SARS-CoV-2 pandemic and repercussions for male infertility patients: A proposal for the individualized provision of andrological services.

The prolonged lockdown of health facilities providing non-urgent gamete cryopreservation-as currently recommended by many reproductive medicine entities and regulatory authorities due to the SARS-CoV-2 pandemic will be detrimental for subgroups of male infertility patients. We believe the existing recommendations should be promptly modified and propose that the same permissive approach for sperm banking granted for men with cancer is expanded to other groups of vulnerable patients. These groups include infertility patients (eg, azoospermic and cryptozoospermic) undergoing medical or surgical treatment to improve sperm quantity and quality, as well as males of reproductive age affected by inflammatory and systemic auto-immune diseases who are about to start treatment with gonadotoxic drugs or who are under remission. In both scenarios, the "fertility window" may be transitory; postponing diagnostic semen analysis and sperm banking in these men could compromise the prospects of biological parenthood. Moreover, we provide recommendations on how to continue the provision of andrological services in a considered manner and a safe environment. Our opinion is timely and relevant given the fact that fertility services are currently rated as of low priority in most countries.

[Biosafety in andrology laboratories during the outbreak of COVID-19].

The novel coronavirus disease 2019 (COVID-19) broke out in December 2019 and has been rapidly escalating throughout the world. Clinical findings show that the patients with either symptomatic or asymptomatic COVID-19 can be a potential source of infection. Although respiratory droplets and close contact are considered to be the main routes of transmission, there is the possibility of aerosol transmission in a relatively closed environment. The nucleic acid of the novel coronavirus can be detected in nasopharyngeal swabs, sputum and other lower respiratory tract secretions, blood, feces, urine and so on, but whether it exists in the semen has not been confirmed. It is reported that the novel coronavirus may affect the testis that highly expresses angiotensin-converting enzyme 2 (ACE2) and theoretically the semen is a possible carrier of the virus considering the fact that it is discharged from the same channel as the urine. Andrology laboratorians are exposed to most of the specimens above, including semen, and some open operations in the laboratory increase the risk of aerosol generation. Therefore, corresponding protective procedures are necessitated in andrology laboratories to reduce the risk of infection during the outbreak of COVID-19. Based on the knowledge and experience available as regards the pandemic and the characteristics of the work in the andrology laboratory, we summarize some biosafety points for andrology laboratorians to attend to during the outbreak of COVID-19.

The management of unexplained infertility: an evidence-based guideline from the Canadian Fertility and Andrology Society.

Unexplained infertility is a common diagnosis affecting as many as 50% of couples seeking infertility care. As a diagnosis of exclusion, its treatment remains largely empirical. Historically, a step-wise progression in treatment has been initiated with the least invasive, least expensive option followed by a gradual progression to therapies using assisted reproductive technology. In recent years there have been advocates for more rapid-progression IVF. This guideline from the Canadian Fertility and Andrology Society (CFAS) provides comprehensive, evidence-based recommendations for the treatment of unexplained infertility, including expectant management, laparoscopy, intrauterine insemination (IUI) alone, ovarian stimulation with oral agents or gonadotropins alone, ovarian stimulation + IUI, and IVF. The quality of supporting evidence for each recommendation is evaluated using the framework outlined by the Canadian Task Force on Preventive Health Care. This guideline recognizes that the therapeutic approach should be individualized taking into account patient age and duration of infertility, and emphasizes those strategies that are most likely to result in a healthy live birth.

Management of thin endometrium in assisted reproduction: a clinical practice guideline from the Canadian Fertility and Andrology Society.

The impact and management of thin endometrium is a common challenge for patients undergoing assisted reproduction. The objective of this Canadian Fertility and Andrology Society (CFAS) guideline is to provide evidence-based recommendations using the GRADE (Grading of Recommendations, Assessment, Development and Evaluations) framework on the assessment, impact and management of thin endometrium in assisted reproduction. The effect of endometrial thickness on pregnancy and live birth outcomes in ovarian stimulation and IVF (fresh and frozen cycles) is addressed. In addition, recommendations on the use of adjuvants to improve endometrial thickness and pregnancy outcomes are provided.

A referenciação para a consulta de andrologia - Quem e como são referenciados? / Andrology - Whom and how are patients being referred?

Introdução: A andrologia é uma área médica que estuda a sexualidade e a fertilidade no sexo masculino. A referenciação de utentes deve ser feita de forma criteriosa e adequada para assegurar o acesso a tratamentos diferenciados sempre que haja indicação. Objetivo: Caracterizar a referenciação específica para a consulta de andrologia no nosso centro hospitalar. Material e métodos: Avaliação retrospectiva da casuística da consulta de andrologia entre janeiro de 2014 e dezembro de 2015. Resultados: Consultaram‐se os registos clínicos de 96 das 102 consultas de primeira vez de andrologia. Cerca de 60% dos doentes foram referenciados por disfunção eréctil, 15% por curvatura peniana e 8% por disfunção ejaculatória. Apenas 27% dos doentes com disfunção eréctil já tinham efetuado prova terapêutica e 40% não tinham perfil metabólico recente. Discussão: A elevada prevalência de comorbilidades sexuais e a elevada prevalência de doentes naïve na população referenciada levam a ponderar se existe dificuldade entre os médicos referenciadores de categorizar e tratar a disfunção sexual masculina de acordo com o modelo tetrafásico da resposta sexual. A ausência de estratificação de doentes segundo os critérios de Princeton III demonstra a dificuldade na seleção de doentes que podem iniciar terapêuticas de primeira linha antes da referenciação. Conclusão: As disfunções sexuais têm uma elevada prevalência na população geral. Os cuidados de saúde necessitam de ter uma maior capacidade de intervenção diagnóstica e terapêutica

Introduction: Andrology focuses in male sexual and fertility diseases. Its referral should be thoughtful and tailored in order to select the correct cases. Objectives: The aim of this work was to evaluate the referral to our department and improvement points. Material and methods: A retrospective analysis was performed of the Andrology consults between January 2014 and December 2015. Results: We evaluated 96 of the 102 consults performed. About 60% of patients were referred with erectile dysfunction complaints, 15% with penile curvature and 8% with ejaculatory dysfunction. About 27% had previously tried phosphodiesterase 5 inhibitor, and 40% lacked recent metabolic workup. Discussion: The high prevalence of sexual complaints coupled with a high number of naïve patients could be due to difficulties by the referral doctors when analyzing and characterizing male sexual dysfunction according to the current sexual response cycle model. The lack of patient categorization accordingly to Princeton criteria (III) shows the difficulties found when selecting patients to start the first line of treatment for erectile dysfunction. Conclusion: Sexual dysfunction are highly prevalent in the general population. Healthcare providers should improve diagnostic and treatment skills in this field of Urology

[Disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology: Confusions and countermeasures in studies].

Researches on the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine are becoming a hot spot in andrology, but many recent studies of this kind have failed to explain the connotation of integrated traditional Chinese and Western medicine in andrology. Related existing problems include repeated researches into the same indexes of action mechanisms of different therapeutic principles of traditional Chinese medicine (TCM), Chinese herbal compound and special prescriptions, studies focusing on individual diseases but ignoring symptoms, immature syndrome models for studies of mechanisms, and too much attention to uncertain or immature target mechanisms. The stress should be placed on the action mechanisms of Chinese herbal compound and special prescriptions on male diseases and, what is more important, on the clarification of the essential principles of differentiation and treatment of TCM syndromes. In the recent years, proteomics, genomics, transcriptomics and metabolomics have shed some light upon researches into the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine in andrology. An insight into the TCM syndrome, a macroscopic inductive analysis, and a comprehension of such microcosmic aspects as the gene, protein, metabolism and metagenome may contribute to some breakthroughs and new ideas in the studies of disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology.

10ª Reunión Ibérica de Andrología 17º Congreso Nacional de Andrología, Medicina Sexual y Reproductiva / No disponible

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La Medicina Sexual en la Historia. Avances y controversias (Parte II) / Sexual Medicine beyond History. Advances and controversies (Part II)

El recorrido histórico de la Medicina Sexual y la Andrología por los 2 últimos siglos permite ver cómo el desarrollo científico se ha acelerado hasta un nivel que hubiera parecido imposible a nuestros predecesores. A ello han contribuido en gran parte los logros en la comprensión de la fisiología y, desde luego, la cirugía, con el descubrimiento de la anestesia y el control de las infecciones y la hemostasia, pero, sin duda, también han sido parte importante en esta historia la nueva mentalidad de trabajo en equipo y el intercambio de información, disponible de modo cada vez más dinámico y con una amplitud insospechada tan solo hace unas décadas. Por otra parte, estos avances en muchas ocasiones no han sido fáciles para quienes los han impulsado, y diferentes controversias han puesto de relieve tanto la necesidad de veracidad en la investigación realizada como la perseverancia ante las dificultades e incomprensiones. Por ello, el presente trabajo de investigación intenta recuperar la importancia del factor humano y las decisiones personales como ejes clave del avance científico, también en lo que corresponde al estudio y tratamiento de los problemas de la sexualidad humana (AU)

The historical journey of Sexual Medicine and Andrology over the last 2 centuries makes it possible to illustrate how scientific development has grown to such a level that would have seemed impossible to our ancestors. This growth has largely contributed to the understanding of the physiology and, of course, the surgery, with the discovery of anesthesia, infection control and hemostasis. However, undoubtedly, the new culture of teamwork and the new possibilities of an increasingly dynamic exchange of information having an extension that was unsuspected only a few decades ago has also played an important part in this history.Moreover, in many cases these advances have not been easy for those who have encouraged them. Different controversies have highlighted both the need for accuracy in the research and perseverance against difficulties and misunderstandings. Therefore, the present research work has tried to recover the importance of the human factor and personal decisions as a key to scientific advance, as well as in that corresponding to the study and treatment of the issues of human sexuality (AU)

Efecto de la eyaculación diaria sobre la calidad seminal y el nivel de calcio y magnesio en semen / Effect of daily ejaculation on semen quality and calcium and magnesium in semen

Objetivo. Los diferentes aspectos del estudio del semen han mejorado el conocimiento del aparato reproductor masculino. El objetivo del presente estudio es descubrir el efecto de la eyaculación diaria durante 10 días sobre la calidad seminal y el nivel de calcio y magnesio en semen. Materiales y métodos. En el estudio participaron 21 varones sanos y sexualmente activos. Se obtuvo su consentimiento previo al estudio. Se analizó el efecto de la eyaculación diaria durante 10 días sobre los parámetros seminales y el nivel de calcio y magnesio. Tras una abstinencia de 3–5 días, se recogieron 11 muestras. Se evaluaron las muestras sobre una base diaria, calculándose el nivel de calcio y magnesio en los espermatozoides, así como en el plasma seminal. Resultados. El estudio mostró que la calidad del semen mejoró con la eyaculación diaria. No se observaron diferencias estadísticas en cuanto al nivel de calcio y magnesio en el plasma seminal y en los espermatozoides. Conclusión. El estudio demostró que la eyaculación diaria es útil para mejorar la calidad seminal(AU)

Objective. Different aspects of semen study improved the knowledge of male reproductive system. Aim of the present study is to find out the effect of daily ejaculation for 10 days on semen quality and the level of calcium and magnesium in semen. Materials and methods. Twenty-one young healthy sexually active men participated in this study. Their consent was collected prior to it. Effect of daily ejaculation for 10 days on semen parameters and calcium and magnesium it were studied. After an abstinence of 3–5 days 11th sample was collected. On a daily basis samples were evaluated and calcium and magnesium were estimated in spermatozoa as well as seminal plasma. Results. The study showed quality of semen improved by daily ejaculation. Statistically no differences in the level of calcium and magnesium in seminal plasma and spermatozoa were observed. Conclusion. The study proved daily ejaculation was useful in improving its quality(AU)

16 Congreso Nacional de Andrología, Medicina Sexual y Reproductiva: Pamplona, 25-27 de abril de 2013 / No disponible

No disponible

V Congreso Iberoamericano de Andrología (ANDRO) y VI Congreso de la Sociedad Argentina de Andrología (SAA) / No disponible

No disponible

[Reorganizing the management of specialist uro-andrologic ultrasound health-care service: impact on professional quality]. / La riorganizzazione della gestione del servizioospedaliero di ecografia specialistica uro-andrologica: impatto sulla qualità professionale.

INTRODUCTION: The process of organizing a ultrasound service nowadays can be improved by properly managing the user's request, the speed of response and safety, the standardization of methods and skills. MATERIALS AND METHODS: The outpatients at our uro-andrologic ultrasound clinic (O.U. of Urology in Ferrara) received a questionnaire each; we administered a total of 640 questionnaires. The number of questionnaires collected was 532. Patients were asked to give an assessment of services using a qualitative method according to a 4-parameter response scale: very satisfied, satisfied, dissatisfied, very dissatisfied. RESULTS: The identification of indicators to be monitored by the user's perceived quality was accomplished by establishing the correlation coefficient between different parameters of analysis and an overall rating of the sample. Some of these parameters were: the relationship with the practitioner, the availability of doctors, the ability of doctors for reassurance, the completeness of information and facilities hygiene conditions. When these parameters vary, positively or negatively, also the citizen's overall opinion changes. CONCLUSIONS: The customer satisfaction is an important component of the quality of care, it represents both an indicator of the effectiveness of health intervention and the ability to meet quality requirements of the health service organization. The objective of an ultrasound service should be to provide, within a reasonable timeframe, the supply of high quality with qualified personnel, with adequate tools and procedures.