Male infertility : diagnosis and treatment

497 Pages·2007·6.313 MB·English

by  Sergio C Oehninger, T F Kruger

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Male Infertility
Diagnosis and Treatment
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DEDICATION
This book is dedicated to our wives, Sanderina Kruger and Laura Oehninger, who
were always there over the last decades, inspiring us to achieve and to contribute.
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Male Infertility
Diagnosis and Treatment
Editors
Sergio C Oehninger MD PhD
Professor, Departments of Obstetrics and Gynecology, and Urology
and
Division Director, The Jones Institute for Reproductive Medicine
Eastern Virginia Medical School, Norfolk, Virginia
USA
Thinus F Kruger MD FRCOG
Professor and Chairperson
Department of Obstetrics & Gynaecology, and Reproductive Biology Unit
Tygerberg Academic Hospital and Stellenbosch University,
Tygerberg
South Africa
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© 2007 Informa UK Ltd
First published in the United Kingdom in 2007 by Informa UK Ltd, 4 Park Square, Milton Park, Abingdon, Oxon OX14 4RN.
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ISBN10: 0-415-39742-1
ISBN13: 978-0-415-39742-1
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Contents
Acknowledgments viii
Foreword ix
Preface xi
List of Contributors xix
Color section xxv
Section 1 – Basic concepts: sperm physiology and pathology
1. Anatomy and molecular morphology of the spermatozoon 3
Christiaan F Hoogendijk, Thinus F Kruger,
Roelof Menkveld
2. Physiology and pathophysiology of sperm motility 13
Michaela Luconi, Elisabetta Baldi, Gustavo F Doncel
3. The pathophysiology and genetics of human male reproduction 35
Christiaan F Hoogendijk, Ralf Henkel
4. Contribution of the male gamete to fertilization and embryogenesis 49
Gerardo Barroso, Sergio Oehninger
5. Genome architecture in human sperm cells: possible implications 73
for male infertility and prediction of pregnancy outcome
Olga Mudrak, Andrei Zalensky
6. Sperm pathology: pathogenic mechanisms and fertility potential in 85
assisted reproduction
Hector E Chemes, Vanesa Y Rawe
7. Testicular dysgenesis syndrome: biological and clinical significance 105
Niels Jørgensen, Camilla Asklund, Katrine Bay,
Niels E Skakkebæk
v
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vi MALE INFERTILITY
Section 2 – Diagnosis of male infertility
8. Evaluation of the subfertile male 117
Agnaldo P Cedenho
9. The basic semen analysis 141
Roelof Menkveld
10. Advances in automated sperm morphology evaluation 171
Kevin Coetzee, Thinus F Kruger
11. Sperm morphology training and quality control programs are 181
essential for clinically relevant results
Daniel R Franken, Thinus F Kruger
12. Role of acrosome index in prediction of fertilization outcome 187
Roelof Menkveld
13. Acrosome reaction: physiology and its value in clinical practice 195
Daniel R Franken, Hadley S Bastiaan, Sergio Oehninger
14. Sperm–zona pellucida binding assays 209
Sergio Oehninger, Murat Arslan, Daniel R Franken
15. Detection of DNA damage in sperm 225
Ralf Henkel
16. Chromosomal and genetic abnormalities in male infertility 239
Pasquale Patrizio, Jose Sepúlveda, Sepideh Mehri
17. Reactive oxygen species and their impact on fertility 255
R John Aitken, Liga E Bennetts
18. How do we define male subfertility and what is the prevalence in the 269
general population?
T Igno Siebert, F Haynes van der Merwe, Thinus F Kruger,
Willem Ombelet
19. DNA fragmentation and its influence on fertilization and pregnancy outcome 277
Ralf Henkel
20. The impact of the paternal factor on embryo quality and development: 291
the embryologist’s point of view
Marie-Lena Windt
Section 3 – Therapeutic alternatives for male infertility
21. Clinical management of male infertility 305
Murat Arslan, Sergio Oehninger, Thinus F Kruger
22. Urological interventions for the treatment of male infertility 319
Victor M Brugh, Donald F Lynch Jr
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CONTENTS vii
23. Medical treatment of male infertility 333
Gerhard Haidl
24. Male tract infections: diagnosis and treatment 345
Frank H Comhaire, Ahmed MA Mahmoud
25. Sperm-washing techniques for the HIV-infected male: rationale and experience 351
Gary S Nakhuda, Mark V Sauer
26. Treatment of HIV-discordant couples: the Italian experience 363
Augusto E Semprini, Lital Hollander
27. Artificial insemination using homologous and donor semen 375
Willem Ombelet, Martine Nijs
28. Intracytoplasmic sperm injection: current status of the technique and outcome 393
André Van Steirteghem
29. Sperm retrieval techniques for intracytoplasmic sperm injection 401
Valérie Vernaeve, Herman Tournaye
30. Hyaluronic acid binding by sperm: andrology evaluation 413
of male fertility and sperm selection for intracytoplasmic sperm injection
Gabor Huszar, Attila Jakab, Ciler Celik-Ozenci, G Leyla Sati
31. In vitro maturation of spermatozoa 425
Rosália Sá, Mário Sousa, Nieves Cremades,
Cláudia Alves, Joaquina Silva, Alberto Barros
32. New developments in the evaluation and management of the infertile male 453
Darius A Paduch, Marc Goldstein, Zev Rosenwaks
Index 461
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Acknowledgments
We have been able to complete this work thanks Biology Research Laboratory at the Department
to the devoted efforts of a few assistants. We wish of Obstetrics and Gynaecology, Tygerberg Hospi-
to acknowledge the editorial assistance of Helena tal, Stellenbosch University; the Vincent Palotti
Krüger (from Tygerberg), who made a significant Hospital, Cape Town, Republic of South Africa;
contribution to the textbook, but died sadly on 14 and the Jones Institute for Reproductive Medi-
October 2005. We sincerely appreciate the excel- cine, Department of Obstetrics & Gynecology,
lent help of Madaleine du Toit, who took over the Eastern Virginia Medical School, Norfolk, VA,
responsibilities for Helena. Irene Foy (from the USA.
Jones Institute) is thanked for her secretarial We are truly indebted to all contributors for
contributions. their enthusiasm in making this project a success.
We also wish to acknowledge clinicians, scien-
tists and laboratory personnel of the Reproductive
viii
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Foreword
In about one-half of all couples who are plagued by specialist who is most likely to be consulted first by
infertility, the male partner has a deficiency in his those who are infertile. Thus, it is not surprising that
sperm. the editors of this book are gynecologists who have
Infertility in the male has two very peculiar char- specialized in problems of reproduction and super-
acteristics. First, even though details of the pathology specialized in problems of male infertility. Hence has
of the sperm deficiency are not at all understood in come into existence the subspecialty of andrology,
most cases, there is a very good therapeutic modality which has found a home most often within the broad
which overcomes these problems and is still able to field of obstetrics and gynecology. Special problems of
transmit the male partner’s genetic message to the next infertility in the male are treated by the urologist, and
generation. This therapeutic modality is, of course, in some countries by dermatologists, but the therapy
intracytoplasmic sperm injection (ICSI). This success- of last resort, i.e. ICSI, is in the hands of reproductive
ful therapy has made it seem less urgent to investigate endocrinologists who have at their fingertips the tech-
the pathophysiology of male infertility. This is unfor- nology of in vitrofertilization (IVF).
tunate, as there is an inner concern and some evidence It is noteworthy that Male Infertility: Diagnosis
that ICSI may transmit to succeeding generations the and Treatment is a synthesis of current knowledge
seeds of an increased incidence of sperm defects. about human andrology, and comes from two depart-
Section 1 and several chapters of Sections 2 and 3 ments of obstetrics and gynecology where it was real-
of this book tell us what is known about this area and ized, even before the era of IVF, that a new perspective
thus serve as a launching pad for the further necessary was required if true progress was to be made in solv-
investigation of the pathophysiology of sperm defi- ing the problems of male infertility.
ciencies. These chapters also alert the clinician to our Notwithstanding these considerations, the editors
ignorance of the molecular details of at least some have assembled an outstanding list of contributors
sperm problems, which may lead to the passing of who thoroughly overview the approach to male infer-
these defects to the next generation by ICSI. There is tility not only from the perspective of the reproductive
no doubt, however, that ICSI is one of the major endocrinologist but also from the urologist, dermatol-
breakthrough ‘blockbuster’ treatments resulting in the ogist and medical scientist points of view.
enjoyment of children for couples who otherwise Andrology is by no means a matured discipline, as
would not be able to. indicated above. However, this book is a superb sum-
The second peculiar characteristic of male infer- mary of our current understanding of the art and sci-
tility is that it is often diagnosed by a most unlikely ence of this dynamic approach to the solution of a
specialist – the gynecologist – simply because it is this major portion of infertility.
Howard W Jones Jr MD
Professor Emeritus, The Jones Institute for
Reproductive Medicine
Department of Obstetrics & Gynecology
Eastern Virginia Medical School
Norfolk, VA
USA
ix