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Review
. 2020 Jul;38(3):308-322.
doi: 10.5534/wjmh.190068. Epub 2019 Jul 12.

A Schematic Overview of the Current Status of Male Infertility Practice

Ashok Agarwal  1   2 , Ahmad Majzoub  1   3 , Neel Parekh  4 , Ralf Henkel  1   5
Affiliations
Review

A Schematic Overview of the Current Status of Male Infertility Practice

Ashok Agarwal et al. World J Mens Health. 2020 Jul.

Abstract

The practice of male infertility has dramatically evolved over the past few decades. This has been achieved after the realization of the important contribution the male counterpart holds in the couple's infertility. It is also supported by a number of breakthroughs in the diagnosis and treatment of this medical condition. Several tests to investigate sperm quality and function were introduced along with refinements and/or institution of novel surgical techniques that can correct several causes of infertility. This manuscript is aimed at highlighting the current state of male infertility practice in a robust, schematic method addressing a broader audience involved in the treatment of male infertility.

Keywords: Andrology; Hormones; Infertility, male; Oxidative stress; Semen analysis.

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Conflict of interest statement

The authors have nothing to disclose.

Figures

Fig. 1
Fig. 1. Various male infertility specialists globally.
Fig. 2
Fig. 2. Incidence of infertility.
Fig. 3
Fig. 3. Evaluation of male infertility. LUTS: lower urinary tract symptoms; WHO: World Health Organization, IUI: intrauterine insemination, IVF: in vitro fertilization, ICSI: intracytoplasmic sperm injection, GU: genitourinary, OAT: oligo-astheno-teratozoospermia, FSH: follicle-stimulating hormone, LH: luteinizing hormone, CFTR: cystic fibrosis transmembrane conductance regulator, MRI: magnetic resonance imaging.
Fig. 4
Fig. 4. Risk factors of male factor infertility.
Fig. 5
Fig. 5. Causes of male infertility. LH: luteinizing hormone, FSH: follicle-stimulating hormone.
Fig. 6
Fig. 6. Laboratory evaluation for male infertility. ROS: reactive oxygen species, SCD: sperm chromatin dispersion test, TUNEL: transferase-mediated dUTP nick end labeling, SCSA: sperm chromatin structure assay.
Fig. 7
Fig. 7. Oxidative stress. ROS: reactive oxygen species.
Fig. 8
Fig. 8. Sperm DNA fragmentation. ART: assisted reproductive technology, IMSI: intracytoplasmic morphologically selected sperm injection, PICSI: physiological intracytoplasmic sperm injection, TUNEL: transferase-mediated dUTP nick end labeling, SCSA: sperm chromatin structure assay, SCD: sperm chromatin dispersion test.
Fig. 9
Fig. 9. Past, present, and future sperm function tests. HEPA: hamster egg penetration assay, ORP: oxidation reduction potential, ROS: reactive oxygen species, SDF: sperm DNA fragmentation, TUNEL: transferase-mediated dUTP nick end labeling, SCSA: sperm chromatin structure assay, SCD: sperm chromatin dispersion test, TAC: total antioxidant capacity, Comet: single cell gel electrophoresis.
Fig. 10
Fig. 10. Azoospermia. CFTR: cystic fibrosis transmembrane conductance regulator, ICSI: intracytoplasmic sperm injection, FSH: follicle-stimulating hormone, LH: luteinizing hormone, US: urethrography, TURED: transurethral resection of ejaculatory ducts.
Fig. 11
Fig. 11. Sperm retrieval procedures in non-obstructive azoospermia. TESA: testicular sperm aspiration, TESE: testicular sperm extraction. aData from the article of Donoso et al (Hum Reprod Update 2007;13:539–49) [64].
Fig. 12
Fig. 12. Surgical correction of obstructive azoospermia.
Fig. 13
Fig. 13. Sperm retrieval procedures in obstructive azoospermia. PESA: percutaneous epididymal sperm aspiration, MESA: microsurgical epididymal sperm aspiration. aData from the article of Esteves et al (J Urol 2013;189:232–7) [68].
Fig. 14
Fig. 14. Varicocele.
See this image and copyright information in PMC

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