Sperm recovery techniques Clinical aspects
David K. Gardner, Ariel Weissman, Colin M. Howles, Zeev Shoham in Textbook of Assisted Reproductive Techniques, 2017
In the past 10-20 years, several changes have taken place in clinical andrology. Gradually, empirical treatments have been replaced by techniques of assisted reproduction (i.e., intrauterine insemination, in vitro fertilization [IVF], and intracytoplasmic sperm injection [ICSI]). In particular, the introduction of ICSI in 1992 (1,2) has completely changed the clinical approach towards male infertility by offering a novel opportunity for parenthood to azoospermic men. A single spermatozoon can be injected into an oocyte and result in normal fertilization, embryonic development, and implantation. Not only ejaculated spermatozoa can be used, but epididymal or testicular spermatozoa can also be used for ICSI. Testicular spermatozoa can be retrieved in some patients with non-obstructive azoospermia (NOA) because of the persistence of isolated foci of active spermatogenesis. The first pregnancies using epididymal and testicular spermatozoa in men with obstructive azoospermia (OA) and NOA were published in 1993 and 1995, respectively (3-6). Surgical retrieval of spermatozoa for ICSI has become a routine technique in clinical andrology. Several techniques are available to retrieve epididymal or testicular spermatozoa. Although there is no real method of choice, some guidelines may be given in order to make the best choice for a specific clinical setting. ICSI has also reinforced the role of non-surgical techniques to retrieve sperm in men suffering from anejaculation.
Semen Analysis and Sperm Washing Techniques
Claude Gagnon in Controls of Sperm Motility, 2020
This chapter provides brief descriptions of the basic technical procedures fundamental to the operation of any clinical andrology laboratory providing diagnostic or therapeutic services. The first section comprises an overview of the standard semen analysis which, despite being an integral part of any studies on human spermatozoa, remains a poorly standardized and rarely quality-controlled procedure. Techniques for evaluating the presence of antisperm antibodies have also been included since their assessment is becoming more routine in andrology laboratories. Finally, there is an extensive review of methods that have been used for preparing populations of motile human spermatozoa in vitro. Recommendations as to preferred preparative methods are discussed in relation to recent experimental and clinical studies on sperm functional competence.
Chronic Prostatitis/Chronic Pelvic Pain Syndrome—A Urologist’s Perspective
Gary W. Jay in Practical Guide to Chronic Pain Syndromes, 2016
A specialist in Andrology should be consulted for management of any attendant symptoms of erectile dysfunction. Specialists at Stanford University found that 92% of men with refractory CP/CPPS reported related erectile dysfunction, including problems with decreased libido (66%), pain upon ejaculation (56%), and ejaculatory dysfunction (31%) (28). Often, men are reluctant to volunteer problems they are facing in this regard. It is important to encourage open discussion of these issues from the outset. Questionnaires, such as the CPSI and International Index of Erectile Function, provide an apercu for patients to raise issues in this sensitive area. Active participation on the part of patient’s partner should be in and treatment (29).
Satisfaction with a Vacuum Constriction Device for Erectile Dysfunction among Middle-Aged and Older Veterans
Published in Clinical Gerontologist, 2021
Sherry A. Beaudreau, Katie Van Moorleghem, Stacy M. Dodd, Victoria Liou-Johnson, Madhuvanthi Suresh, Christine E. Gould
An Andrology clinic in a northern California VA health-care system conducted a program evaluation to assess patient satisfaction with the vacuum constriction device to treat ED. The Andrology clinic is an interdisciplinary clinic staffed by physicians, clinical psychologists, and medical and psychology trainees that provides comprehensive evaluations and treatment of male patients referred for sexual functioning difficulties, including ED. The evaluation was not restricted to heterosexual male patients, though the majority seeking treatment with the device had female sexual partners. Male patients received training and education in the device prior to using it. Semi-structured interviews of their satisfaction occurred during a follow-up visit. Female partners who accompanied patients to the appointments also rated satisfaction with the device. Data for this project were originally collected to improve clinic procedures. Institutional Review Board (IRB) approval, including a waiver of consent, was subsequently obtained from Stanford University School of Medicine to conduct a medical chart review and to summarize findings of the program evaluation on satisfaction with the vacuum constriction device. Information provided herein abides to the IRB approval.
Sperm motility in asthenozoospermic semen samples can be improved by incubation in a continuous single culture medium (CSCM®)
Published in Systems Biology in Reproductive Medicine, 2022
Caroline Ranéa, Juliana Risso Pariz, Joël R. Drevet, Jorge Hallak
In conclusion, under our experimental conditions, which largely mimic the daily procedures in the vast majority of andrology and micromanipulation laboratories in dozens of countries, the incubation of semen samples for 2 h in CSCM® supplemented with HSA® proved to be better than any of the other classical medium tested in terms of stimulating the motility of semen samples from asthenozoospermic patients. This simple, inexpensive, and easily reproducible protocol could prove useful for andrology laboratories working alone or in conjunction with micromanipulation laboratories and IVF clinics for improved management of infertile patients with asthenozoospermia. Further research will determine whether this improved motility translates into higher pregnancy rates following ART procedures. Indeed, we expect this to be the case because sperm motility is positively correlated with higher pregnancy rates (Shulman et al. 1998; Björndahl 2010; Lumley et al. 2015).
Application of dual-energy CT angiography in diagnosis of arterial erectile dysfunction: new scanning technology, new scanning area
Published in The Aging Male, 2022
Ming Wang, Yutian Dai, Hui Jiang, Andrea Sansone, Emmanuele A. Jannini, Xiansheng Zhang
The study was performed in our andrology clinical center. Between April 2017 and July 2021, 377 consecutive patients that complained of ED were evaluated for inclusion in the study based on the following criteria: age ≥18 years; difficulty in obtaining or maintaining erection for more than six months, as measured by International Index for Erectile Function (IIEF)-5. Exclusion criteria were the following: severe hepatic and renal impairment, hormonal disorders, contrast agent hypersensitivity, presence of a known neoplasia, serious psychological abnormalities, neurologic disease, and penile fibrosis. Furthermore, subjects who had taken drugs that may affect erectile within four weeks were excluded. Forty sexually active male health volunteers were also recruited to undergo the testing as a healthy control population.
Related Knowledge Centers
- Assisted Reproductive Technology
- Circumcision
- Surgery
- Vasectomy
- Vasovasostomy
- Male Reproductive System
- Urology
- Gynaecology
- Orchiopexy
- Semen Cryopreservation