An Introduction to Male Reproductive Medicine

Half-title......Page 3
Title......Page 5
Copyright......Page 6
Contents......Page 7
Contributors......Page 8
Preface......Page 9
Anatomy......Page 11
Embryology......Page 14
Feedback regulation......Page 15
Downregulation, upregulation, and desensitization......Page 16
Gonadotropin-releasing hormone......Page 17
Gonadotropins......Page 19
Testicular factors......Page 20
Spermatogenic cycles......Page 22
Role of Sertoli cells......Page 26
Hormonal control of spermatogenesis......Page 27
Biosynthesis......Page 28
Transport......Page 31
Mechanism of androgen action......Page 32
Epididymis......Page 33
Ejaculation......Page 35
Brief excursion into sperm-egg interaction......Page 36
References......Page 37
Why evaluate the male?......Page 39
Male reproductive history......Page 40
History of spermatotoxicity......Page 41
History of infectious disease......Page 42
Sexual history......Page 43
The male physical exam......Page 44
Examining the testis......Page 47
Examining the spermatic cord......Page 49
Semen analysis......Page 51
Azoospermia......Page 53
Semen volume......Page 54
Sperm motility......Page 56
Sperm morphology......Page 57
Leukocytes......Page 58
Endocrine assays......Page 59
Assays of steroidogenesis......Page 60
Genetic assays......Page 62
Oligoasthenospermia......Page 63
Asthenospermia......Page 64
Normozoospermia......Page 65
Wrapping up......Page 66
References......Page 0
Varicocele and varicocelectomy......Page 68
Obstructive azoospermia......Page 72
Congenital bilateral absence of the vas deferens......Page 73
Ejaculatory duct obstruction......Page 74
Vasal occlusion......Page 75
Spermatogenic dysfunction......Page 79
Anejaculation......Page 81
Vasectomy......Page 84
Introduction......Page 87
Medications and substances to avoid among men seeking to establish a pregnancy......Page 88
Infections......Page 89
Androgen replacement therapy......Page 90
Use of clomiphene citrate before testis biopsy......Page 91
Empiric non-surgical therapy for male infertility......Page 92
Infections of the male reproductive tract......Page 94
Urethra......Page 95
Prostate......Page 96
Seminal vesicles......Page 97
Epididymis......Page 98
Leukocytospermia......Page 99
Reactive oxygen species and oxidative stress......Page 101
Antisperm antibodies......Page 102
Antisperm antibodies diagnostic testing......Page 103
Antibiotics......Page 105
Lifestyle modification......Page 106
Antioxidant therapy......Page 107
Immune suppressive therapy......Page 108
Sperm washing with intrauterine insemination or in vitro fertilization......Page 109
Conclusions......Page 110
Numerical chromosomal abnormalities......Page 113
Y-chromosomal anomalies......Page 116
X-chromosomal anomalies......Page 119
Chromosomal anomalies of androgen metabolism and signaling......Page 120
Other single gene mutations......Page 123
Epigenetics......Page 125
DNA repair and recombination errors......Page 126
Anomalies of mitochondrial DNA......Page 127
Acknowledgment......Page 128
7 Semen: analysis and processing......Page 139
Abstinence and collection......Page 140
Laboratory analysis......Page 141
Sperm morphology......Page 142
Normal ranges......Page 143
Other tests of male fertility potential......Page 145
Sperm processing: intrauterine insemination and assisted reproductive technologies\n......Page 146
Cryopreservation of ejaculated and testicular sperm......Page 149
Summary and conclusions......Page 150
8 What to know about the infertile female......Page 152
Causes of infertility......Page 153
How do we test for ovulation?......Page 154
Elevated prolactin level......Page 156
Obesity-related anovulation......Page 157
Limitations of testing......Page 158
What can lead to damaged fallopian tubes or pelvic adhesions?......Page 159
What is the best treatment for tubal damage?......Page 160
Endometriosis......Page 161
Inadequate endometrial development or \"luteal phase defect\"\n......Page 162
Unexplained infertility......Page 163
Gonadotropin injections......Page 164
Steps in the in vitro fertilization process......Page 165
Other treatments available with in vitro fertilization include......Page 166
Lifestyle recommendations for improved fertility......Page 168
Index......Page 170