabling informed genetic counseling of these patients. Materials and Methods: Eighty-two male carriers of a translocation who were infertile or receiving fertility counseling were recruited. Cytogenetic analyses were performed using G-banding. A search of PubMed was performed to determine whether the identified translocations on chromosome 2 are involved in male infertility. The relationships of translocation breakpoints with male infertility and recurrent pregnancy loss were analyzed. Results: Of the 82 translocation carriers, 9 (11%) were carriers of a chromosome 2 translocation. Four cases had oligozoospermia or infertility, while five had normal semen. In an analysis of the literature, 55 patients who were carriers of chromosome 2 translocations were also reviewed. Breakpoints at 2p13 and 2q31 were observed in six patients each, and were the most common. Breakpoints at 2p23, 2p13, 2p11.2, 2q31, and 2q37 were associated to both pre-gestational and gestational infertility, while other breakpoints were associated with gestational infertility. Conclusions: All breakpoints at chromosome 2 were correlated with gestational infertility. Carriers of chromosome 2 translocations should therefore receive counseling to continue with natural conception and use of different technologies available via assisted reproductive technology, such as preimplantation genetic diagnosis.
Descritores: Translocação Genética/genética
Cromossomos Humanos Par 2/genética
Infertilidade Masculina/genética
-Padrões de Referência
Resultado da Gravidez
Análise Citogenética
Análise do Sêmen
Pontos de Quebra do Cromossomo
Aconselhamento Genético
Triagem de Portadores Genéticos
Limites: Humanos
Masculino
Feminino
Gravidez
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: biblio-952818
Autor: Oliveira, Francisco Barros de; Pereira, Vadelias Xavier; Oliveira, Fernando Rocha; Abreu, Luiz Carlos de; Daboin, Blanca Elena Guerrero; Norberto, Alex Rey; Alcantara Sousa, Luiz Vinicius de; Tavares, Luis Fernando B; Glina, Sidney.
Título: Effect of ductus deferens lavage on the time to achieve azoospermia in patients undergoing vasectomy
Fonte: Clinics;73:e504, 2018. tab, graf.
Idioma: en.
Resumo: OBJECTIVE: To evaluate the effect of normal saline lavage of the distal vas deferens ampulla in patients undergoing vasectomy on the time to achieve azoospermia. METHODS: A prospective randomized study of 60 men divided into two groups, group lavage (GL, n=30) in which distal vas deferens ampulla lavage was performed with 10 ml of normal saline during the vasectomy, and group without lavage (GWL, n=30) in which control patients received only a vasectomy. The patients provided sperm for semen analysis at the 5th, 10th, 15th, 20th and 25th ejaculations. RESULTS: Fifteen participants in GL and 16 in GWL, for a total of 31 patients, were excluded due to not completing the control spermiogram. The tests carried out at the five ejaculations showed immobile spermatozoa in 40 and 85.71%, 66.67 and 78.57%, 93.33 and 85.71%, 86.67 and 71.43%, and 93.33 and 85.71% of participants in GL and GWL, respectively. CONCLUSION: Vas deferens duct lavage with 10 ml of normal saline during vasectomy did not decrease the time required to achieve postoperative azoospermia.
Descritores: Contagem de Espermatozoides
Ducto Deferente/cirurgia
Vasectomia/métodos
Cloreto de Sódio/administração & dosagem
Azoospermia
-Estudos Prospectivos
Análise do Sêmen
Irrigação Terapêutica/métodos
Limites: Humanos
Masculino
Adulto
Tipo de Publ: Ensaio Clínico Controlado Aleatório
Responsável: BR1.1 - BIREME


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Id: biblio-1056368
Autor: Esteves, Sandro C.
Título: Are specialized sperm function tests clinically useful in planning assisted reproductive technology?
Fonte: Int. braz. j. urol;46(1):116-123, Jan.-Feb. 2020. graf.
Idioma: en.
Resumo: CASE STUDY 40-year-old male patient and 32-year-old female partner, with a history of primary infertility of two years duration. The workup revealed idiopathic mild oligoasthenotheratozoospermia, and no apparent female infertility factors. The couple has failed three intrauterine insemination (IUI) cycles, planning more IUI cycles but also considering in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI).
Descritores: Espermatozoides/patologia
Estresse Oxidativo
Injeções de Esperma Intracitoplásmicas/métodos
-Oligospermia/patologia
Espermatozoides/fisiologia
Reprodutibilidade dos Testes
Análise do Sêmen/métodos
Fertilização/fisiologia
Limites: Humanos
Masculino
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-1154505
Autor: Xavier, Rosana; Carvalho, Renata Cristina de; Fraietta, Renato.
Título: Semen quality from patients affected by seminomatous and non-seminomatous testicular tumor
Fonte: Int. braz. j. urol;47(3):495-502, May-June 2021. tab, graf.
Idioma: en.
Resumo: ABSTRACT Testicular cancer is considered a rare disease affecting approximately 1% to 2% of the male population. This neoplasm has a cure rate of over 95%; as a result, a major concern is the future of fertility of carriers from this disease. There are several histological subtypes of testicular tumors; however, the Testicular Germ Cell Tumors (TGCTs), comprising both seminoma and non-seminoma tumors, are considered the main subtypes of testicular neoplasms. TGCT are characterized by being a solid tumor that mostly affects young men aged between 15 and 40 years old. While TGCT subtypes may have an invasive potential, seminoma subtype does not affect other cells rather than germ cells, while non-seminomas have more invasive properties and can achieve somatic cells; thus, having a more aggressive nature. This research intends to review the literature regarding information about sperm parameters, correlating the data found in those studies to the subfertility and infertility of patients with TCGTs. Furthermore, it will also correlate the data to the non-seminoma and seminoma histological subtypes from pre- and post-cancer therapy. PubMed databases were used. Searched keywords included: seminoma AND non-seminoma; male infertility; germ cell tumor; chemotherapy AND radiotherapy. Only articles published in English were considered. Current studies demonstrate that both TGCT subtypes promote deleterious effects on semen quality resulting in decreased sperm concentration, declined sperm total motility and an increase in the morphology alterations. However, findings suggest that the non-seminoma subtype effects are more pronounced and deleterious. More studies will be necessary to clarify the behavior of seminoma and non-seminoma tumors implicating the reproductive health of male patients.
Descritores: Neoplasias Testiculares/terapia
Seminoma
Neoplasias Embrionárias de Células Germinativas/terapia
-Espermatozoides
Análise do Sêmen
Limites: Humanos
Masculino
Adolescente
Adulto
Adulto Jovem
Tipo de Publ: Revisão
Responsável: BR1.1 - BIREME


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Id: lil-788911
Autor: Puerta Suárez, Jenniffer; Cardona Maya, Walter D.
Título: Evaluación in vitro del efecto de Neisseria gonorrhoeae y los factores solubles producto de su metabolismo sobre la calidad espermática / In vitro evaluation of the effect of Neisseria gonorrhoeae and the soluble factors produced by its metabolism on sperm quality
Fonte: Rev. chil. obstet. ginecol;81(3):211-217, jun. 2016. ilus.
Idioma: es.
Resumo: AANTEDENTES: N. gonorrhoeae es una de las principales causas de uretritis, prostatitis y epididimitis en hombres. En el tracto urogenital masculino, esta bacteria o los factores solubles producto de su metabolismo pueden interactuar con los espermatozoides y alterar su calidad. OBJETIVOS: Determinar el efecto de la incubación in vitro de N. gonorrhoeae y los factores solubles producto de su metabolismo sobre la calidad espermática y evaluar la interacción bacteria-espermatozoide. MÉTODO: Se realizó incubación de una concentración 0,5 McFarland de N. gonorrhoeae y de los factores solubles producto de su metabolismo bacteriano con muestras de semen de voluntarios aparentemente sanos. Se cuantificaron los parámetros espermáticos convencionales (movilidad y viabilidad) y funcionales (potencial de membrana mitocondrial, integridad y lipoperoxidación de la membrana espermática, detección de especies reactivas del oxígeno, integridad de la cromatina y expresión de Anexina V), empleando microscopía y citometría de flujo, respectivamente. Para evaluar la interacción de N. gonorrhoeae con los espermatozoides humanos se realizaron extendidos en placas para su observación al microscopio. RESULTADOS: N. gonorrhoeae puede unirse al espermatozoide y disminuir la viabilidad espermática luego de 1,5 horas de incubación con los espermatozoides humanos (84,5% vs 66,5%, p<0,05), sin afectar los parámetros espermáticos funcionales. CONCLUSIÓN: N. gonorrhoeae interactúa con los espermatozoides humanos afectando la viabilidad espermática.

BACKGROUND: N. gonorrhoeae is a major cause of urethritis, prostatitis and epididymitis in men. In the male urogenital tract, the bacteria or soluble products of their metabolism may interact with sperm, and alter their quality. AIMS: To determine the in vitro effect of incubation of N. gonorrhoeae and soluble products of their metabolism on sperm quality and assess the bacteria-sperm interaction. METHODS: Soluble products of bacterial metabolism and 0.5 McFarland concentration of N. gonorrhoeae were incubated with semen samples from healthy volunteers. Conventional (motility and viability) and functional sperm parameters (potential of mitochondrial membrane integrity and sperm membrane lipid peroxidation, detection of reactive oxygen species, chromatin integrity and expression of annexin V) were quantified using microscopy and cytometry flow, respectively. To assess the interaction of N. gonorrhoeae to human sperm microscopic observation was performed. RESULTS: N. gonorrhoeae can join the sperm and decreases sperm viability after 1.5 hours of incubation with human sperm (84.5% vs 66.5%, p<0.05), without affecting the functional sperm parameters. CONCLUSION: N. gonorrhoeae interacts with human sperm affecting sperm viability.
Descritores: Solubilidade
Espermatozoides/microbiologia
Análise do Sêmen
Neisseria gonorrhoeae/metabolismo
-Motilidade Espermática/fisiologia
Técnicas In Vitro
Citometria de Fluxo
Neisseria gonorrhoeae/fisiologia
Limites: Humanos
Masculino
Responsável: CL1.1 - Biblioteca Central


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Texto completo SciELO Chile
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Id: lil-759066
Autor: Galarzo Pardo, Sebastián; Cano Cháves, Maria Alejandra; Puerta Suarez, Jennifer; Giraldo, Mariluz; Mayorga, B. José Manuel; Cadavid, Ángela P; Cardona Maya, Walter.
Título: Efecto de los factores solubles de Staphylococcus aureus, Staphylococcus capitis y Staphylococcus epidermidis sobre la funcionalidad espermática / Effect of soluble factors of Staphylococcus aureus, Staphylococcus capitis and Staphylococcus epidermidis on sperm functionality
Fonte: Rev. chil. obstet. ginecol;80(4):316-323, ago. 2015. ilus, tab.
Idioma: es.
Projeto: Colciencias; . Universidad de Antioquia. Estrategia de Sostenibilidad 2014-2015, Grupo Reproducción.
Resumo: ANTECEDENTES: La interacción entre los espermatozoides con algunas especies bacterianas o sus factores solubles influyen en el deterioro de la calidad seminal, alterando la función reproductiva del hombre. OBJETIVO: El objetivo de este trabajo fue determinar el efecto de los factores solubles de Staphylococcus aureus, Staphylococcus capitis y Staphylococcus epidermidis sobre la calidad seminal. MÉTODO: Los factores solubles producto del metabolismo bacteriano de las cepas de S. aureus y S. Capitis sensible a oxacilina y S. aureus y S. Epidermidis resistente a oxacilina se incubaron con las muestras de semen de 20 voluntarios y se cuantificaron los parámetros seminales convencionales y funcionales por microscopía y citometría de flujo, respectivamente. RESULTADOS: Se observó una disminución en la movilidad espermática con los factores solubles de S. aureus, esta disminución fue mayor con la cepa sensible y el efecto negativo sobre la movilidad fue inmediato. Al incubar los espermatozoides con los factores solubles de S. aureus sensible a oxacilina, se afectaron todos los parámetros funcionales excepto la integridad de la cromatina y se observó menor liberación de especies reactivas de oxígeno; con los factores solubles de la cepa de S. aureus resistente a oxacilina se observó una disminución en la lipoperoxidación de membrana y en la expresión de anexina V. CONCLUSIÓN: Este estudio da cuenta del efecto negativo de los factores solubles de la bacteria S. aureus tanto sensible como resistente a oxacilina sobre los parámetros espermáticos convencionales y funcionales, y por ende en su función reproductiva.

BACKGROUND: The interaction between sperm with some bacteria species and their soluble factors are the deterioration of semen quality by altering the reproductive function of man. AIM: The aim of this study was to determine the effect of soluble factors Staphylococcus aureus, Staphylococcus epidermidis and Staphylococcus capitis on semen quality. METHODS: The soluble factors product of bacterial metabolism of the strains of S. aureus and S. capitis methicillin sensitive and S. aureus and S. epidermidis resistant to oxacillin, were incubated with semen samples from 20 volunteers. Subsequently, conventional seminal parameters were measured and functional quantified by microscopy and flow cytometry, respectively. RESULTS: A decrease was observed in sperm motility with soluble factors of S. aureus, this decrease was higher with the sensitive strain that with oxacillin resistant strain and the negative effect on motility was immediate. By incubating the sperm with soluble factor from oxacillin-sensitive S. aureus, all functional parameters were affected except the chromatin integrity and reduced release of reactive oxygen species, mean fluorescence intensity in oxacillin resistant S. aureus strain was decrease in membrane lipid peroxidation and annexin V expression. CONCLUSIONS: This study reports the negative effect of soluble factors of bacteria either S. aureus sensitive and resistant to oxacillin, over conventional and functional sperm parameters, and therefore in their reproductive function.
Descritores: Espermatozoides/metabolismo
Espermatozoides/microbiologia
Staphylococcus aureus/metabolismo
Staphylococcus epidermidis/metabolismo
Análise do Sêmen
Staphylococcus capitis/metabolismo
-Sêmen/metabolismo
Sêmen/microbiologia
Solubilidade
Motilidade Espermática/fisiologia
Bactérias/metabolismo
Peroxidação de Lipídeos
Espécies Reativas de Oxigênio
Potencial da Membrana Mitocondrial
Citometria de Fluxo
Limites: Humanos
Masculino
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1024900
Autor: Sertão, Agatha Thais; Machado, Nancy França Rehem.
Título: Controle externo da qualidade em espermograma: avaliação do desempenho de laboratórios clínicos participantes de dois provedores de ensaio de proficiência / External quality control in spermogram: performance evaluation of participating clinical laboratories of two proficiency testing providers
Fonte: Rev. bras. anal. clin;51(2):120-126, 20191011. tab, graf.
Idioma: pt.
Resumo: Objetivo: Identificar os parâmetros com maior incidência de erros no programa de controle de qualidade externo em espermograma e descrever o panorama da participação dos laboratórios brasileiros em ensaios de proficiência para espermograma. Métodos: Trata-se de um estudo descritivo, retrospectivo de análise de dados com abordagem quantitativa que descreve e avalia o desempenho de laboratórios de análises clínicas participantes do Programa Nacional de Controle de Qualidade (PNCQ) e Controllab entre os anos de 2010 ­ 2017. Resultados: Os resultados obtidos revelaram que até o momento existe um total de 273 participantes de controle externo da qualidade na especialidade de espermograma e, quando comparado com o total de laboratórios de análises clínicas no Brasil (20.800), esse percentual é de 1,3%. Em ambos os programas, o maior percentual de erros foi na análise da concentração espermática com 12,6% (PNCQ) e 20,7% Controllab) e esses dados podem inferir as deficiências de padronização na contagem espermática. Conclusão: Esses resultados apontam para um déficit de participação, que, apesar de não poder ser estatisticamente comprovado, alerta para a nula participação de alguns estados. Os ensaios de proficiência associados ao treinamento constante do pessoal do laboratório são importantes medidas em atenção à qualidade da análise seminal.

Objective: To identify the parameters with higher incidence of errors in the program of external quality control in spermogram and to describe the panorama of the participation of the Brazilian laboratories in tests of proficiency for spermogram. Methods: This is a descriptive, retrospective study of data analysis with a quantitative approach that describes and evaluates the performance of clinical analysis laboratories participating in the National Quality Control Program (PNCQ) and Controllab between the years 2010 - 2017. Results: The results show that up to now there are 273 participants of external quality control in the specialty of sperm
Descritores: Controle de Qualidade
Contagem de Espermatozoides
Análise do Sêmen
Melhoria de Qualidade
Ensaio de Proficiência Laboratorial
Limites: Humanos
Masculino
Responsável: BR408.1 - Biblioteca da Faculdade de Medicina - BFM



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