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In Vitro Fertilization and Embryo Transfer
Published in Asim Kurjak, Ultrasound and Infertility, 2020
The andrologist prepares the sperm necessary for the fertilization process. He is important in establishing the diagnosis of male infertility and in preparing the sperm concentration most suitable for oocyte fertilization. In large centers, andrologists take care of banks of sperm and together with geneticists decide on the profile of potential sperm donors.
Ultrasound Imaging of the Infertile Male
Published in Botros Rizk, Ashok Agarwal, Edmund S. Sabanegh, Male Infertility in Reproductive Medicine, 2019
Amr Abdel Raheem, Giulio Garaffa, Hatem El-Azizi
Screening for male-factor infertility is done by a semen-analysis test. Men with identified male factor should be referred to an andrologist. Assessment of the infertile male involves history taking and genital examination. Based on the semen-analysis results, some men may require male reproductive hormonal and genetic profiling. In addition to laboratory tests, imaging modalities may be helpful in establishing the underlying cause and assisting in treatment.
Evaluation of sperm
Published in David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham, Textbook of Assisted Reproductive Techniques, 2017
Kaylen M. Silverberg, Tom Turner
If antibodies are absent, the beads will not attach. Like the MAR test, this test can be used for the detection of direct antibodies in men. However, it may also be used to detect antibodies produced in a woman’s serum, follicular fluid, or cervical mucus by incubating these bodily fluids with washed sperm that have previously tested negative for antibodies. To perform an indirect test, known direct antibody-negative sperm are washed free of seminal plasma and resuspended in a small volume of media plus BSA. They are incubated for one hour at 37°C with the bodily fluid to be tested. The sperm are then washed free of the bodily fluid, resuspended in media plus BSA, and mixed on a slide with IgG- or IgA-coated latex beads. The test is interpreted by noting the percentage and location of the bead attachment. The third edition WHO standard considers the level of binding of >20% as representing a positive test, whereas the fourth edition WHO standard considers a level of >50% to be a positive test. The level of binding of >50% is commonly considered to be clinically significant (10, 25). The clinical value of antisperm antibody testing is predicated on the observation that the presence of a significant concentration of antibodies may impair fertilization. It has been reported that antibody- positive sperm may have difficulty penetrating cervical mucus. Although in these cases intrauterine insemination or IVF may improve the prognosis for fertilization, antibody levels >80%, coupled with subpar concentration, motility, or morphology, may necessitate the addition of ICSI in order to achieve the highest percentage of fertilization (26). As suggested by the literature, andrology laboratories may do a significantly better job of preparing sperm if they are aware of the presence of antibodies. Specifically, it has been demonstrated that the use of increased concentrations of protein in the media used for sperm preparation will reduce the adverse effect of antisperm antibodies on sperm motility. In summary, antisperm antibodies have been demonstrated to be a contributing factor in infertility. While their presence alone may not be sufficient to prevent pregnancy, their detection should encourage the andrologist to pursue additional appropriate action.
Brain structural network topological alterations of the left prefrontal and limbic cortex in psychogenic erectile dysfunction
Published in International Journal of Neuroscience, 2018
Jianhuai Chen, Yun Chen, Qingqiang Gao, Guotao Chen, Yutian Dai, Zhijian Yao, Qing Lu
The diagnosis of pED was conducted by one experienced andrologist according to current guidelines [1]. Each patient in this study should meet following inclusion criteria: (1) being diagnosed as pED rather than organic disorders (absence of organic ED, normal morning and nocturnal erections, normal penile hemodynamics); (2) 18–45 of age and be right handed; (3) being in a stable heterosexual relationship for at least one year with their female partners. In addation, basic laboratory tests of all patients including the testosterone level, were by checked before being enrolled in this study. And the testosterone level of all patients was normal. Normal morning and nocturnal erections and penile hemodynamic were also verified in HC. All subjects underwent a 1 h medical interview (especially psychiatric and neurological symptoms) by one experienced psychiatrist with the Mini International Neuropsychiatric Interview (MINI). And all subjects did not meet the criterias for any Axis 1 and 2 psychiatric disorders (or had a relative with a history of psychiatric disorder or any mental illness).
Comparison of semen quality between university-based and private assisted reproductive technology laboratories
Published in Scandinavian Journal of Urology, 2018
Christian Fuglesang S. Jensen, Omar Khan, Jens Sønksen, Mikkel Fode, James M. Dupree, Tariq Shah, Dana A. Ohl
Institutional review board approval was obtained to evaluate records of patients referred to a university-based ART laboratory and reproductive medicine clinic. Men were referred for a second opinion of male infertility after prior evaluations at private ART laboratories between 2012–2016. A private ART laboratory was defined as a privately owned, for profit business, that offers IVF procedures. Accordingly, all hospital-based ART laboratories were excluded. Only those private ART laboratories performing semen analyses according to WHO 5th edition and reporting morphology as Kruger’s strict morphology were included. If more than one semen analysis was present from either the private ART laboratory or the University-based ART laboratory, the first analysis performed at each location was used. Patients were categorized according to the University-based ART laboratory semen analysis. If all semen parameters were above the WHO 5th edition reference limits, the patient was categorized as normal. If one or more of the major semen parameters were below the WHO 5th edition reference limits, the patients were categorized according to the male factor infertility diagnosis given by the same experienced andrologist after a full medical history, physical examination and hormonal investigation.
Does male fertility-related quality of life differ when undergoing evaluation by reproductive urologist versus reproductive endocrinologist?
Published in Human Fertility, 2023
Rachel Danis, Intira Sriprasert, William Petok, Jesse Stone, Richard Paulson, Mary Samplaski
Longer durations of infertility do seem to affect males (Greil, 1997; Pook & Krause, 2005; Schick et al., 2016; Wischmann & Thorn, 2013). Men with known male factor infertility, and having longer durations of infertility and treatment failure, were found to have higher levels of male distress (Pook & Krause, 2005). Men with known male factor infertility have been shown to have a lower FertiQoL (Asazawa et al., 2019). Likewise, with time and care by an andrologist, the male fertility experience and FertiQoL changes (Warchol-Biedermann, 2021). While we did not identify a correlation between infertility duration and overall FertiQoL scores, we did find that quantity of failed IVF attempts related to make lower FertiQoL scores.