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  3. An Introduction to Male Reproductive Medicine
  • Cited by 3
Publisher:
Cambridge University Press
Online publication date:
May 2011
Print publication year:
2011
Online ISBN:
9780511736254
DOI:
https://doi.org/10.1017/CBO9780511736254
Subjects:
Obstetrics and Gynecology, Reproductive Medicine, Medicine, Surgery
Information

Book description

An Introduction to Male Reproductive Medicine is written specifically for readers seeking entry into this fast-moving, complex specialty with a solid understanding of the subject. The first chapters cover the anatomy and physiology, clinical evaluation, surgery, medicine, genetics and laboratory testing involved in the current evaluation and treatment of the infertile male, and the final chapter describes the interaction of the field with female reproductive medicine. Throughout the book, references are directly made to the fourth edition of the major text in the specialty, Infertility in the Male, edited by Larry Lipshultz, Stuart Howards and Craig Niederberger, allowing readers to expand their understanding of specific areas where desired. Each chapter is written by a well-renowned expert in an easy to follow, informal style, making the text ideal for students, residents and general physicians who are seeking to increase their general knowledge of the field.

Reviews

“…Marvelously well-written and easy to read with well-chosen graphs, pictures, and illustrations. Contributors are highly accomplished urologists and reproductive endocrinologists from throughout…the world…wonderful resource and one I would highly recommend.”Doody's Review Services

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Contents

Contents
  • 6 - Genetics of male reproductive medicine
    pp 103-120
  • View abstract

    Summary

    This chapter briefly reviews the embryology of the male reproductive system, whose knowledge is required to understand the physiopathology of cryptorchidism and of hypospadias. One distinctive feature of hormone secretion through the hypothalamus-pituitary-gonadal axis is that they regulate their own secretion through negative feedback inhibition. Androgens are essential for spermatogenesis, maturation of secondary sexual characteristics, masculine settlement of the bone-muscle apparatus, and libido. Testosterone is the most important circulating androgen in men's blood. Sperm progression in the seminal tract during ejaculation and contractions of the epididymis are supported by oxytocin and guided by sympathetic and parasympathetic nerves. Sperm-egg interaction is a specialized process that leads to fertilization. The occurrence of acrosomal exocytosis facilitates sperm penetration through the zona pellucida, and exposure of certain molecules on the sperm equatorial segment that participate in fusion with the oolemma.
  • 7 - Semen: analysis and processing
    pp 121-133
  • View abstract

    Summary

    At the heart of the male reproductive physical examination is investigation of the scrotum and its contents. The scrotum itself may be hypoplastic on one or both sides, suggesting lack of contents since birth. This chapter describes the basics of interpreting semen analysis in the context of a man's initial evaluation presenting with concerns about fertility, or a couple who has not conceived within a reasonable period of time. Sperm motility may be difficult to assess, and is often inaccurately reported by labs infrequently performing semen analyses whose technicians may be unfamiliar with the appearance of sperm under the microscope. Sperm morphology can be one of the most frustrating parameters of semen analysis. Sperm shape is highly variable, and a normal man's ejaculate contains a broad assortment of strange-looking sperm. Excessive aromatase activity resulting in abundant estradiol may interfere with the male endocrine axis and sperm production.
  • 8 - What to know about the infertile female
    pp 134-151
  • View abstract

    Summary

    This chapter introduces medical students, residents, fellows, and practicing urologists to surgical syndromes that can affect a man's reproductive potential. The most widely accepted theory of how varicocele affects testicular function is that of elevated testicular temperature. When obstructive azoospermia is present, sperm production by the testis remains normal and often epididymal tubules become quite dilated. The yield of sperm from the epididymis is logarithmically higher than the yield of sperm from the testis. The anatomy of the male reproductive tract is such that sperm exit the testes, travel through the epididymis, and enter the vas deferens. The vas deferens travels into the inguinal canal with the spermatic cord and then dives posteromedially to fuse with the seminal vesicles at the ampulla of the vas deferens. Any serious medical illness or surgery can result in impaired testicular function and disruption of normal ejaculatory function.
References

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