Treatment of Male Infertility

Treatment of Male Infertility

Paperback(Softcover reprint of the original 1st ed. 1982)

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Product Details

ISBN-13: 9783642682254
Publisher: Springer Berlin Heidelberg
Publication date: 12/06/2011
Edition description: Softcover reprint of the original 1st ed. 1982
Pages: 332
Product dimensions: 6.69(w) x 9.61(h) x 0.03(d)

Table of Contents

I. General Considerations.- Male Infertility: Problems in Assessing Response to Treatment.- II. Medical Treatment.- 1 Inflammation and Infection.- 1.1 Inflammation of Male Accessory Sex Organs.- 1.1.1 Genital and Rectal Examination.- 1.1.2 Collection and Processing of the Prostatic Vesicular Fluid (PVF).- 1.1.3 Cytological Examination of PVF.- 1.1.3.1 Cellular Elements of the PVF.- 1.1.3.2 Quantitative Changes of the PVF Cells During Inflammation.- 1.1.3.3 Qualitative Changes of Epithelial Cells During Inflammation.- 1.1.3.4 Cellular Patterns of the Smears.- 1.1.4 Molecular Tracers of the Inflammatory Process.- 1.1.4.1 Immunoglobulins.- 1.1.4.2 C3 Factor of the Complement System.- 1.1.4.3 Albumin.- 1.1.4.4 ?1-Antitrypsin.- 1.1.4.5 ?1-Acid Glycoprotein.- 1.2 Infectious Male Adnexitis.- 1.2.1 General Considerations.- 1.2.2 Qualitative and Quantitative Data on Genital Infection in Infertile Patients.- 1.3 Secretory Function of Accesory Glands and Male Adnexitis.- 1.4 Treatment of Male Adnexitis.- 1.4.1 Introduction.- 1.4.2 Therapeutic Procedures.- 1.4.3 Follow-Up.- 1.5 Gaps in Our Knowledge.- 1.6 References.- 2 Clomiphene Citrate in the Treatment of Male Infertility.- 2.1 Testicular Control and Function.- 2.2 The Clomiphene Test.- 2.3 Clomiphene Citrate in Male Infertility.- 2.3.1 Clomiphene Citrate Therapy.- 2.3.2 Material and Methods.- 2.3.3 Review of Results Obtained with Clomid.- 2.4 Side and Secondary Effect of Clomiphene Citrate.- 2.5 Discussion.- 2.6 References.- 3 Tamoxifen.- 3.1 Mode of Action.- 3.2 Patients.- 3.3 Results.- 3.3.1 Plasma Hormone Levels.- 3.3.1.1 Testosterone.- 3.3.1.2 Estradiol.- 3.3.1.3 Gonadotropins (LH and FSH).- 3.3.2 Sperm Characteristics.- 3.3.2.1 Sperm Concentration.- 3.3.2.2 Sperm Motility.- 3.3.2.3 Sperm Morphology.- 3.3.3 Biochemical Composition of Seminal Plasma.- 3.3.4 Pregnancy.- 3.3.5 Side Effects.- 3.4 Conclusions.- 3.5 References.- 4 LHRH and Its Analogs in the Treatment of Idiopathic Normogonadotropic Oligozoospermia.- 4.1 General Considerations.- 4.1.1 Hypothalamic Hormones.- 4.1.2 Male Infertility.- 4.2 Experience with LHRH and Its Analogs.- 4.2.1 Selection of Patients.- 4.2.2 Evaluation of Results.- 4.2.3 Experience with LHRH.- 4.2.4 D-Leucine6-LHRH-Ethylamide.- 4.2.5 D-Tryptophan6-LHRH.- 4.3 Conclusions.- 4.4 References.- 5 Hyperprolactinemia in Male Infertility: Treatment with Bromocriptine.- 5.1 Control of PRL Release: The Role of Dopamine and Estrogens.- 5.2 Modification of PRL Secretion by Pharmacological Agents and Drug Interaction.- 5.3 Physiology and Physiopathology of PRL in Men.- 5.4 Incidence and Causes of Male Hyperprolactinemia.- 5.5 Biological and Biochemical Effect of Excessive PRL Secretion in Men.- 5.6 Bromocriptine Treatment of Male Hypogonadism.- 5.7 Conclusions.- 5.8 References.- 6 Gonadotropin Therapy in Male Infertility.- 6.1 Gonadotropin Preparations.- 6.1.1 Pituitary Gonadotropins.- 6.1.2 hCG.- 6.1.3 FSH.- 6.2 Hypogonadotropic Hypogonadism.- 6.2.1 Treatment of Hypogonadotropics with hCG.- 6.2.2 Therapy with hMG.- 6.2.3 Therapy with hCG and hMG.- 6.3 Gonadotropin Treatment in Idiopathic Oligozoospermia.- 6.4 Conclusions.- 6.5 References.- 7 Androgen Therapy in Hypogonadism and Infertility.- 7.1 Mechanism of Testosterone Action.- 7.2 Pharmacology of Androgens.- 7.2.1 Free Testosterone.- 7.2.2 Parenteral Testosterone Esters.- 7.2.3 Testosterone Undecanoate.- 7.2.4 Synthetic Androgens.- 7.2.4.1 Methyltestosterone.- 7.2.4.2 Fluoxymesterone.- 7.2.4.3 Mesterolone.- 7.2.5 Testis Sicca and Testis Extracts.- 7.3 Clinical Application.- 7.3.1 Substitution of Endocrine Testicular Insufficiency.- 7.3.2 Idiopathic Delayed Puberty.- 7.3.3 Excessively Tall Boys.- 7.3.4 Androgens in Adavanced Age.- 7.3.5 Testosterone Rebound Therapy as Treatment of Male Infertility.- 7.4 References.- 8 Mesterolone: a New Androgen for the Treatment of Male Infertility.- 8.1 Properties of Mesterolone.- 8.2 Literature Review.- 8.3 Toleration and Function of the Liver.- 8.4 Conclusions.- 8.5 References.- 9 Kinin-Releasing Pancreatic Proteinase Kallikrein.- 9.1 Kallikrein-Kinin System.- 9.1.1 Biochemistry and Physiology.- 9.1.2 Reproductive Functions.- 9.2 Experimental Investigations.- 9.2.1 In Vitro Studies.- 9.2.2 Animal Studies.- 9.2.3 Biochemical and Endocrinological Studies in Men.- 9.3 Clinical Investigations and Application.- 9.3.1 Systemic Kallikrein Treatment.- 9.3.1.1 Open Clinical Trials.- 9.3.1.2 Double Blind Studies.- 9.3.1.3 Routes of Administration and Side Effects.- 9.3.2 In Vitro Improvement of Human Semen.- 9.4 Conclusions.- 9.5 References.- 10 Treatment of Male Infertility with Nucleotides.- 10.1 Structure and Metabolism.- 10.2 Clinical Studies.- 10.2.1 Procedure.- 10.2.2 Treatment.- 10.3 Results.- 10.4 Conclusion.- 10.5 References.- 11 Immunological Infertility in Men: Clinical and Therapeutic Considerations.- 11.1 The Different Types of Sperm Antibodies Observed in Men.- 11.2 Antibody Nature of Sperm-Agglutinating and Sperm-Immobilizing Activities.- 11.3 Causes of Sperm Antibody Production.- 11.4 The Significance of Sperm Antibodies in Men.- 11.5 Treatment of Men with Sperm Antibodies.- 11.5.1 Treatment of Men with Genital Infections.- 11.5.2 Surgical Treatment.- 11.5.3 Sperm Washing and Intrauterine Inseminations.- 11.5.4 Immunosuppressive Treatment.- 11.5.4.1 Low-Dose Corticosteroids.- 11.5.4.2 High-Dose Corticosteroids.- 11.5.4.3 Azathioprine.- 11.5.5 The Testosterone Rebound Phenomenon and Sperm Antibodies.- 11.6 Conclusions.- 11.7 References.- 12 Nonsurgical Treatment of Varicocele.- 12.1 Historical Background.- 12.1.1 Diagnosis of Varicocele.- 12.1.2 Treatment of Varicocele.- 12.2 Transcatheter Sclerosis of the Spermatic Veins.- 12.3 Technique.- 12.4 Observations in 88 Patients.- 12.5 Conclusions.- 12.6 References.- 13 Retrograde Ejaculation.- 13.1 Anatomy of the Male Urethra and Internal Genitalia.- 13.2 Physiology of Ejaculation.- 13.3 Etiology of Retrograde Ejaculation.- 13.4 Diagnosis of Retrograde Ejaculation.- 13.5 Treatment of Retrograde Ejaculation.- 13.5.1 Retrieval of Semen.- 13.5.1.1 Replacement of Bladder Urine with an Isotonic Alkaline Solution.- 13.5.1.2 Systemic Alkalinization of the Urine.- 13.5.1.3 Washing of Semen in Nutrient Alkaline Solution.- 13.5.2 Medication.- 13.5.3 Surgery.- 13.5.4 Miscellaneous.- 13.6 Conclusions.- 13.7 References.- 14 Sexual Dysfunction in the Male.- 14.1 Definition.- 14.1.1 Kinds of Sexual Dysfunction.- 14.1.1.1 Sexual Approach.- 14.1.1.2 Sexual Stimulation.- 14.1.1.3 Intromission and Preorgasmic Coitus.- 14.1.1.4 Orgasm.- 14.1.1.5 Postorgasmic Period.- 14.1.2 Circumstances of Occurrence.- 14.2 Interviewing Technique and Differential Diagnosis Between “Organic” and “Psychogenic” Male Sexual Dysfunction.- 14.2.1 Interviewing Technique.- 14.2.2 Differential Diagnosis.- 14.3 Etiology.- 14.3.1 Organic Sexual Dysfunctions.- 14.3.1.1 Libido Disturbances.- 14.3.1.2 Erectile Impotence.- 14.3.1.3 Ejaculatory Disturbances.- 14.3.2 Psychogenic Sexual Dysfunctions.- 14.4 Therapy.- 14.4.1 Therapy of Organic Sexual Dysfunctions.- 14.4.2 Therapy of Psychogenic Sexual Dysfunctions.- 14.4.2.1 Sexual Counseling.- 14.4.2.2 Partner Therapy.- 14.4.2.3 Psychoanalysis.- 14.4.2.4 Behavior Therapy.- 14.4.2.4.1 Therapy Concept and Format.- 14.4.2.4.2 Initial Results.- 14.4.2.4.3 Follow-up Studies.- 14.4.2.4.4 Conclusions.- 14.5 Effect of Psychological Factors on the Production and Action of Spermatozoa.- 14.6 References.- III. Surgical Treatment.- 15 Varicocele: Its Role in Male Infertility.- 15.1 Definition and Classification.- 15.2 Pathogenesis and Etiology.- 15.2.1 Metabolites.- 15.2.2 Heat.- 15.2.3 Hormonal Factors.- 15.2.4 Abnormal Gases.- 15.2.5 Epididymal Factors.- 15.3 Diagnosis.- 15.4 Indications for Treatment.- 15.5 Management.- 15.5.1 Surgical.- 15.5.2 Medical.- 15.6 Results.- 15.7 Discussion and Conclusions.- 15.8 References.- 16 Obstruction in the Male Reproductive Tract.- 16.1 Causes of Obstruction of the Male Reproductive Tract.- 16.1.1 Obstruction After Inflammation.- 16.1.2 Obstruction After Vasography.- 16.1.3 Aplasia or Hypoplasia of the Vas Deferens.- 16.1.4 Obstruction After Vasectomy.- 16.1.5 Obstruction After Herniotomy.- 16.2 Therapy and Results.- 16.2.1 Epididymovasostomy.- 16.2.2 Vasovasostomy.- 16.2.3 Alloplastic Spermatocele.- 16.3 Discussion and Conclusions.- 16.4 References.- 17 Hydrocele, Spermatocele, and Peyronie’s Disease.- 17.1 Hydrocele.- 17.1.1 Definition and Etiology.- 17.1.2 Symptoms.- 17.1.3 Diagnosis.- 17.1.4 Hydrocele and Testicular Tumors.- 17.1.5 Treatment.- 17.2 Spermatocele.- 17.2.1 Definition and Etiology.- 17.2.2 Symptoms.- 17.2.3 Diagnosis.- 17.2.4 Spermatocele and Epididymal Tumors.- 17.2.5 Treatment.- 17.3 Peyronie’s Disease (Induratio Penis Plastica).- 17.3.1 Definition and Etiology.- 17.3.2 Symptoms.- 17.3.3 Diagnosis.- 17.3.4 Nonsurgical Treatment.- 17.3.5 Surgical Treatment.- 17.3.5.1 Excision of the Plaques.- 17.3.5.2 Implantation of Penile Prosthesis.- 17.4 Conclusion.- 17.5 References.- IV. Cryopreservation and Insemination.- 18 Cryopreservation and Pooling of Spermatozoa.- 18.1 History.- 18.2 Application of Cryobanking.- 18.3 The Biological Process in Cryopreservation.- 18.4 Sperm Freezing and Insemination Techniques.- 18.4.1 Freezing Methods.- 18.4.2 Preparation for Freezing.- 18.4.3 Storage of Semen.- 18.4.4 Insemination with Frozen Semen.- 18.5 Enhancing Sperm Motility After Thawing.- 18.6 Conclusions.- 18.6.1 Pooling and Storing of Semen.- 18.6.2 Suggested Freezing Methods.- 18.6.3 The Future.- 18.7 References.- 19 Enhancement of Sperm Motility: Selecting Progressively Motile Spermatozoa.- 19.1 Techniques.- 19.1.1 Caffeine Stimulation of Motility for Cryopreservatio6n.- 19.1.2 Selection of Motile Spermatozoa.- 19.1.2.1 Glass Wool Filtration.- 19.1.2.2 Active Selection of Motile Spermatozoa in BWW Medium.- 19.1.2.3 Selection of Motile Spermatozoa on Albumin Columns.- 19.1.3 Techniques for the Concentration of Spermatozoa.- 19.1.3.1 Millipore Filter Absorption of Water.- 19.1.3.2 Centrifugation.- 19.1.4 Techniques of Semen Analysis.- 19.1.4.1 Motility of Spermatozoa.- 19.1.4.2 Sperm Density.- 19.2 Results.- 19.2.1 Caffeine Stimulation and Cryopreservation.- 19.2.2 Selection of Motile Spermatozoa.- 19.2.2.1 Glass Wool Filtration.- 19.2.2.2 BWW Selection.- 19.2.3 Concentration Procedures.- 19.2.3.1 Millipore Filter Concentration.- 19.2.3.2 Centrifugation.- 19.2.3.3 BWW Plus Centrifugation.- 19.3 Discussion.- 19.4 References.- 20 Artificial Homologous Insemination.- 20.1 Indications for AIH.- 20.1.1 Subnormal Semen.- 20.1.1.1 Oligozoospermia.- 20.1.1.2 Asthenozoospermia.- 20.1.1.3 Teratozoospermia and Debris-Contaminated Semen.- 20.1.1.4 Increased Seminal Viscosity and Delayed Seminal Liquefaction.- 20.1.1.5 Hypospermia.- 20.1.2 Deposition Failure.- 20.1.2.1 Impotence and Anejaculation.- 20.1.2.2 Vaginismus.- 20.1.2.3 Deformed Female or Male Genital Organs.- 20.1.3 Failure of Sperm Migration.- 20.1.4 Cryopreserved Semen.- 20.2 Technique of Artificial Insemination.- 20.2.1 Intravaginal Insemination.- 20.2.2 Pericervical and Intracervical Insemination.- 20.2.3 Cap Insemination.- 20.2.4 Intrauterine Insemination.- 20.3 Timing of Insemination.- 20.4 Contraindications for AIH.- 20.5 Results of AIH.- 20.6 The Value of Split Insemination.- 20.7 Conclusions.- 20.8 References.- 21 In Vitro Fertilization: Future Treatment for Male Infertility.- 21.1 In Vitro Fertilization.- 21.1.1 Background.- 21.1.2 Human IVF.- 21.2 IVF and Male Infertility.- 21.2.1 Rationale.- 21.2.2 Ovum Retrieval and Sperm Capacitation.- 21.2.3 Sperm Characteristics.- 21.3 Conclusion.- 21.4 References.- V. Closing Remarks.- The Last Word—For Now.

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