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Geneva, Switzerland, WHO, 2016 May 30.  p. (WHO/ZIKV/MOC/16.1 Rev.1)This document is an update of guidance published on 18 February 2016 to provide advice on the prevention of sexual transmission of Zika virus.The primary transmission route of Zika virus is via the Aedes mosquito. However, mounting evidence has shown that sexual transmission of Zika virus is possible and more common than previously assumed. This is of concern due to an association between Zika virus infection and adverse pregnancy and fetal outcomes, including microcephaly, neurological complications and Guillain-Barre syndrome. The current evidence base on Zika virus remains limited. This guidance will be reviewed and the recommendations updated as new evidence emerges.
Geneva, WHO, 1973. (WHO Technical Report Series No. 520) 34 p.After summarizing current WHO research directed at the control of male fertility focusing on 1) gametogenesis and ultrastructure of the testis; 2) cytogenetic aspects; 3) hormonal regulation; 4) epididymal function (the maturation and preservation of spermatozoa); 5) vas deferens; and 6) semen analysis; recommendations for further research in the area are made. Studies are required on the following aspects of reproductive function in the male: 1) structural and cytochemical organization of the various classes of germ cells in humans and nonhuman primates; 2) interstitial tissues and the components of the blood-testis barrier and their role in the regulation of gametogenic function of the testis; 3) structural and functional state of the testis during growth and development, during aging, and in most histopathological conditions leading to partial or complete sterility; 4) the role of meiotic chromosome aberration in degeneration of germ cells; 5) role of abnormal chromosomes as an etiological factor in male infertility; 6) binding and metabolism of androgens and their effects on the seminiferous tubule; 7) role of gonadotropins, particularly follicle stimulating hormone (FSH), in regulation of spermatogenesis; 8) identification of tubular factors involved in regulation of FSH secretion; 9) elucidation of epididymal function in a number of species; 10) characteristics of sperm surface; 11) nature of epididymal plasma and the factors that control it; 12) anatomy, physiology, and functional role of human vas deferens, with emphasis on blood supply; 13) effect of vasectomy on male reproductive function and possible immunological sequelae of this operation; 14) relationship between fertility and such characteristics of sperm as number, motility, and morphology; 15) biochemical characteristics of the nucleus, acrosome, and midpiece of sperm, and their relationship to sperm motility and fertility; 16) chemical nature of substances secreted specifically in different accessory sex organs; 17) the possible relationship between autoimmune phenomenoa and testicular disease; and 18) immunological sequelae of vasectomy. In addition, studies on the cryobiology of human and animal sperm are expected to yield information on the biology of sperm.
Geneva, World Health Organization, 1966. (Technical Report Series No. 334.) 21 p.A WHO Scientific Group on Immunological Aspects of Human Reproduction met in Geneva October 4-9, 1965. Topics of discussion included: 1) immunology of human gonadotropins; 2) sperm and seminal fluid; 3) blood group antigens and human reproduction; and 4) maternal-fetal immunological interactions. It was concluded that further investigations are required to study: 1) the correlation between physiocochemical, biological, and immunological criteria for the purity of antigens concerned in human reproduction; 2) the chemical structure of hormones concerned with reproduction, with special reference to the biologically active sites and the nature of antibodies against these active sites; 3) production of antibodies to the gonadotropins by the use of adjuvants and/or chemically modified gonadotropins; 4) modification of hormones from other species to render them active but non-antigenic in man; 5) the use of immunological methods for assisting in the detection of the time of ovulation: these could aid in the control of fertility and in the treatment of infertility; 6) the development of strains of animals of high immunological competence; 7) characterization of the male antigens responsible for various immunological phenomena in males; 8) characterization of male antigens responsible for inducing circulating antibodies and reducing the fertility of immunized females; 9) the nature and biological significance of the antagglutinins; 10) possible ways of interfering with the transmission of antibodies in man; and 11) the possible occurrence of specific antitrophoblastic antibodies in pre and postpartum. Other research needs are also outlined.
The biochemistry and microbiology of the female and male genital tracts: report of a WHO Scientific Group.
Geneva, World Health Organization, 1965. (World Health Organization Technical Report Series No. 313.) 15 p.A WHO Scientific Group on the Biochemistry and Microbiology of the Female and Male Genital Tracts met in Geneva on April 20-26, 1965. It was the sixth of a series of meetings giving detailed consideration to the biology of human reproduction. Topics investigated included: 1) the chemistry and enzymology of the uterus; 2) sperm transport; 3) capacitation and the acrosome reaction; 4) nidation and placentation; 5) the chemistry and enzymology of semen; 6) the effects of cadmium, zinc, and selenium compounds on reproduction; and 7) microbiology. The Group considered that many of the subjects discussed required further investigation. The discussions repeatedly indicated the need for more broadly based comparative studies in the physiology of reproduction. They also underlined the need for more extensive studies in primates, particularly with a view to determining the time of ovulation and the reaction of uterine tissues to the changing stages of the cycle and of pregnancy. The importance of viewing the male and female components in reproduction as an integrated whole rather than as isolated events was stressed.
WHO laboratory manual for the examination of human semen and sperm-cervical mucus interaction. 3rd ed.
Cambridge, England, Cambridge University Press, 1992. viii, 107 p.In 1992, WHO's special program of research, development and research training in human reproduction updated its laboratory manual for the examination of human semen and sperm-cervical mucus interaction because the field of andrology continues to progress quickly and there is heightened realization of the need for standardized measurement of all semen variables. This manual is designed to mainly serve the needs of researchers and clinicians in developing countries. Chapter 2 addresses laboratory procedures that are minimal essential steps for semen evaluation, optional procedures, and procedures needing additional evaluation, such as computer-aided sperm analysis used to measure sperm motion (i.e., research tools). The Shorr stain has replaced the Papanicolaou stain. Measurements of acid phosphatase and neutral alpha-glucosidase were added, while the measurement of adenosine triphosphatase was excluded. Few changes between the 2nd and 3rd editions occurred in Chapter 3. Chapters 4 and 5 are rather brief but discuss interlaboratory and technical standardization procedures. New appendices present safety guidelines and basic requirements for the andrology laboratory.
WHO laboratory manual for the examination of human semen and semen-cervical mucus interaction. 2nd ed.
Cambridge, England, Cambridge University Press, 1987. , 67 p.The WHO Special Programme of Research, Development and Research Training in Human Reproduction has revised its manual designed to standardize procedures for the examination of human semen. This revised manual, for instance, describes a simplified method for screening the morphology of cellular elements other than spermatozoa; the previous method now appears in the section on optional procedures. WHO has also included methods to determine the presence of spermatozoa antibodies. The manual has guidelines on measurement of biochemical components of seminal plasma to evaluate the secretory function of accessory glands (e.g., fructose indicates secretory function of the seminal vesicles). Even though these biochemical tests may not mark a man's fertility, they demonstrate the functional state of these glands. Besides, someday they may even help assess the possible effects of xenobiotic factors and of disease. Some researchers believe adenosine triphosphate levels are linked to spermatozoal function and that the zona free hamster oocyte test can determine the ability of human spermatozoa to join with the oocyte; so WHO has listed protocols for these 2 tests. The manual also has protocols to assess the ability of spermatozoa to penetrate cervical mucus in vitro: the microscopic method and the capillary tube test. WHO believes that determining this ability is important when evaluating the fertility of a couple. The Standard Procedures section on collection and examination of human semen considers appearance, volume, consistency, pH, motility, preparation and grading, agglutination, sperm viability, sperm count, and testing for antibody-coating of spermatozoa. The section on sperm cervical mucus interaction examines volume, consistency, ferning, spinnbarkeit, cellularity, pH, and in vivo and in vitro tests. It hopes that researchers will adapt the standard procedures presented in this manual to improve quality control between laboratories and allow aggregation of data from several sources for analysis.
In: Morris, N. and Arthure, H. Sterilization as a means of birth control in men and women. London, Peter Owen, 1976. p. 80-100Vasectomy was 1st used at the start of the 20th century and became prominent in the 1950s in family planning programs in Asian countries. The secondary sex characteristics do not change after vasectomy, and there is normal erectile power, libido, orgasm, and ejaculatory volume. Spermatogenesis continues normally in men following vasectomy, and plasma testosterone levels remain unchanged. Vasectomy involves cutting both vasa deferentes through an incision in the scrotum which is usually performed with local anesthesia without hospitalization. Preliminary counseling is necessary so that both partners understand the nature and effects of the operation. Semen banks may be used when available for men undergoing vasectomy. There is no evidence for the greater efficiency of 1 technique over the other. Patients must submit sperm samples for examination after 8-12 weeks and then every 4 weeks until 2 consecutive specimens are negative. Possible complications include: 1) a vasovagal reaction; 2) skin discoloration; 3) edema of the scrotal skin, 4) postoperative pain, 5) infection; 6) ulceration and gangrene of the scrotal skin, and 7) hydrocele or epididymo-orchitis. Successful reanastamosis of the vas deferens with reappearance of sperm can be accomplished in 50-80% of the patients, and the semen is not of quality to insure impregnation in 1/4 of these cases.