IMR Press / CEOG / Volume 34 / Issue 4 / pii/2007057

Clinical and Experimental Obstetrics & Gynecology (CEOG) is published by IMR Press from Volume 47 Issue 1 (2020). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with S.O.G.

Editorial

Treatment of male infertility

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1 Cooper Medical School of Rowan University, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology & Infertility, Camden, NJ (USA)
Clin. Exp. Obstet. Gynecol. 2007, 34(4), 201–206;
Published: 10 December 2007
Abstract

Purpose: To present various treatment options for male subfertility. Methods: Surgical therapy for varicocele, hormonal therapy, mechanical therapy, e.g., intrauterine insemination, special treatment for antisperm antibodies and low hypoosmotic swelling testscores with protein digestive enzymes. and in vitro ferilization (IVF) with and with out intracytoplasmic sperm injection are discussed. Results: Questions have been raised as to the efficacy of varicocelectomy. Perhaps only a minority of the best of males respond to this therapy. Clomiphene citrate or gonadotropins or hCG may be effective but usually only when serum FSH, LH and lortestosterone levels are low or are in the low normal range. Intrauterine insemination is helpful for oligoasthenozoospermia but is not so beneficial for antisperm antibodies or low hypoosmotic swelling test scores unless first pretreated with chymotrypsin. Conclusions: Obstructive or non-obstructive azoospermia requires sperm aspiration from the testes or testicular biopsy followed by IVF with intracytoplasmic sperm injection (ICSI). In vitro fertilization with ICSI is needed for extremely low counts or motility. Otherwise less costly or invasive therapy can be tried first but IVF with ICSI can eventually be performed if more conservative therapy fails to achieve a pregnancy.

Keywords
Intrauterine insemination
Chymotrypsin
Intracytoplasmic sperm injection
Clomiphene citrate
Gonadotropins
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