Skip to main content Accessibility help
×
Home
Hostname: page-component-888d5979f-lv79x Total loading time: 0.959 Render date: 2021-10-26T16:35:08.239Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

Chapter 5 - Andrology and Infertility

Published online by Cambridge University Press:  25 February 2021

Siladitya Bhattacharya
Affiliation:
University of Aberdeen
Mark Hamilton
Affiliation:
University of Aberdeen
Get access

Summary

Reproductive problems in the male contribute significantly to subfertility in heterosexual couples but can also impact on the ability of single or homosexual men to take part in donation or surrogacy. The main causes of reproductive problems in males can be classified as either (1) pre-testicular (those affecting the regulatory hormonal pathway); (2) testicular (those which relate to impaired testicular function); and (c) post-testicular, where there is a blockage of the male genital tract or other problems with associated ejaculation or sperm delivery; however, it is possible that there can be more than one cause. The main diagnostic procedures include physical examination, followed by semen analysis and, in some instances, endocrine tests (follicle-stimulating hormone and testosterone), genetic tests (karotyping, Y chromosome microdeletion testing and cystic fibrosis testing) and radiological investigations. In the case of secondary hypogonadism, medical treatment with human chorionic gonadotropin can improve sperm quality but in the majority of azoospermic men only various surgical interventions to recover sufficient sperm for intracytoplasmic sperm injection are of proven value.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

El Osta, R, Almont, T, Diligent, C, Hubert, N, Eschwège, P, Hubert, J. Anabolic steroids abuse and male infertility. Basic Clin Androl. 2016;26:2. DOI: 10.1186/s12610-016-0029-4.Google ScholarPubMed
Eley, A, Pacey, AA, Galdiero, M, Galdiero, M, Galdiero, F. Can Chlamydia trachomatis directly damage your sperm? Lancet Infect Dis. 2005;5:53–7.Google ScholarPubMed
Povey, AC, Clyma, JA, McNamee, R, Moore, HD, Baillie, H, Pacey, AA, Cherry, NM; Participating Centres of Chaps-UK. Modifiable and non-modifiable risk factors for poor semen quality: a case referent study. Hum Reprod. 2012;27:2799–806.CrossRefGoogle ScholarPubMed
World Health Organization. WHO laboratory manual for the examination and processing of human semen, 5th ed. Geneva: World Health Organization; 2010.Google Scholar
Tomlinson, M, Lewis, S, Morroll, D; British Fertility Society. Sperm quality and its relationship to natural and assisted conception: British Fertility Society guidelines for practice. Hum Fertil (Camb). 2013;16:175–93. DOI: 10.3109/14647273.2013.807522.Google Scholar
Pacey, A. Is sperm DNA fragmentation a useful test that identifies a treatable cause of male infertility? Best Pract Res Clin Obstet Gynaecol. 2018;53:1119.CrossRefGoogle ScholarPubMed
Prior, M, Stewart, J, McEleny, K, Dwyer, AA, Quinton, R. Fertility induction in hypogonadotropic hypogonadal men. Clin Endocrinol (Oxf). 2018;89:712–18.CrossRefGoogle ScholarPubMed
Smits, RM, Mackenzie-Proctor, R, Yazdani, A, Stankiewicz, MT, Jordan, V, Showell, MG. Antioxidants for male subfertility. Cochrane Database Syst Rev. 2019;(3): CD007411. DOI: 10.1002/14651858.CD007411.pub4.Google Scholar
Yan, S, Shabbir, M, Yap, T, Homa, S, Ramsay, J, McEleny, K, Minhas, S. Should the current guidelines for the treatment of varicoceles in infertile men be re-evaluated? Hum Fertil (Camb). 2019; (in press).CrossRefGoogle Scholar
Veltman-Verhulst, SM, Hughes, E, Ayeleke, RO, Cohlen, BJ. Intra-uterine insemination for unexplained subfertility. Cochrane Database Syst Rev. 2016;Feb 19;(2):CD001838. DOI: 10.1002/14651858.CD001838.pub5.Google Scholar

Send book to Kindle

To send this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Send book to Dropbox

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Dropbox.

Available formats
×

Send book to Google Drive

To send content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about sending content to Google Drive.

Available formats
×