Title: The neglected male [editorial]

POPLINE Document Number: 018116

Author(s):

Moghissi KS

Source citation:

Fertility and Sterility, 1981 Jun;35(6):609-10.

Abstract:

Infertility should not be considered a condition that affects the male and female separately. The concept of evaluating and managing infertile couples as a unit is becoming well established among sophisticated physicians. The investigation and management of male related infertility continues to be a cause for concern among both physicians and the lay public. Generally, the male partner of an infertile union is neglected. Most physicians refer their infertile males to a urologist for initial evaluation or management of specific problems. A few urologists who have the expertise and experience to manage male infertility can be found in most large communities and medical centers, and some of these physicians have limited their entire practices to infertility. Many urology residency programs are deficient in subjects related to male reproductive biology and endocrinology. Urologists who graduate from such programs are unprepared to provide care for infertile men. The result of this system is that the male partner of the infertile couple is neglected by both the gynecologist and the urologist. In many localities it is common to see men who have been under the care of a physician for months and at times years without the benefit of adequate evaluation or treatment. The use of long discarded therapeutic modalities such as thyroid preparations for the treatment of oligospermia continues unabated. Another problem is the lack of laboratory facilities and trained technicians for semen analysis. Knowledge of the physiology of the male reproductive function is still rudimentary, and diagnostic tools are crude. Satisfactory tests to assess the capability of sperm to effect migration and survival in the female reproductive tract and fertilize the ovum have not been developed. The level of training of both gynecologists and urologists in reproductive sciences must be improved. Semen analysis should be performed in laboratories equipped to process the sample by trained technicians who will provide the physician with a comprehensive support. Research in male reproductive biology must continue with the purpose of elucidating parameters which indicate functional disorders of spermatozoa. Several new techniques have recently been developed for the investigation of functional defects in human spermatozoa.

Keywords:

Infertility
Treatment
Physicians
Health Personnel
Reproduction
Spermatogenesis
Research Methodology
Men
Delivery of Health Care
Health
Demographic Factors
Population