Session 1: Primary investigation of the infertile coupleBack to Index
Pages: 1  3 4 5 6 Test
2. Male infertility – evaluation and worries !
Male infertility can primarily be classified as obstructive and
non-obstructive infertility. More infrequent are retrograde ejaculation, sexual
dysfunction, and congenital abnormalities. Obstructive disorders which are caused
by a former vasectomy must be attempted re-anastomosed prior to other treatment.
Non-obstructive disorders are often detected because of impaired sperm quality
– from a slightly reduced sperm count and morphology to no sperm cells at all
in the ejaculate. Patients who lack spermatic cords or have less than 1 mill.
sperm cells per ml in the ejaculate must be evaluated genetically prior to
treatment where own sperm cells will be used. Therefore – these flow-charts.
Patients with male infertility are treated after flow-chart:
Treatment of severe male infertility in an IVF clinic:
Genetics and cancer risks at male infertility:
The below stated guidelines are due to the fact that many men with a severely
reduced sperm count have micro-deletions on the Y-chromosome or chromosome
aberrations. Furthermore, these men have a considerable risk of developing
testicle cancer, as compared to normospermatic men. It is today possible to
evaluate for this diagnosis by ultrasound scan of the testes, as this will disclose
a possible preliminary stage of carcinoma in situ. Men with cystic fibrosis deletions
might also have a congenital absent vas deferens (CAVD) as the only symptom, whereas
their children can get the disease. Now, where it is possible via ICSI (Intra
Cytoplasmatic Sperm Injection) to treat almost all men with reduced or lacking
spermatogenesis, there are great worries about the increased genetic risk these
parents expose their offspring to. Therefore – this genetic evaluation of the
Genetic evaluation program for all men referred for ICSI due to oligozoospermia: