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All Journal Indonesian Andrology and Biomedical Journal Cermin Dunia Kedokteran
Angellee, Jesselyn
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Health Professions

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Non-obstructive Azoospermia in Male with Y-Chromosome Microdeletion: A Case Report Angellee, Jesselyn; Agustinus, Agustinus; Narulita, Pety; Hartanto, Markus Christian; William, William; Suharyani, Sally
Indonesian Andrology and Biomedical Journal Vol. 5 No. 2 (2024): December
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/iabj.v5i2.64323

Abstract

Male factors have contributed to at least 50% of all infertility cases worldwide. Numerous factors causing male infertility have been identified, one of which is azoospermia due to genetic defects. The detection of Y-chromosome microdeletion may assist in diagnosing male infertility as well as predicting the success rate of testicular sperm extraction. A man in his mid-thirties visited the Andrology outpatient clinic at Dr. Soetomo General Hospital accompanied by his wife. They have been married for eight years and have had regular unprotected sexual intercourse, but pregnancy has never been achieved. The patient’s semen analyses showed azoospermia in three examinations conducted at different times. Follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were significantly increased, and genetic screening showed microdeletion in the Azoospermia Factor b (AZFb) subregion. Y-chromosome microdeletion is the second most common genetic defect causing azoospermia after Klinefelter syndrome. The AZF region in the distal part of the Y chromosome plays a key role in regulating spermatogenesis. Mutation or loss of any subregions in this factor may affect spermatogenesis, with the worst outcome being azoospermia. Detailed examinations are important to determine the cause of azoospermia, which may assist a physician in choosing the appropriate management for this condition. Infertile men with Y-chromosome microdeletion face challenges in reproducing naturally. They may also need genetic counseling regarding the possibility of passing on this genetic defect to their offspring and information on how to prevent it.
Exploring the Interplay of Mental and Metabolic Factors in Erectile Dysfunction Management: A Case Report Angellee, Jesselyn; Suharyani, Sally; Tanojo, Tjahjo Djojo; Pakpahan, Cennikon; William, William; Utomo, Natasha Susanto
Indonesian Andrology and Biomedical Journal Vol. 6 No. 1 (2025): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/iabj.v6i1.66725

Abstract

Background: Erectile dysfunction (ED) affects 20-50% of men globally and considerably diminishes the patients’ and their partners’ quality of life. This condition has multifactorial causes, including depression and metabolic syndrome, resulting in a complicated interaction of physical and psychological components. Case: A man in his mid-twenties presented to the Andrology outpatient clinic at Dr. Soetomo General Hospital with a sudden onset of ED, reporting a decrease in his Erection Hardness Score (EHS) from 3-4 to 1 following penetration attempts. He had a history of childhood attention deficit hyperactivity disorder (ADHD) and recent unemployment, resulting in profound depression. Prior inconsistent treatments encompassed sertraline, fluvoxamine, and clobazam. Physical and laboratory examinations revealed metabolic syndrome. The patient was diagnosed with severe ED secondary to mixed etiology, class II obesity, major depressive episode, and metabolic syndrome. He received education on the diagnosis, possible underlying causes, and management options. Discussion: The case presented illustrates the intricate interplay between ED and comorbidities such as depression and metabolic syndrome. Depression exacerbates ED through hormonal dysregulation and reduced parasympathetic activity, while metabolic syndrome contributes to ED through endothelial dysfunction and nitric oxide (NO) depletion. Effective ED management requires a multidisciplinary approach, combining lifestyle modifications, psychological support, and pharmacological treatment. Tailored strategies addressing both physical and psychological aspects are essential for improving outcomes. Conclusion: Comprehensive and integrative care in managing ED, particularly when associated with complex comorbidities, is needed to enhance the patient’s erectile function and quality of life.
Sindrom Putus Steroid Anabolik Androgenik: Tinjauan untuk Praktisi Kesehatan: Tinjauan Pustaka -, William; Angellee, Jesselyn
Cermin Dunia Kedokteran Vol 53 No 01 (2026): Kedokteran Umum
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i01.1680

Abstract

The non-medical use of anabolic androgenic steroid (AAS) has significantly increased among athletes, bodybuilders, and individuals who focus on physical performance as well as body aesthetics. Although AAS has certain therapeutic benefits, use outside of medical supervision can lead to AAS withdrawal syndrome. This condition is characterized by physical and psychological symptoms, such as fatigue, decreased libido, anxiety, depression, and sleep disturbances. Its primary mechanism is the suppression of the hypothalamic–pituitary–gonadal (HPG) axis, which reduces endogenous testosterone production after discontinuation of AAS. Disruption of this axis not only decreases endogenous testosterone production but also alters gonadotropin hormone dynamics and androgen receptor responsiveness. Several risk factors, such as high doses, prolonged duration of use, specific usage patterns (cycling, stacking, pyramiding), and a history of psychological disorders, may exacerbate withdrawal symptoms. Management of AAS withdrawal syndrome includes short-term hormonal therapy, agents that stimulate endogenous testosterone production, psychological interventions, and physical rehabilitation. A multidisciplinary approach and close medical monitoring are required to restore endocrine function, prevent complications, and improve the patient’s psychological well-being. This paper provides a comprehensive overview to assist healthcare practitioners in recognizing, diagnosing, and appropriately managing AAS withdrawal syndrome.
Co-Authors -, William Agustinus Agustinus Hartanto, Markus Christian Narulita, Pety Pakpahan, Cennikon Suharyani, Sally Tanojo, Tjahjo Djojo Utomo, Natasha Susanto William William