BOOK
Current Management of Male Infertility, An Issue of Urologic, E-Book
(2014)
Additional Information
Book Details
Abstract
Current Management of Male Infertility, An Issue of Urologic, E-Book
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| Current Managementof Male Infertility | i | ||
| Copyright\r | ii | ||
| Contributors | v | ||
| Contents | ix | ||
| Forthcoming Issues | xiii | ||
| Current Management of Male Infertility | xv | ||
| The Field of Male Infertility Moves Fast! | xvii | ||
| Genetics of Male Infertility | 1 | ||
| Key points | 1 | ||
| Introduction | 1 | ||
| Phenotype definitions | 2 | ||
| Genetics background | 4 | ||
| Basic Genetics | 4 | ||
| DNA mutations | 4 | ||
| DNA polymorphisms | 4 | ||
| Genetic Disorders | 4 | ||
| Current genetic tools | 7 | ||
| Congenital Bilateral Absence of the Vas Deferens | 7 | ||
| Karyotype Abnormalities | 8 | ||
| Karyotype | 8 | ||
| 47,XXY KS | 9 | ||
| 46,XX male syndrome | 9 | ||
| Other karyotype abnormalities | 10 | ||
| Y Chromosome Microdeletions | 10 | ||
| Hormone Levels and Epigenetics | 11 | ||
| Hormone levels | 11 | ||
| Epigenetics | 12 | ||
| Genetics of male infertility in 2034 | 12 | ||
| Summary | 13 | ||
| References | 13 | ||
| The Office Visit | 19 | ||
| Key points | 19 | ||
| Introduction | 19 | ||
| The history and physical examination | 20 | ||
| History | 20 | ||
| Physical Examination | 22 | ||
| Initial laboratory assessment | 22 | ||
| The Semen Analysis | 22 | ||
| The Endocrine Evaluation | 22 | ||
| Imaging in the male infertility office evaluation | 23 | ||
| Interpretation of the initial evaluation | 23 | ||
| Normal Semen Parameters | 23 | ||
| Defects in isolated semen parameters | 24 | ||
| Seminal Volume Abnormalities | 24 | ||
| Abnormalities in Sperm Concentration | 24 | ||
| Oligospermia | 24 | ||
| Azoospermia | 25 | ||
| Abnormalities in motility | 25 | ||
| Abnormalities in morphology | 26 | ||
| Multiple semen abnormalities | 26 | ||
| Other seminal abnormalities | 26 | ||
| Leukocytospermia | 26 | ||
| Additional semen tests | 27 | ||
| ROS | 27 | ||
| DNA Fragmentation | 27 | ||
| Fluorescent in situ Hybridization | 28 | ||
| The genetic evaluation | 28 | ||
| Congenital Bilateral Absence of the Vasa and Cystic Fibrosis Gene Mutations | 28 | ||
| Karyotype-Associated Abnormalities | 28 | ||
| Y-chromosome Microdeletions | 29 | ||
| The year is 2034 | 29 | ||
| Evolving Genomic Assessments | 29 | ||
| The Role of Proteomics and Metabolomics | 30 | ||
| Changes in Insurance Coverage and Referral Patterns | 30 | ||
| Summary | 31 | ||
| References | 31 | ||
| Male Endocrine Dysfunction | 39 | ||
| Key points | 39 | ||
| Introduction | 39 | ||
| Male endocrine physiology | 39 | ||
| HPG Axis | 40 | ||
| Nongonadotrope Hormones | 40 | ||
| Male endocrine dysfunction | 42 | ||
| Endogenous Dysfunction | 42 | ||
| Iatrogenic Dysfunction | 43 | ||
| Endogenous influences from outside the HPG axis | 45 | ||
| Growth Hormone | 45 | ||
| Treatment | 45 | ||
| Conservative Therapy | 45 | ||
| Pituitary Stimulation | 46 | ||
| Future therapy | 48 | ||
| Gene Therapy | 48 | ||
| Autologous Hormone Replacement | 49 | ||
| Summary | 49 | ||
| References | 50 | ||
| Lifestyle, Environment, and Male Reproductive Health | 55 | ||
| Key points | 55 | ||
| Introduction | 55 | ||
| Personal health factors | 55 | ||
| Diet | 55 | ||
| Exercise | 56 | ||
| Obesity | 56 | ||
| Psychological Stress | 57 | ||
| Substances of abuse | 57 | ||
| Alcohol | 57 | ||
| Cigarette Smoking | 58 | ||
| Marijuana | 59 | ||
| Anabolic Steroids | 59 | ||
| Opiates | 59 | ||
| Environmental factors | 60 | ||
| Cell Phone Use | 60 | ||
| Pollution | 61 | ||
| Heat Exposure | 61 | ||
| Trends in environment, lifestyle, and reproductive health: predictions for 2033 | 62 | ||
| Summary | 63 | ||
| References | 63 | ||
| Infectious, Inflammatory, and Immunologic Conditions Resulting in Male Infertility | 67 | ||
| Key points | 67 | ||
| Introduction | 67 | ||
| Inflammation—effect on the male reproductive tract | 68 | ||
| Inflammatory conditions potentially associated with male infertility | 69 | ||
| Prostatitis | 69 | ||
| Epididymitis | 71 | ||
| Orchitis | 71 | ||
| Urethritis | 71 | ||
| Pyospermia: a marker of reproductive tract inflammation? | 71 | ||
| Infections—effect on the male reproductive tract | 72 | ||
| Infections—C trachomatis | 72 | ||
| Infections—N gonorrhoeae | 73 | ||
| Infections—other bacterial STDs | 73 | ||
| Infections—non-STD bacteria | 74 | ||
| Infections—viruses | 75 | ||
| Inflammation, infections, and antisperm antibodies | 75 | ||
| Summary | 77 | ||
| References | 77 | ||
| Obstructive Azoospermia | 83 | ||
| Key points | 83 | ||
| Background | 83 | ||
| Causes | 83 | ||
| Diagnosis | 84 | ||
| Treatment and outcomes | 86 | ||
| VV/VE Surgical Principles | 87 | ||
| EDO | 90 | ||
| Alternatives to Reconstruction, MESA | 90 | ||
| Perspective of the future: obstructive azoospermia | 92 | ||
| Summary | 92 | ||
| Supplementary data | 92 | ||
| References | 92 | ||
| Azoospermia due to Spermatogenic Failure | 97 | ||
| Key points | 97 | ||
| Introduction | 97 | ||
| Causes of Spermatogenic Failure | 97 | ||
| Cryptorchidism | 98 | ||
| Endocrinologic abnormalities | 98 | ||
| Varicocele | 98 | ||
| Other acquired causes of spermatogenic failure | 98 | ||
| Histologic Diagnoses in Spermatogenic Failure | 98 | ||
| Genetic basis of spermatogenic failure | 99 | ||
| Chromosomal Abnormalities—Klinefelter Syndrome | 99 | ||
| Other Chromosomal Structural Abnormalities | 99 | ||
| Y Chromosomal Microdeletions | 100 | ||
| Medical therapy for spermatogenic failure | 100 | ||
| Specific Endocrine Therapy | 100 | ||
| Gonadotropin replacement therapy | 100 | ||
| Dopamine receptor agonists | 101 | ||
| Empiric Endocrine Therapy | 101 | ||
| Gonadotropin replacement therapy | 101 | ||
| Empiric selective estrogen receptor modulators (SERM) | 102 | ||
| Aromatase inhibitor therapy | 102 | ||
| Surgical therapy for spermatogenic failure | 102 | ||
| Varicocelectomy | 103 | ||
| Sperm Retrieval Techniques | 103 | ||
| FNA/TESA | 103 | ||
| Testicular sperm extraction | 104 | ||
| Microdissection TESE | 104 | ||
| Complications | 105 | ||
| Fresh Versus Frozen Sperm | 105 | ||
| Surgical Sperm Retrieval Rates According to Etiology of Spermatogenic Failure | 106 | ||
| KS | 106 | ||
| Cryptorchidism | 106 | ||
| Postchemotherapy azoospermia | 106 | ||
| Microdeletions in the AZF region of the Yq | 107 | ||
| Uniform MA | 107 | ||
| Sertoli cell only | 107 | ||
| Future directions in the treatment of spermatogenic failure | 107 | ||
| Stem Cell Therapy | 107 | ||
| Gene Therapy | 108 | ||
| Summary | 108 | ||
| References | 108 | ||
| Ejaculatory Dysfunction | 115 | ||
| Key points | 115 | ||
| Introduction | 115 | ||
| Anatomy of the ejaculatory apparatus | 115 | ||
| Epididymis | 115 | ||
| Vas Deferens | 116 | ||
| Seminal Vesicles | 116 | ||
| Ejaculatory Ducts | 116 | ||
| Bladder Neck | 116 | ||
| External Urethral Sphincter | 116 | ||
| Perineal Periurethral Muscles | 116 | ||
| Neurophysiology of ejaculation | 116 | ||
| Spinal Ejaculation Generator | 117 | ||
| Cortical Input to the Spinal Ejaculation Generator | 117 | ||
| Afferent Sensory Input to the Spinal Ejaculation Generator | 118 | ||
| Efferent Sympathetic Output from the Spinal Ejaculation Generator | 118 | ||
| Efferent Somatic Output from the Spinal Ejaculation Generator | 118 | ||
| Temporal sequence of the ejaculatory process | 118 | ||
| Disorders resulting in ejaculatory failure | 119 | ||
| RPLND | 119 | ||
| Various Types of Pelvic Surgery | 120 | ||
| Inguinal Herniorrhaphy | 120 | ||
| Neurologic Illnesses | 120 | ||
| Diabetes Mellitus | 121 | ||
| Traumatic SCI | 121 | ||
| Treatment strategies for ejaculatory failure | 121 | ||
| Oral Sympathomimetic Medications | 121 | ||
| PVS | 122 | ||
| Rectal Probe Electroejaculation | 123 | ||
| Direct Microsurgical Sperm Harvesting | 124 | ||
| Summary and the future | 124 | ||
| References | 124 | ||
| The Varicocele | 129 | ||
| Key points | 129 | ||
| Historical perspective | 129 | ||
| Anatomy | 130 | ||
| Pathophysiology | 131 | ||
| Presentation | 133 | ||
| Diagnosis | 133 | ||
| Ultrasonography | 134 | ||
| Venography | 134 | ||
| Treatment indications | 135 | ||
| Infertility | 135 | ||
| Hypogonadism | 136 | ||
| Symptomatic Varicoceles | 136 | ||
| Treatment options | 137 | ||
| Inguinal and Subinguinal Approach | 137 | ||
| Alternative Surgical Approaches | 138 | ||
| Percutaneous Venous Occlusion | 138 | ||
| Treatment outcomes | 139 | ||
| Varicocelectomy in 2034: what does the future hold? | 140 | ||
| References | 140 | ||
| Male Contraception | 145 | ||
| Key points | 145 | ||
| Introduction | 145 | ||
| Currently available methods | 145 | ||
| Condoms | 145 | ||
| Vasectomy | 145 | ||
| Hormonal | 146 | ||
| Pure Androgen | 147 | ||
| Ethnic Differences | 148 | ||
| Testosterone + Progestin | 148 | ||
| Oral Testosterone | 149 | ||
| Implants | 149 | ||
| Transdermal | 150 | ||
| Addition of GnRH Antagonists | 151 | ||
| 7α-Methyl-19-Nortestosterone | 151 | ||
| Overview of Hormonal Contraceptives | 151 | ||
| Nonhormonal contraception | 152 | ||
| Pharmacologic | 152 | ||
| Gossypol | 152 | ||
| Triptolide | 152 | ||
| Indenopyridines | 152 | ||
| Lonidamine derivates | 152 | ||
| Testicular retinoic acid inhibition | 153 | ||
| Calcium channel blockers | 153 | ||
| Sperm Na+/H+ exchanger | 153 | ||
| Inhibitors of glycosphingolipid synthesis | 154 | ||
| Bromodomain BRDT inhibitor (JQ1) | 154 | ||
| Thermal | 154 | ||
| Ultrasound | 154 | ||
| Vasal Occlusion/Interruption | 154 | ||
| Intravas device | 154 | ||
| Reversible inhibition of sperm under guidance | 155 | ||
| Immunologic | 155 | ||
| Summary | 156 | ||
| Future perspectives | 156 | ||
| References | 156 | ||
| Semen Assessment | 163 | ||
| Key points | 163 | ||
| Introduction | 163 | ||
| Initial assessment | 163 | ||
| Laboratory examination | 164 | ||
| Interpretation of semen analysis | 164 | ||
| Future considerations: a look to year 2040 and beyond | 165 | ||
| References | 166 | ||
| Identification and Preparation of Sperm for ART | 169 | ||
| Key points | 169 | ||
| Introduction | 169 | ||
| Modern era of ART | 170 | ||
| Principles of sperm selection | 170 | ||
| Conventional sperm selection methods | 170 | ||
| Sperm Washing | 170 | ||
| Migration Techniques | 171 | ||
| DGC | 171 | ||
| Filtration | 171 | ||
| Advanced sperm selection methods | 172 | ||
| Sperm Maturity | 172 | ||
| Sperm Ultramorphology | 172 | ||
| Sperm Surface Electric Charge | 173 | ||
| Separation of Apoptotic and Nonapoptotic Sperm | 173 | ||
| DNA damage | 174 | ||
| Aneuploidy | 174 | ||
| Sperm-oocyte interaction | 174 | ||
| Optimizing sperm function in vitro | 175 | ||
| Pentoxifylline | 175 | ||
| Hypoosmotic Sperm Swelling | 175 | ||
| Bicarbonate | 175 | ||
| Platelet Activating Factor | 175 | ||
| ROS Scavengers | 176 | ||
| Future techniques | 176 | ||
| RMS | 176 | ||
| Confocal Light Absorption and Scattering Spectroscopic Microscopy | 176 | ||
| Polarizing Microscopy | 176 | ||
| Summary | 177 | ||
| References | 177 | ||
| The Role of Nutraceuticals in Male Fertility | 181 | ||
| Key points | 181 | ||
| Introduction | 181 | ||
| Oxidative stress | 181 | ||
| Antioxidants | 182 | ||
| Definition of nutraceuticals | 182 | ||
| Review of nutraceuticals | 182 | ||
| Arginine | 182 | ||
| Carnitines | 182 | ||
| Coenzyme Q10 | 184 | ||
| Folic Acid (Folate) | 184 | ||
| Glutathione | 184 | ||
| Lycopene | 185 | ||
| Omega Fatty Acids | 185 | ||
| Phytoestrogens | 185 | ||
| Selenium | 186 | ||
| Vitamin A | 187 | ||
| Vitamin C | 187 | ||
| Vitamin E | 187 | ||
| Zinc | 188 | ||
| Discussion | 188 | ||
| Summary | 189 | ||
| References | 189 | ||
| The Epidemiology of Male Infertility | 195 | ||
| Key points | 195 | ||
| Introduction | 195 | ||
| Epidemiology | 196 | ||
| Infertility | 197 | ||
| Male infertility | 198 | ||
| Incidence of male infertility | 198 | ||
| Secular or birth cohort trends in diagnosis | 200 | ||
| Racial variation | 201 | ||
| Geographic variation | 201 | ||
| Infertility in unique exposure populations: obesity as an example | 201 | ||
| Summary and limits to epidemiologic analysis of male infertility | 202 | ||
| Research moving forward | 202 | ||
| References | 203 | ||
| Reproductive Health Care Delivery | 205 | ||
| Key points | 205 | ||
| Introduction | 205 | ||
| What constitutes reproductive health care? | 205 | ||
| Changes in reproductive health care through time | 206 | ||
| Models of reproductive health care delivery | 207 | ||
| Fee For Service | 207 | ||
| State-mandated Coverage | 207 | ||
| Winfertility: A Private, Bundled Model | 208 | ||
| Reproductive Endocrinologist Group Risk-sharing Model | 208 | ||
| Counsyl: Flat-rate Genetic Testing | 208 | ||
| Federal Title X | 208 | ||
| Federal/State: Medicaid | 209 | ||
| Military Personnel and Tricare | 209 | ||
| Veterans Health Administration | 209 | ||
| Should reproductive health care be covered? | 209 | ||
| The future of reproductive health care | 210 | ||
| References | 210 | ||
| Index | 213 |