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Published in Asim Kurjak, Ultrasound and Infertility, 2020
Joseph G. Schenker, Aby Lewin, Menashe Ben-David
The examination of ejaculate is undertaken with regard to morphological, biochemical, and vitality aspects (Figure 8). Approximately 20% of infertile males are azoospermic. Azoospermia may be due to spermatogenic failure, obstruction of any level of the genital tract, or retrograde ejaculation. The algorithmic approach to the evaluation and treatment of the azoospermic male is shown in Figure 10. In most azoospermic males, there is little hope of restoring normal spermatogenesis. Only in cases of hypogonadotrophic hypogonadism was fertility achieved following administration of HMG-HCG therapy and more recently following application of Gn-RH analogs. Cryptorchidism is a potentially preventable cause of infertility, if the testis is brought into the scrotum early in life. When the epididimis or vas has become obstructed because of veneral disease, tuberculosis, or after acute nonspecific epididimitis, the obstruction can often by surgically corrected in about 40 to 50% of the cases. Pregnancies in cases of retrograde ejaculation were obtained following pharmacological therapy or recovery of sperm from the urinary bladder.
Windows of sensitivity to toxic chemicals in the development of reproductive effects: an analysis of ATSDR’s toxicological profile database
Published in International Journal of Environmental Health Research, 2018
Melanie C Buser, Henry G Abadin, John L Irwin, Hana R Pohl
If a substance affects Sertoli and Leydig cell differentiation at an early developmental stage, germ cell growth and testosterone production are impaired (Lemasters et al. 2000). As a consequence, genital abnormalities, such as cryptorchidism or hypospadias, may occur at birth, while fertility problems including poor semen quality and testicular germ cell cancer may occur later, with some effects not being seen until adulthood. Our review on alterations in normal development of the male reproductive system includes evidence of many of these effects (Figure 4). Testicular dysgenesis syndrome (TDS) is a condition characterized by the presence of such disorders in humans (Skakkebaek et al. 2001). It was postulated that the origin of TDS is due to both environmental and genomic factors affecting the development of the male reproductive system in fetuses (Toppari et al. 1996; Virtanen et al. 2005). From a genetic perspective, mutations in androgen receptor genes are associated with TDS with high probability, as these are involved in penile development, testes descent, and testes development (Skakkebaek et al. 2001). Similarly, testicular germ cell cancer shows a strong genetic disposition, with the most significant gene variants being those associated with gonad formation and germ cell function (Skakkebaek et al. 2016).