... Male infertility accounts for 30%-50% of infertile couples (10%-15% of marriages). Both partners should be evaluated for causes of infertility. The causes of male infertility include the following: congenital anomalies (genetic, such as Klinefelter’s syndrome, or developmental, such as absent...
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... The purpose of the male infertility evaluation is to (1) identify and correct the reversible causes of male infertility with the goal of allowing a couple to conceive through intercourse, or with the least amount of technology; (2) identify irreversible conditions that may be amenable to treatment...
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... The causes underlying male infertility are numerous and best categorized by effects at one or more of the following levels: pretesticular, testicular, and posttesticular. ...
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... Beyond the significant psychosocial and marital stress, which is associated with male infertility, several epidemiologic studies have suggested that male infertility may be a marker for overall health. A large, longitudinal Danish study suggested that male fertility may be associated with overall...
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... Infertility is defined as the failure to conceive despite 1 year of regular unprotected intercourse. Approximately 15% of couples will experience infertility, and of these, 20% will have a male factor that is solely responsible; male factors will contribute in an additional 30% of cases...
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... ASAs are a complex problem underlying male infertility. Available treatment options include corticosteroid immune suppression, sperm washing, IUI, IVF, and ICSI. Steroid suppression is based on the concept that the immune system can be weakened to reduce antibodies on sperm; however, this modality...
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... Infertility is defined as failure to conceive after 1 year of normal coital activity without use of contraceptives. About 15% of couples are infertile within this definition. When the etiology of infertility is evaluated, approximately 40% will be attributable to male factor infertility...
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... Table 44–12. Testicular Causes of Infertility. Chromosomal (Klinefelter syndrome [XXY], XX sex reversal, XYY syndrome) Noonan syndrome (male Turner syndrome) Myotonic dystrophy Vanishing testis syndrome (bilateral anorchia) Sertoli-cell-only syndrome (germ cell aplasia...
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... exposure, testicular abnormalities, infertility, and conditions that cause hormonal imbalance (i.e., obesity, cirrhosis) are risk factors in men. 92 The tumor usually presents with a lump or retraction of the skin or nipple and men tend to be diagnosed at a later stage of disease. Histologically...
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... ectopia). The vas deferens may enter the retained Mullerian duct structures accounting for future infertility. ...
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... Laboratory testing is an important part of the male infertility evaluation. ...
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... Table 44–12. Testicular Causes of Infertility. Chromosomal (Klinefelter syndrome [XXY], XX sex reversal, XYY syndrome) Noonan syndrome (male Turner syndrome) Myotonic dystrophy Vanishing testis syndrome (bilateral anorchia) Sertoli-cell-only syndrome (germ cell aplasia...
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... Table 44–14. Posttesticular Causes of Infertility. Reproductive tract obstruction Congenital blockages Congenital absence of the vas deferens (CAVD) Young syndrome Idiopathic epididymal obstruction Polycystic kidney disease Ejaculatory duct obstruction...
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... Nearly a quarter of men evaluated for infertility will not have an identifiable cause. Because the pathophysiology is ill defined, this is termed idiopathic infertility. Additionally, other men in whom an abnormality is identified on semen analysis may have no specific target for therapy. Both...
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... Table 44–11. Pretesticular Causes of Infertility. Hypothalamic disease Gonadotropin deficiency (Kallmann syndrome) Isolated LH deficiency (“fertile eunuch”) Isolated FSH deficiency Congenital hypogonadotrophic syndromes Pituitary disease Pituitary...
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..., with permission, from Zachman M et al: Testicular volume during adolescence: Cross-sectional and longitudinal studies. Helv Paediatr Acta 1974;29:61; and McClure RD: Endocrine investigation and therapy. Urol Clin North Am 1987;14:471.) A complete examination of the infertile male is important to identify...
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... Table 44–4. Components of the Infertility History. Fertility history Previous pregnancies (all partners) Duration of infertility Previous infertility treatments Female evaluation Sexual history Erections Timing and frequency Lubricants...
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