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1.
J Urol ; 205(1): 36-43, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33295257

RESUMO

PURPOSE: The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated. MATERIALS/METHODS: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January, 2000 through May, 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table 1[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology. RESULTS: This Guideline provides updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions. The detection of male infertility increases the risk of subsequent development of health problems for men. In addition, specific medical conditions are associated with some causes for male infertility. Evaluation and treatment recommendations are summarized in the associated algorithm (figure[Figure: see text]). CONCLUSION: The presence of male infertility is crucial to the health of patients and its effects must be considered for the welfare of society. This document will undergo updating as the knowledge regarding current treatments and future treatment options continues to expand.


Assuntos
Infertilidade Masculina/diagnóstico , Medicina Reprodutiva/normas , Urologia/normas , Aconselhamento/normas , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Humanos , Infertilidade Masculina/etiologia , Infertilidade Masculina/terapia , Estilo de Vida , Masculino , Medicina Reprodutiva/métodos , Escroto/diagnóstico por imagem , Análise do Sêmen , Sociedades Médicas/normas , Ultrassonografia , Estados Unidos , Urologia/métodos
2.
J Urol ; 205(1): 44-51, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33295258

RESUMO

PURPOSE: The summary presented herein represents Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part II outlines the appropriate management of the male in an infertile couple. Medical therapies, surgical techniques, as well as use of intrauterine insemination (IUI)/in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) are covered to allow for optimal patient management. Please refer to Part I for discussion on evaluation of the infertile male and discussion of relevant health conditions that are associated with male infertility. MATERIALS/METHODS: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January 2000 through May 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology. RESULTS: This Guideline provides updated, evidence-based recommendations regarding management of male infertility. Such recommendations are summarized in the associated algorithm (figure[Figure: see text]). CONCLUSION: Male contributions to infertility are prevalent, and specific treatment as well as assisted reproductive techniques are effective at managing male infertility. This document will undergo additional literature reviews and updating as the knowledge regarding current treatments and future treatment options continues to expand.


Assuntos
Infertilidade Masculina/terapia , Medicina Reprodutiva/normas , Urologia/normas , Varicocele/terapia , Aconselhamento/normas , Suplementos Nutricionais , Medicina Baseada em Evidências/métodos , Medicina Baseada em Evidências/normas , Fertilização In Vitro/métodos , Fertilização In Vitro/normas , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Masculino , Medicina Reprodutiva/métodos , Escroto/diagnóstico por imagem , Moduladores Seletivos de Receptor Estrogênico/uso terapêutico , Análise do Sêmen , Sociedades Médicas/normas , Recuperação Espermática/normas , Resultado do Tratamento , Estados Unidos , Urologia/métodos , Varicocele/complicações , Varicocele/diagnóstico
4.
Zhonghua Nan Ke Xue ; 26(10): 922-925, 2020 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-33382225

RESUMO

Objective: To explore the distribution of Traditional Chinese Medicine (TCM) syndrome types and their relationship with semen parameters in infertility male patients with varicocele (VC). METHODS: Using Questionnaire on Clinical Symptoms of Varicocele-Caused Male Infertility, we made an investigation among 147 infertility male patients with VC, determined the types of their TCM syndromes, obtained their semen parameters, and analyzed the distribution of the TCM syndrome types and their correlation with semen parameters. RESULTS: Of the TCM syndrome types identified, kidney deficiency and stagnated heat constituted the largest proportion (34.7%), and the mixed type accounted for a significantly higher percentage than the simple type (P < 0.05). The patients with kidney deficiency and stagnated heat, compared with those with other syndrome types, had a dramatically lower sperm concentration (ï¼»21.62 ± 9.25ï¼½ vs ï¼»28.88 ± 12.92ï¼½ ×106/ml, P < 0.01), but a higher percentage of morphologically abnormal sperm (ï¼»98.33 ± 0.15ï¼½% vs ï¼»96.27 ± 0.18ï¼½%, P < 0.05) and DNA fragmentation index (ï¼»19.72 ± 3.17ï¼½% vs ï¼»10.96 ± 3.82ï¼½%, P < 0.01). No statistically significant differences were observed in the percentage of progressively motile sperm among different TCM syndrome types. CONCLUSIONS: Kidney deficiency and stagnated heat is a main TCM syndrome type in infertility male patients with varicocele and correlated with sperm concentration, the percentage of morphologically abnormal sperm and DNA fragmentation index.


Assuntos
Infertilidade Masculina , Medicina Tradicional Chinesa , Varicocele , Fragmentação do DNA , Humanos , Infertilidade Masculina/complicações , Infertilidade Masculina/diagnóstico , Masculino , Sêmen , Análise do Sêmen , Contagem de Espermatozoides , Motilidade Espermática , Espermatozoides , Síndrome , Varicocele/complicações , Varicocele/diagnóstico
5.
Urol Clin North Am ; 47(4): 523-536, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33008501

RESUMO

Personalized medicine uses a patient's genotype, environment, and lifestyle choices to create a tailored diagnosis and therapy plan, with the goal of minimizing side effects, avoiding lost time with ineffective treatments, and guiding preventative strategies. Although most precision medicine strategies are still within the laboratory phase of development, this article reviews the promising technologies with the greatest potential to improve the diagnosis and treatment options for male infertility, including sperm cell transplantation, genomic editing, and new biomarker assays, based on the latest proteomic and epigenomic studies.


Assuntos
Genômica , Infertilidade Masculina/genética , Infertilidade Masculina/terapia , Medicina de Precisão/métodos , Biomarcadores/sangue , Terapia Combinada , Previsões , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Proteômica , Medição de Risco , Resultado do Tratamento
6.
Khirurgiia (Mosk) ; (10): 44-48, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33047585

RESUMO

OBJECTIVE: To reveal the association of tension-free inguinal hernia repair and pathospermia in fertile men. MATERIAL AND METHODS: We have retrospectively analyzed medical records of 512 men who appealed to andrologist with complaints of the absence of pregnancy in wife in 2018. We evaluated duration and features of infertility, presence/absence of previous inguinal hernia repair, spermogram data (according to WHO criteria, 2010) in all patients. RESULTS: Duration of infertility in men after inguinal hernia repair persists for 4.2±2.1 years. Right-sided hernia repair was performed in 36 (48.6%) patients, left-side - 23 (31%), bilateral repair - 15 (20.2%) patients. Men with impaired sperm motility prevailed among patients after right-sided inguinal hernia repair (17 (47.2%) people). Left-sided hernia repair was followed by asthenozoospermia in 8 (34.7%) cases, bilateral hernia repair - in 3 (20%) cases. The most severe abnormalities in semen analysis (azoospemia) develop after bilateral hernia repair. CONCLUSION: Inguinal tension-free hernia repair is a risk factor for male infertility in 14.4% of cases. It is very important to examine a man in case of infertile marriage. Previous surgical interventions including inguinal hernia repair should be considered.


Assuntos
Hérnia Inguinal/cirurgia , Herniorrafia/efeitos adversos , Infertilidade Masculina/etiologia , Astenozoospermia/diagnóstico , Astenozoospermia/etiologia , Azoospermia/diagnóstico , Azoospermia/etiologia , Herniorrafia/métodos , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Estudos Retrospectivos , Fatores de Risco , Análise do Sêmen
7.
Medicine (Baltimore) ; 99(37): e22124, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925763

RESUMO

RATIONALE: This study aimed to report 1 family case with novel Y chromosome structural variations by an established next-generation sequencing (NGS) method using unique STSs. PATIENT CONCERNS: The case studied was from a family with a father and son (the proband). G-band staining was used for karyotype analysis. Y chromosome microdeletions were detected by sequence-tagged site (STS)-PCR analysis and a new NGS screening strategy. DIAGNOSES: Semen analysis showed that the proband was azoospermic. The patient had an abnormal karyotype (45,X[48%]/46,XY[52%]). His father exhibited a normal karyotype. STS-PCR analysis showed that the proband had a deletion of the AZFb+c region, and his father had no deletion of STS markers examined. The sequencing method revealed that the patient had DNA sequence deletions from nt 20099846 to nt 28365090 (8.3 Mb), including the region from yel4 to the Yq terminal, and his father exhibited a deletion of b1/b3 and duplication of gr/gr. INTERVENTIONS: The proband was advised to undergo genetic counseling, and consider the use of sperm from a sperm bank or adoption to become a father. OUTCOMES: The proband was azoospermic. AZFc partial deletions may produce a potential risk for large AZFb+c deletions or abnormal karyotypes causing spermatogenic failure in men. LESSONS: The NGS method can be considered a clinical diagnostic tool to detect Y chromosome microdeletions. The partial AZFc deletions and/or duplications can be a risk of extensive deletions in offspring.


Assuntos
Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/diagnóstico , Transtornos do Cromossomo Sexual no Desenvolvimento Sexual/genética , Adulto , Deleção Cromossômica , Cromossomos Humanos Y/genética , Sequenciamento de Nucleotídeos em Larga Escala , Humanos , Cariotipagem , Masculino , Sitios de Sequências Rotuladas , Aberrações dos Cromossomos Sexuais
9.
Acta Clin Croat ; 59(1): 154-160, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32724287

RESUMO

The prevalence and importance of male infertility make it a serious worldwide medical and social problem. The aim of this study was to determine if there were any significant differences in zinc concentrations in seminal fluid in men diagnosed with infertility compared to control group, and if there were, to determine how it affected the number and percentage of sperm cells with normal motility and morphology. A case-control study was conducted in the Osijek-Baranja County from January 2014 to June of 2015. The study included 276 subjects referred to biochemistry laboratory of the Osijek University Hospital Centre, 100 (36.2%) of them with low sperm count confirmed by spermiogram after 3 months. Semen samples were processed according to the World Health Organization criteria, and zinc concentrations were determined using spectrophotometry and direct colorimetry without deproteinization on a chemistry analyzer (Olympus AU 680, Beckman Coulter, Tokyo, Japan). Study results showed the men with low sperm count to be significantly older (Mann Whitney U test: p=0.013) and to have lower zinc levels (χ2-test: p<0.001). Further analysis included 100 (36.2%) patients with low sperm count. In the group of infertile men, those with low sperm count had higher zinc levels compared to men with azoospermia (Mann Whitney U test: p=0.036), suggesting a connection between lower zinc level in seminal fluid and male fertility. Zinc as a biological marker and an antioxidant affects sperm count, motility and morphology. Zinc supplemental therapy could improve seminal parameters in patients diagnosed with low sperm count. Dietary habits of the subjects differ regionally, and future research could make a solid foundation for complementary approach to treatment of male infertility.


Assuntos
Infertilidade Masculina , Sêmen , Zinco , Adulto , Estudos de Casos e Controles , Humanos , Infertilidade Masculina/diagnóstico , Masculino , Sêmen/química , Contagem de Espermatozoides , Motilidade Espermática , Zinco/análise
10.
Fertil Steril ; 114(2): 233-238, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32650948

RESUMO

OBJECTIVE: To investigate the presence of viral RNA in human semen of patients with severe acute-respiratory syndrome coronavirus 2 (SARS-CoV-2) and to evaluate its presence and relevance in semen parameters. DESIGN: Pilot cohort study. SETTING: University hospital. PATIENT(S): Thirty-four men were distributed as: 1) patients in convalescence (patients with confirmed SARS-CoV-2 infection in pharyngeal swab according to reverse-transcription polymerase chain reaction [RT-PCR] or antibodies); 2) negative control group (no antibodies); and 3) patients with an acute infection (detection of SARS-CoV-2 in pharyngeal swab). INTERVENTION: Semen and a blood sample were collected from each individual. MAIN OUTCOME MEASURE(S): Analysis of semen quality according to the World Health Organization standards. Detection of SARS-CoV-2 by RT-PCR in the native semen sample and after density gradient preparation. Confirmation of immunoglobulin (Ig) A und IgG antibodies in the blood. RESULT(S): Eighteen semen samples from recovered men were obtained 8-54 days after absence of symptoms, 14 from control subjects, and 2 from patients with an active COVID-19 infection. No RNA was detected by means of RT-PCR in the semen, including semen samples from two patients with an acute COVID-19 infection. Subjects with a moderate infection showed an impairment of sperm quality. CONCLUSION(S): A mild COVID-19 infection is not likely to affect testis and epididymis function, whereas semen parameters did seem impaired after a moderate infection. SARS-CoV-2 RNA could not be detected in semen of recovered and acute COVID-19-positive men. This suggests no viral transmission during sexual contact and assisted reproductive techniques, although further data need to be obtained.


Assuntos
Betacoronavirus/metabolismo , Infecções por Coronavirus/sangue , Pneumonia Viral/sangue , RNA Viral/sangue , Sêmen/metabolismo , Sêmen/virologia , Adulto , Estudos de Coortes , Infecções por Coronavirus/diagnóstico , Humanos , Infertilidade Masculina/sangue , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/virologia , Masculino , Pessoa de Meia-Idade , Pandemias , Projetos Piloto , Pneumonia Viral/diagnóstico , Estudos Prospectivos , Adulto Jovem
11.
Proc Natl Acad Sci U S A ; 117(31): 18302-18309, 2020 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-32690677

RESUMO

The ability to evaluate sperm at the microscopic level, at high-throughput, would be useful for assisted reproductive technologies (ARTs), as it can allow specific selection of sperm cells for in vitro fertilization (IVF). The tradeoff between intrinsic imaging and external contrast agents is particularly acute in reproductive medicine. The use of fluorescence labels has enabled new cell-sorting strategies and given new insights into developmental biology. Nevertheless, using extrinsic contrast agents is often too invasive for routine clinical operation. Raising questions about cell viability, especially for single-cell selection, clinicians prefer intrinsic contrast in the form of phase-contrast, differential-interference contrast, or Hoffman modulation contrast. While such instruments are nondestructive, the resulting image suffers from a lack of specificity. In this work, we provide a template to circumvent the tradeoff between cell viability and specificity by combining high-sensitivity phase imaging with deep learning. In order to introduce specificity to label-free images, we trained a deep-convolutional neural network to perform semantic segmentation on quantitative phase maps. This approach, a form of phase imaging with computational specificity (PICS), allowed us to efficiently analyze thousands of sperm cells and identify correlations between dry-mass content and artificial-reproduction outcomes. Specifically, we found that the dry-mass content ratios between the head, midpiece, and tail of the cells can predict the percentages of success for zygote cleavage and embryo blastocyst formation.


Assuntos
Doenças dos Bovinos/diagnóstico , Processamento de Imagem Assistida por Computador/métodos , Infertilidade Masculina/veterinária , Redes Neurais de Computação , Espermatozoides/ultraestrutura , Animais , Bovinos , Feminino , Infertilidade Masculina/diagnóstico , Masculino , Folículo Ovariano , Óvulo/fisiologia , Análise do Sêmen
13.
Fertil Steril ; 113(6): 1140-1149, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32482250

RESUMO

OBJECTIVE: To summarize current understanding of the effects of novel and prior coronaviruses on human reproduction, specifically male and female gametes, and in pregnancy. DESIGN: Review of English publications in PubMed and Embase to April 6, 2020. METHOD(S): Articles were screened for reports including coronavirus, reproduction, pathophysiology, and pregnancy. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Reproductive outcomes, effects on gametes, pregnancy outcomes, and neonatal complications. RESULT(S): Seventy-nine reports formed the basis of the review. Coronavirus binding to cells involves the S1 domain of the spike protein to receptors present in reproductive tissues, including angiotensin-converting enzyme-2 (ACE2), CD26, Ezrin, and cyclophilins. Severe Acute Respiratory Syndrome Coronavirus 1 (SARS-CoV-1) may cause severe orchitis leading to germ cell destruction in males. Reports indicate decreased sperm concentration and motility for 72-90 days following Coronavirus Disease 2019 (COVID-19) infection. Gonadotropin-dependent expression of ACE2 was found in human ovaries, but it is unclear whether SARS-Coronavirus 2 (CoV-2) adversely affects female gametogenesis. Evidence suggests that COVID-19 infection has a lower maternal case fatality rate than SARS or Middle East respiratory syndrome (MERS), but anecdotal reports suggest that infected, asymptomatic women may develop respiratory symptoms postpartum. Coronavirus Disease 2019 infections in pregnancy are associated with preterm delivery. Postpartum neonatal transmission from mother to child has been reported. CONCLUSION(S): Coronavirus Disease 2019 infection may affect adversely some pregnant women and their offspring. Additional studies are needed to assess effects of SARS-CoV-2 infection on male and female fertility.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/virologia , Infertilidade Feminina/virologia , Infertilidade Masculina/virologia , Orquite/virologia , Pneumonia Viral/virologia , Reprodução , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico , Feminino , Fertilidade , Interações Hospedeiro-Patógeno , Humanos , Infertilidade Feminina/diagnóstico , Infertilidade Feminina/fisiopatologia , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/fisiopatologia , Masculino , Orquite/diagnóstico , Orquite/fisiopatologia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Complicações Infecciosas na Gravidez/virologia , Resultado da Gravidez , Medição de Risco , Fatores de Risco , Contagem de Espermatozoides , Motilidade Espermática
14.
Lasers Med Sci ; 35(8): 1671-1680, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32483749

RESUMO

Male infertility is a worldwide critical condition that affects about the 7.5% of males in Europe leading to an increment of the couples referring to reproductive medicine units to achieve pregnancy. Moreover, in the recent years, an increased number of patients have required to freeze their gametes in order to preserve their fertility. Photobiomodulation (PBM) therapy is a potential treatment that has been used for different clinical application basically aimed at biostimulating cells and tissues. Here, we report a deep overview of the published studies, focusing on PBM mechanism of action, with the aim of expanding the knowledge in the field of laser light for a rational utilization of irradiation in the clinical practice. In the field of reproductive science, PBM was employed to increment spermatozoa's metabolism, motility, and viability, due to its beneficial action on mitochondria, leading to an activation of the mitochondrial respiratory chain and to the ATP production. This treatment can be particularly useful to avoid the use of chemicals in the spermatozoa culture medium as well as to promote the spermatozoa survival and movement especially after thawing or in largely immotile sperm samples.


Assuntos
Infertilidade Masculina/radioterapia , Terapia com Luz de Baixa Intensidade , DNA/efeitos da radiação , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Masculino , Motilidade Espermática/efeitos da radiação , Espermatozoides/efeitos da radiação
15.
Medicine (Baltimore) ; 99(26): e20863, 2020 Jun 26.
Artigo em Inglês | MEDLINE | ID: mdl-32590788

RESUMO

INTRODUCTION: The infertile male individuals carrying the Y-autosome translocations are seldom reported in clinic. Herein, we described a severe oligozoospermic male with rare unbalanced Y;3 translocation transmitted through 3 generations. PATIENT CONCERNS: A 33-year-old Chinese male was referred for infertility consultation in our center after 10 years' primary infertility. He was diagnosed as severe oligozoospermia according to the semen analysis. DIAGNOSIS: G-banding analysis initially described the karyotype as 46, XY, add (3) (p26) for the patient, and his wife's karyotype was 46, XX. The chromosomal microarray analysis identified 3.81Mb and 0.29Mb duplications in Yq11.223q11.23 and Yq12, separately. No deletions were detected in azoospermia factors (AZF)a, AZFb and AZFc. Fluorescence in situ hybridization analysis further confirmed the existence of sex-determining region Y gene and verified that Yq12 was translocated to the terminal short arm of chromosome 3(3p26). INTERVENTIONS: The couple chose intracytoplasmic sperm injection to get their offspring. The wife underwent amniocentesis for cytogenetic analysis but suffered termination of pregnancy due to premature rupture of membranes. OUTCOMES: The karyotype of the patient was finally described as 46, X, der(3)t(Y;3)(q11.22;p26). His father and the aborted fetus showed the same karyotypes as the patient. CONCLUSION: Our study not only enriched the karyotype-phenotype correlation of Y-autosome translocation, but also strengthened the critical roles of molecular genetic techniques in identifying the chromosomal breakpoints and regions involved.


Assuntos
Transtornos Cromossômicos/complicações , Infertilidade Masculina/genética , Adulto , Transtornos Cromossômicos/genética , Citogenética/métodos , Humanos , Hibridização in Situ Fluorescente/métodos , Infertilidade Masculina/diagnóstico , Masculino
16.
Biochim Biophys Acta Mol Cell Res ; 1867(7): 118708, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32240712

RESUMO

Spermatogonia migrate to the microenvironment during the establishment from gonocytes and leave it when they differentiate. However, the mechanisms underlying the regulation of spermatogonial differentiation-associated migration remain mostly unknown. In this study, we show that spermatogonial differentiation induced by retinoic acid (RA) was accompanied with increased migration ability and elevated expression of connective tissue growth factor (CTGF), a member of the CCN family. CTGF was mainly expressed in the testicular somatic cells and committed spermatogonial progenitors. Recombinant CTGF (rCTGF) promoted the spermatogonial migration and silencing of endogenous CTGF suppressed the migration of homogenous spermatogonial cell lines. Moreover, depletion of CTGF by neutralizing antibody inhibited the elevated migration ability induced by RA, suggesting both the paracrine and autocrine roles of CTGF in spermatogonial migration associated with differentiation. Finally, CTGF interacted with ß1-integrin and regulated its level in spermatogonial cell lines. Together, our study provides novel insights into the regulation of spermatogonial migration by CTGF, which may shed light on the diagnosis and treatment of male infertility.


Assuntos
Movimento Celular/genética , Fator de Crescimento do Tecido Conjuntivo/genética , Integrina beta1/genética , Espermatogônias/crescimento & desenvolvimento , Animais , Diferenciação Celular/efeitos dos fármacos , Linhagem Celular , Humanos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/genética , Infertilidade Masculina/patologia , Masculino , Camundongos , Espermatogônias/metabolismo , Tretinoína/farmacologia
17.
Urol Clin North Am ; 47(2): 129-138, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32272984

RESUMO

A male factor is a contributor in 50% of cases of infertility. Although assisted reproductive techniques can often bypass the need to improve semen parameters, the evaluation of the infertile man remains critical. Current methods for evaluating the infertile man are discussed, beginning with the basic workup that all suspected infertile men should undergo, followed by subsequent evaluation steps. Although the fundamental components of the evaluation have remained consistent, several new tools are available to assist in identifying the underlying etiology. As our understanding of male fertility expands, the technologies available to diagnose and ultimately treat it continue to evolve.


Assuntos
Infertilidade Masculina/diagnóstico , Infertilidade Masculina/etiologia , Testes Genéticos , Humanos , Infertilidade Masculina/genética , Masculino , Anamnese , Exame Físico , Análise do Sêmen
19.
Urol Clin North Am ; 47(2): 165-174, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32272988

RESUMO

Sperm DNA damage reduces pregnancy rates in couples undergoing in vitro fertilization (IVF). Because it has been shown that testicular sperm have lower DNA damage than ejaculated sperm, it is an attractive idea to consider using testicular sperm for IVF for men with high sperm DNA damage. In fact, there are multiple centers throughout the world now offering sperm retrieval for IVF to manage this condition. However, there is insufficient evidence to conclude that testicular sperm improves pregnancy/live birth rates. Further studies are required before offering sperm retrieval as a standard of care to manage high sperm DNA damage.


Assuntos
Dano ao DNA , Fertilização In Vitro/métodos , Infertilidade Masculina/diagnóstico , Infertilidade Masculina/terapia , Recuperação Espermática , Aborto Espontâneo/etiologia , Humanos , Infertilidade Masculina/etiologia , Masculino , Espermatozoides , Testículo/patologia
20.
Urol Clin North Am ; 47(2): 185-191, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32272990

RESUMO

With male factor infertility accounting for up to 50% of infertility cases, demand for male fertility services has increased. Integrating a reproductive urologist within a fertility center allows for treatment of both partners simultaneously with easier, more convenient access to a comprehensive male evaluation and any indicated interventions. A joint practice allows urologists to collaborate more closely with reproductive endocrinologists, which can, in turn, improve clinical care and research endeavors. This full-service, streamlined approach translates to optimized care for the infertile couple and allows for emphasis of male partner health.


Assuntos
Infertilidade Masculina/diagnóstico , Infertilidade Masculina/terapia , Papel do Médico , Medicina Reprodutiva , Urologia , Feminino , Fidelidade a Diretrizes , Humanos , Relações Interprofissionais , Masculino , Guias de Prática Clínica como Assunto , Prática Profissional
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