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5 results

  • Chapter 9 - The Mechanistic and Predictive Utility of Sperm Epigenetics

  • from Section 2 - The Biology of Male Reproduction and Infertility
  • Edited by Douglas T. Carrell, Utah Center for Reproductive Medicine, Alexander W. Pastuszak, University of Utah, James M. Hotaling, Utah Center for Reproductive Medicine
  • Book:
    Men's Reproductive and Sexual Health Throughout the Lifespan
    Published online:
    06 December 2023
    Print publication:
    16 November 2023, pp 76-80

  • Summary

    For many years sperm epigenetics has been a focus of studies hoping to identify novel mechanisms that drive infertility and offspring health abnormalities. This effort has yielded many exciting prospects but to date no direct and firm mechanistic pathways have been fully elucidated. This is largely a result of the unique nature of the mature sperm that is reflected in the distinct epigenetic signatures that are found therein. This unique landscape makes traditional approaches for understanding mechanisms difficult. However, the utility of sperm epigenetic marks in the prediction of specific reproductive outcomes is becoming clearer. While the mechanisms that explain the biological underpinnings of some of the associations between sperm epigenetics and reproductive health have yet to be elucidated, the value that these marks offer in prediction of various reproductive outcomes is becoming clearer.

  • Chapter 7 - Surgical and Nonsurgical Sperm Retrieval Techniques in Patients with Ejaculatory Dysfunctions

  • from Part II - Sperm Retrieval
  • Edited by Ashok Agarwal, Ahmad Majzoub, Sandro C. Esteves
  • Book:
    Manual of Sperm Retrieval and Preparation in Human Assisted Reproduction
    Published online:
    09 April 2021
    Print publication:
    10 June 2021, pp 44-55

  • Summary

    There is a complex interplay between male sexual dysfunction and male factor infertility, including ejaculatory dysfunctions which are the most common male sexual dysfunction. It is divided into four categories: premature ejaculation (PE), delayed ejaculation (DE), retrograde ejaculation (RE), and anejaculation/anorgasmia (AE). Unfortunately, some of these ejaculatory dysfunctions are less studied and not as well understood. Various pharmacologic treatments and surgical procedures can be offered for patients with ejaculatory dysfunctions seeking fertility. These include the off-label use of SSRIs (selective serotonin reuptake inhibitors) for PE, surgical (testicular sperm aspiration, testicular sperm extraction, and microsurgical epididymal sperm aspiration) and nonsurgical methods (medications, positive predictive value, and electroejaculation) for patients with RE and AE. The interaction between chemical impulses and the modulation of the ejaculation process in an individual patient is necessary to conclude the clinical status of the patient and feasibility of the available treatment techniques. Ultimately, this can help in deciding the best sperm retrieval technique to increase pregnancy outcomes.

  • Chapter 18 - Laboratory techniques in IVF

  • Edited by Gab Kovacs
  • Book:
    The Subfertility Handbook
    Published online:
    06 December 2010
    Print publication:
    11 November 2010, pp 193-210

  • Summary

    Donor insemination (DI) remains a very important treatment option with acceptable pregnancy rates. In order to optimize pregnancy rates with DI, careful consideration should be given to various aspects of this service, including the recruitment and screening of sperm donors, cryopreservation of semen, and the screening and management of recipients. This chapter examines these important aspects of treatment to consider how to optimize DI services in the future. Treatment using DI was initially designed to treat male factor infertility. However, DI remains a therapeutic option for male factor infertility when either too few or no sperm are obtained at surgical sperm aspiration. With the advent of intracytoplasmic sperm injection (ICSI) many assumed that DI would become a very limited treatment. Although the numbers of cycles have reduced considerably there has been an increasing trend for DI to be used for other groups of patients such as single women and lesbians.

  • 20 - Male Factor Infertility: State of the ART

  • from PART II - INFERTILITY EVALUATION AND TREATMENT
  • Edited by Botros R. M. B. Rizk, University of South Alabama, Juan A. Garcia-Velasco, Hassan N. Sallam, Antonis Makrigiannakis, University of Crete
  • Book:
    Infertility and Assisted Reproduction
    Published online:
    04 August 2010
    Print publication:
    15 September 2008, pp 178-186

  • Summary

    Rational treatment of the infertile male requires a correct and complete etiological diagnosis. Varicocele develops during puberty, and it is the most common cause of male infertility with prevalence varying between 30 and 60 percent. Thermography, endovascular treatment, and transcatheter embolization are treatment options for varicocele patients. Male accessory gland infection (MAGI) may result from infestation by sexually transmitted pathogens. The prevalence of immunological infertility is related to that of the diseases initiating the antibody formation, but it is no more than 5 percent in our population. Idiopathic sperm deficiency probably results from the combination of unfavorable external and lifestyle factors which includes conditions like idiopathic oligozoospermia, asthenozoospermia, or teratozoospermia. Intrauterine insemination (IUI) is an effective mode of treatment but if IUI remains unsuccessful after a maximum of four cycles, intracytoplasmic sperm injection (ICSI) should be recommended.

  • 2 - Clinical assessment and management of the infertile man

  • Edited by Paul Serhal, Caroline Overton
  • Book:
    Good Clinical Practice in Assisted Reproduction
    Published online:
    22 October 2009
    Print publication:
    01 July 2004, pp 19-58

  • Summary

    This chapter deals firstly with the anatomy and physiology of male reproduction, and then gives an account of the aetiology and management of male factor infertility. The male reproductive system consists of the penis, testes, ejaculatory ducts and accessory sex glands. The testis produces the majority (6-7 mg/day) of testosterone, although a small amount is also produced by the adrenal glands. Spermatogenesis and synthesis of testosterone are under control of the anterior pituitary gland. Prior to investigating the infertile male, the clinician must ensure that the female partner has been thoroughly evaluated. The World Health Organization has defined the minimal semen parameters for fertility. These parameters are volume, pH, sperm concentration, total sperm number, motility and morphology. The surgical causes of male infertility include varicocele and cryptorchidism. The infertile male should be managed in a tertiary centre where appropriate facilities exist for microsurgery, assisted conception techniques and cryostorage of sperm.