Book contents
- Infertility in the Male
- Infertility in the Male
- Copyright page
- Contents
- Contributors
- Foreword
- Abbreviations
- Introduction
- Section 1 Scientific Foundations of Male Infertility
- Section 2 Clinical Evaluation of the Infertile Male
- Section 3 Laboratory Diagnosis of Male Infertility
- Chapter 17 Laboratory Evaluation of the Infertile Male
- Chapter 18 Advanced Diagnostic Approaches to Male Infertility
- Chapter 19 Evaluating Defects in Sperm Function
- Chapter 20 Cryopreservation of Sperm – History and Current Practice
- Section 4 Treatment of Male Infertility
- Section 5 Health Care Systems and Culture
- Index
- References
Chapter 18 - Advanced Diagnostic Approaches to Male Infertility
from Section 3 - Laboratory Diagnosis of Male Infertility
Published online by Cambridge University Press: 08 July 2023
Book contents
- Infertility in the Male
- Infertility in the Male
- Copyright page
- Contents
- Contributors
- Foreword
- Abbreviations
- Introduction
- Section 1 Scientific Foundations of Male Infertility
- Section 2 Clinical Evaluation of the Infertile Male
- Section 3 Laboratory Diagnosis of Male Infertility
- Chapter 17 Laboratory Evaluation of the Infertile Male
- Chapter 18 Advanced Diagnostic Approaches to Male Infertility
- Chapter 19 Evaluating Defects in Sperm Function
- Chapter 20 Cryopreservation of Sperm – History and Current Practice
- Section 4 Treatment of Male Infertility
- Section 5 Health Care Systems and Culture
- Index
- References
Summary
Routine semen analysis remains the one laboratory diagnostic test that should be the cornerstone of evaluation of the infertile male. With visual assessment of semen characteristics, namely, color, volume (also may be defined by weight, as recommended by the World Health Organization (WHO) [1]), viscosity, and liquefaction, the analysis proceeds with a strictly defined series of steps using microscopic assessment of sperm agglutination, sperm aggregation, motility, morphology, and sperm concentration. The test provides a wealth of information about spermatogenesis (sperm morphology and count), function of the testis, and the genitourinary tract and glands – production of normal-appearing spermatozoa, acquisition of sperm motility during passage through the epididymis, functions of accessory organs (seminal vesicles and prostate impacting semen volume, liquefaction), including a reflection of androgen action in these tissues/organs, patency and health of the genital tract, and processes of emission and ejaculation. Yet, with few exceptions (no sperm in the ejaculate, complete globozoospermia, or asthenozoospermia), the test cannot be used to distinguish fertile from infertile men [2]. Even in the presence of severe idiopathic oligozoospermia, paternity has been documented without the use of assisted reproductive technology (ART) [3], and studies of large numbers of proven fertile men undergoing vasectomy revealed that about 11 percent of them were severely oligozoospermic who nevertheless fathered children without medical assistance (based upon WHO 3 and WHO 4 criteria; reviewed in [4]). Indeed, although increasing numbers of abnormal semen parameters are associated with a higher risk of infertility in men, for an individual male, it is impossible to predict with certainty whether or not he is infertile, based upon abnormal semen parameters.
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- Information
- Infertility in the Male , pp. 348 - 362Publisher: Cambridge University PressPrint publication year: 2023
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