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Table of Contents
1: Introduction; References; 2: Prevalence, Definition, and Classification of Infertility; 2.1 Definition; 2.2 Epidemiology; 2.3 Incidence; 2.4 Classification; References; 3: Interpretation of Sperm Analysis; 3.1 Is Sperm Analysis an Indicator of Male Infertility?; 3.2 Macroscopic Parameters; 3.3 Microscopic Parameters; 3.3.1 Sperm Concentration; 3.3.2 Sperm Motility; 3.3.3 Sperm Morphology; 3.3.4 Non-Sperm Cellular Components; 3.4 Sperm Function Tests; 3.4.1 Test of Sperm Capacitation; 3.4.2 Testing for Antibody Coating of Spermatozoa; 3.4.3 Tests of Sperm DNA Damage
3.4.3.1 Direct Tests3.4.3.2 Indirect Tests; 3.5 Conclusions; References; 4: Diagnosis of Infertility; 4.1 Andrologic Evaluation for Male Infertility: The Initial Office Visit; 4.1.1 Medical History; 4.1.1.1 Reproductive History; 4.1.1.2 Occupational History; 4.1.1.3 Lifestyle Risk Factors; 4.1.1.4 Andrologic History; 4.1.1.5 Sexual History; 4.1.2 Physical Examination; 4.1.3 Semen Analysis; 4.1.4 Ultrasonography Evaluation of Testes and Prostate; 4.2 Andrologic Evaluation for Male Infertility: Additional Investigations; 4.2.1 Endocrine Evaluation; 4.2.2 Genetic Testing
4.2.3 Postorgasmic Urinalysis4.2.4 Specialized Sperm Evaluations; 4.2.4.1 Reactive Oxygen Species; 4.2.4.2 Sperm Chromatin Assessments; 4.3 Thinking of the Man, Not Only of the Sperm: Potentials of Infertility Male Workup to Detect Underlying Abnormalities and Risk Factors for Male Health; 4.4 When to Refer, How to Refer: Key Elements of the Referral Letter; Conclusions; References; 5: General Therapeutic Approach to Male Infertility; 5.1 Introduction; 5.2 Sperm Analysis; 5.3 Female Age; 5.4 Diet; 5.5 Smoking Habits; 5.6 Caffeine; 5.7 Alcohol; 5.8 Stress; 5.9 Exercise; 5.10 Illicit Drugs
5.10.1 Marijuana5.10.2 Cocaine; 5.10.3 Opiates; 5.11 Radiofrequency Electromagnetic Waves (Cell Phones); 5.12 Male Fertility and Longevity; 5.13 Residual Fertility; References; 6: Azoospermia; 6.1 Definition; 6.2 Epidemiology and Classification; 6.3 Aetiology; 6.3.1 Obstructive Azoospermia; 6.3.1.1 Testicular Obstruction; 6.3.1.2 Epididymal Obstruction; 6.3.1.3 Vas Deferens Obstruction; 6.3.1.4 Obstruction of the Ejaculatory Ducts; 6.3.2 Non-obstructive Azoospermia; 6.3.2.1 Idiopathic; 6.3.2.2 Genetic; 6.3.2.3 Cryptorchidism; 6.3.2.4 Testicular Torsion; 6.3.2.5 Orchitis; 6.3.2.6 Varicocele
6.3.2.7 Exposure to Drugs, Toxic Substances and Radiation6.3.2.8 Hypogonadotropic Hypogonadism; 6.4 Diagnosis; 6.5 Therapy; 6.5.1 Obstructive Azoospermia; 6.5.2 Non-obstructive Azoospermia; 6.5.2.1 Sperm Retrieval Techniques for ART; References; 7: Varicocele and Infertility; 7.1 Definition and Classification; 7.2 Pathogenesis and Etiology; 7.2.1 Heat; 7.3 Diagnosis; 7.4 Treatment; 7.4.1 Medical Treatment; 7.5 Discussion; References; 8: Chromosomic Causes of Infertility; 8.1 Definition and Epidemiology; 8.2 Etiology; 8.3 Pathology, Diagnosis, Therapy, and Prognosis
3.4.3.1 Direct Tests3.4.3.2 Indirect Tests; 3.5 Conclusions; References; 4: Diagnosis of Infertility; 4.1 Andrologic Evaluation for Male Infertility: The Initial Office Visit; 4.1.1 Medical History; 4.1.1.1 Reproductive History; 4.1.1.2 Occupational History; 4.1.1.3 Lifestyle Risk Factors; 4.1.1.4 Andrologic History; 4.1.1.5 Sexual History; 4.1.2 Physical Examination; 4.1.3 Semen Analysis; 4.1.4 Ultrasonography Evaluation of Testes and Prostate; 4.2 Andrologic Evaluation for Male Infertility: Additional Investigations; 4.2.1 Endocrine Evaluation; 4.2.2 Genetic Testing
4.2.3 Postorgasmic Urinalysis4.2.4 Specialized Sperm Evaluations; 4.2.4.1 Reactive Oxygen Species; 4.2.4.2 Sperm Chromatin Assessments; 4.3 Thinking of the Man, Not Only of the Sperm: Potentials of Infertility Male Workup to Detect Underlying Abnormalities and Risk Factors for Male Health; 4.4 When to Refer, How to Refer: Key Elements of the Referral Letter; Conclusions; References; 5: General Therapeutic Approach to Male Infertility; 5.1 Introduction; 5.2 Sperm Analysis; 5.3 Female Age; 5.4 Diet; 5.5 Smoking Habits; 5.6 Caffeine; 5.7 Alcohol; 5.8 Stress; 5.9 Exercise; 5.10 Illicit Drugs
5.10.1 Marijuana5.10.2 Cocaine; 5.10.3 Opiates; 5.11 Radiofrequency Electromagnetic Waves (Cell Phones); 5.12 Male Fertility and Longevity; 5.13 Residual Fertility; References; 6: Azoospermia; 6.1 Definition; 6.2 Epidemiology and Classification; 6.3 Aetiology; 6.3.1 Obstructive Azoospermia; 6.3.1.1 Testicular Obstruction; 6.3.1.2 Epididymal Obstruction; 6.3.1.3 Vas Deferens Obstruction; 6.3.1.4 Obstruction of the Ejaculatory Ducts; 6.3.2 Non-obstructive Azoospermia; 6.3.2.1 Idiopathic; 6.3.2.2 Genetic; 6.3.2.3 Cryptorchidism; 6.3.2.4 Testicular Torsion; 6.3.2.5 Orchitis; 6.3.2.6 Varicocele
6.3.2.7 Exposure to Drugs, Toxic Substances and Radiation6.3.2.8 Hypogonadotropic Hypogonadism; 6.4 Diagnosis; 6.5 Therapy; 6.5.1 Obstructive Azoospermia; 6.5.2 Non-obstructive Azoospermia; 6.5.2.1 Sperm Retrieval Techniques for ART; References; 7: Varicocele and Infertility; 7.1 Definition and Classification; 7.2 Pathogenesis and Etiology; 7.2.1 Heat; 7.3 Diagnosis; 7.4 Treatment; 7.4.1 Medical Treatment; 7.5 Discussion; References; 8: Chromosomic Causes of Infertility; 8.1 Definition and Epidemiology; 8.2 Etiology; 8.3 Pathology, Diagnosis, Therapy, and Prognosis