الفهرس 
ACKNOWLEDGEMENT
EtiologyOnly 14 pages are availabe for public view
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Abstract
Male infertility is a common problem in diabetic patients. The effects of diabetes mellitus include long-term damages, dysfunctions, and failures of male reproductive system. Erectile and ejaculatory difficulties arise due to vascular and neuropathic problems. there is also some evidence that spermatogenesis is affected by diabetes and that patients have a reduced sperm motility and semen volume. Therefore, diabetes has a significant impact on the fertility of men with this disease both directly and indirectly (Glenn DR et al., 2003).
This study was directed to detect the impact of HbA1C level on:
1-Semen parameters.
2- Reproductive hormones.
This study was carried out in Assiut University Hospital (Department of Dermatology ,Venereology &Andrology and diabetes clinic) during the period from from April 2016 to September 2017 on (100) male individuals classified into two groups age and behavior matched
group 1: was include (60) diabetic patient. The mean age of those patients was (43.87±5.92) years and the mean duration of diabetes was (12.15±11.59) years.(47) of the patient with type 2 diabetes and (13) with type 1and( 35) of them take oral medication while the other (25) take insulin.
group 2: was include (40) non diabetic control individuals. The mean age of those group (40.90±8.93).
Each patient was subjected to the following:
A) Medical history
B) Clinical examination
C) CASA.
D) Measurement of serum HbA1C
E) Measurement of serum reproductive hormones (Total Testosterone ,free testosterone, FSH, LH and prolactin )levels.
There is a statistical significant difference between patients and control group in volume , sperm motility, count and abnormal forms .
There is a statistical significant difference between patients and control group in free and total Testosterone, FSH, LH and Prolactin hormones levels.
Statistical analysis between HbA1C and reproductive hormones in patient group showed that there is a Statistically significant negative correlation between HA1C and free Testosterone and Statistically significant positive correlation with prolactin hormones.
On studding the correlation of the duration DM and semen parameters and reproductive hormones there was a statistical significant negative correlation between the duration of DM and the count of sperm Also a statistical significant negative correlation was found between duration of DM and both Free and Total Testosterone . Moreover, a statistical significant positive correlation between duration of DM and FSH and Prolactin hormones.
It was found that the mean of HbA1c was higher in type I DM than in type II also there was a statistical significant difference between type I and type II DM regarding to the count , while there were no statistical significant differences regarding volume, motility and abnormal forms.
Relationship between reproductive hormones and type of DM illustrated that there were statistical significant differences between type I and type II DM regarding to free testosterone, total testosterone and prolactin , while there were no statistical significant differences regarding FSH and LH.
Statistical analysis was performed to study semen parameters and reproductive hormones according to HbA1C level after subdividing the patients to three groups according to the level of HbA1C :
1- HbA1C < 6.5% (goal)
2- HbA1C 6.5-7.9 % ( Good)
3- HbA1C >= 8% ( control)
And the result showed that there was a Statistical significant difference in sperm count, motility ,abnormal forms and LH levels
The present study showed a high prevalence of HbA1c , low serum Free testosterone levels and high serum prolactin level in diabetic male patients.