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Male methods
Published in Suzanne Everett, Handbook of Contraception and Sexual Health, 2020
A vasectomy involves cutting the vas deferens, which is the tube that transports sperm from the epididymis in the testes to the seminal vesicles. By cutting the vas deferens sperm is unable to be ejaculated and a man will become infertile once the vas deferens is clear of sperm, which takes about three months.
Regulation of Reproduction by Dopamine
Published in Nira Ben-Jonathan, Dopamine, 2020
Birth control methods to prevent pregnancy include physical barriers, hormone contraceptives, and surgical ablation methods, which vary in efficacy, side effects, and permanence. Physical barrier methods include intrauterine devices (IUDs) that can be impregnated with copper or progestin, sponges, cervical caps, vaginal rings, and diaphragms and also spermicides for women and condoms for men. Hormonal contraceptives include pills that contain various combinations of estrogen and progesterone, intradermal implantable progesterone rods, injectable Depo-Provera (medroxy-progesterone acetate), and estrogen/progestin-containing skin patches. Emergency contraceptives (also known as the “morning-after pill”) refer to the use of drugs or devices as an emergency measure to prevent unwanted pregnancy. These include levonorgestrel (Plan B One-Step), a progestin only pill that prevents ovulation. Surgical ablation methods include tubal ligation or sterilization in women and vasectomy for men. Vasectomy, or the disconnection of the vas deferens in the scrotal area, is an effective method of male contraception. Because of sperm storage in the ampulla, men remain fertile for 4–5 weeks after vasectomy.
Influencing the sperm count
Published in David J Cahill, Practical Patient Management in Reproductive Medicine, 2019
The vas deferens can be blocked or damaged in several unrelated medical conditions. In male children born with cystic fibrosis, the vas deferens is almost uniformly absent, a congenital condition involving bilateral absence of the vas deferens. This causes difficulty with fertility from the beginning of the man's reproductive life. It appears, however, that sperm aspirated from the epididymis have the potential to fertilise oocytes and produce viable offspring (9) – whether these were screened for cystic fibrosis isn't entirely clear from the paper or subsequent correspondence (9).
Protein markers of spermatogenesis and their potential use in the management of azoospermia
Published in Expert Review of Proteomics, 2021
Sophia Costa Araujo, Ricardo Pimenta Bertolla
Currently, the main procedure for this differential diagnosis is through a testicular biopsy followed by a histopathological examination [7,15]. Despite being the conventional method, biopsy is an invasive and potentially harmful technique for infertile patients, which can cause complications such as: bleeding, permanent damage to the testis, vas deferens and epididymis, chronic pain in the testis, and possible loss of fertility [21]. Furthermore, as a random segment of the testis is removed, residual spermatogenesis may not be identified, as the extent of spermatogenesis within the seminiferous tubules, in the testis, is not homogeneous [15]. Consequently, it would also impair the differentiation between the NOA subtypes, as the biopsy may not accurately reflect the complete histopathology of the subtype. Thus, it is imperative to search for a noninvasive alternative that provides an accurate diagnosis, in addition to differentiating the types and subtypes of azoospermia, and that can also evaluate the success of the testicular sperm extraction (TESE) [14,15]. An alternative technique would also be of great value to fertile patients who have had a vasectomy, to verify the success of the procedure [7,8,22–24].
Non-pharmacological treatments for chronic orchialgia: A systemic review
Published in Arab Journal of Urology, 2021
Kareim Khalafalla, Mohamed Arafa, Haitham Elbardisi, Ahmad Majzoub
The present review identified 19 individual studies including 1676 testicular units for which MSCD was performed. In most cases an open approach for surgery was performed (inguinal [n = 14]; subinguinal [n = 3]; Table 1) [9–27]. Depending on the level of the incision, the aponeurosis of the external oblique muscle is either spared or opened. The ilioinguinal nerve is identified and a 2 cm segment is excised and ligated with proximal part buried well to avoid neuroma formation. Under microscopic magnification, the spermatic cord is brought up and its fascia is opened to expose the cord contents. Micro-Doppler ultrasonography (US) is used to identify the arterial flow in attempt to preserve testicular and cremasteric arteries during the procedure. The contents of the cord are ligated and dissected, which includes the cremasteric fascia, spermatic cord fat, and the pampiniform plexus of veins. Lymphatics are preferably spared to avoid hydrocele formation. The vas deferens is also preserved to reduce epididymal congestion, which decreases the incidence of post-vasectomy pain syndrome (PVPS). However, stripping of the perivasal tissues is performed to ensure obliteration of all the neural fibres.
Effects of testicular sperm aspiration upon first cycle ICSI-ET for type 2 diabetic male patients
Published in Systems Biology in Reproductive Medicine, 2020
Xiang Liu, Ming Gao, Jianhua Sun, Zheng Sun, Juan Song, Xia Xue, Zhou Zhang, Juanzi Shi, Junping Xing
For the non-diabetic group, due to large sample, the situation presented differently: 817 cases exhibited congenital bilateral absence of the vas deferens (70.10%); 113 cases failed masturbation during partner egg collection (9.70%); 156 cases displayed epididymitis (13.40%); 7 cases (0.60%) had previous vasectomy (6 cases remarried and had a history of childbearing; 1 case was the first marriage and the couple wanted another child); and 72 cases lacked seminal vesicles (6.18%). One hundred and fifty-two cases in the non-diabetic group (excluding 113 patients that failed masturbation) and 16 T2DM men with non-ejaculation underwent TESA operation before ART to assess whether the testicular sperm met ICSI criteria (Figure 2). The TESA sperm was evaluated for ICSI criteria by the laboratory staff in the Reproductive Center of Northwest Women’s and Children’s Hospital. Finally, in the non-diabetic group, 774 cases were performed with first fresh transplant cycles.