Title: Present-day management of male infertility.

POPLINE Document Number: 018197

Author(s):

Carruthers GB

Source citation:

Ippf Medical Bulletin, 1982 Jun;16(3):1-2.

Abstract:

An overview is presented of the management of impaired fertility in men. Laboratory examination of semen, the primary determination of fertility status, is complicated by the lack of criteria of "normal" parameters. Most seminologists agree that fertility is compatible with a count below 20 million/ml, but the quality of motility and morphology is the critical factor. Consecutive semen analyses in the same person can also show great variation, so several specimens should be studied over a period of months. A definite cause for infertility can be found in less than 10% of cases. Half of those with a known cause are azoospermic due to an obstructive lesion of the conducting pathways or to total failure of spermatogenesis. Varicocele and immunolgoic aspects of infertility have attracted recent interest. New investigational methods have identified a substantial retrograde flow down the internal spermatic vein whenever a true varicocele is palpable. Suprainguinal ligation of the internal spermatic vein has been performed in these cases and estimates of improvement in the semen profile range from 30-80% of cases. However, many clinicians have reservations about the overall role of spermatic venous reflex in male infertility. When a significant titer of antibodies is noted, corticosteroids are generally administered. Despite little evident benefit, the trend toward prolonged treatment of infertility with pituitary hormones and stimulants continues. Increasingly, the infertile couple is being treated as a unit. Since specific measures seldom improve the semen profile, attention should be focused on improvement of opportunity for any effective sperm to achieve fertilization. There has been renewed interest in the cervical insemination cap method. About 14% of couples where the man shows seminal impairment conceived by this method, provided some of the sperm are of normal morphology. Artificial insemination with pooled stored sperm has produced disappointing results.

Keywords:

Infertility
Spermatozoa
Spermatogenesis
Reproduction
Artificial Insemination
Treatment
Men
Germ Cells
Genitalia
Urogenital System
Physiology
Biology
Reproductive Technologies
Demographic Factors
Population