What every gynecologist should know about male infertility: an update

Esteves, Sandro C.; Hamada, Alaa; Kondray, Victor; Pitchika, Aruna; Agarwal, Ashok

doi:10.1007/s00404-012-2274-x

Cited by 65 publications

(51 citation statements)

References 96 publications

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“…Semen analysis is the most widely used biomarker to predict male fertility potential (10). It provides information on the functional status of the seminiferous tubules, epididymis and accessory sex glands, and its results are often taken as a surrogate measure of a man's ability to father a pregnancy.…”

Section: Importance and Limitations Of Semen Analysis For Male Infertmentioning

confidence: 99%

“…Semen analysis alone is only a tool among several others for determining clinical care. The male infertility evaluation must go far beyond a simple semen analysis, as it has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations (10,11).…”

Section: Impact Of the 2010 Who Criteria For Semen Analysis In The Mamentioning

confidence: 99%

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Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

2014

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Section: Importance and Limitations Of Semen Analysis For Male Infertmentioning

confidence: 99%

Section: Impact Of the 2010 Who Criteria For Semen Analysis In The Mamentioning

confidence: 99%

Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

2014

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“…Up to 30% of men who are unable to father a biological child have a normal male infertility workup, which commonly constitutes one or two semen analyses. The male infertility evaluation must go far beyond a simple semen analysis [Esteves et al , 2012. We believe that the assessment of male fertility based on conventional semen analysis alone should not be considered adequate and must be complemented with more reliable, quantifiable, unbiased and universal functional measures of semen quality.…”

Section: Semen Analysismentioning

confidence: 99%

“…Semen analysis is the most widely used biomarker of male fertility potential [Esteves et al 2012]. The results provide information on the functional status of the seminiferous tubules, epididymis and accessory sex glands [Esteves, 2014], which in turn influences the subsequent workup, treatment and outcomes [Baker et al 2015].…”

Section: Semen Analysismentioning

confidence: 99%

Oxidation-reduction potential of semen: what is its role in the treatment of male infertility?

Agarwal

Roychoudhury

Bjugstad³

et al. 2016

Therapeutic Advances in Urology

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140

118

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The diagnosis of male infertility relies largely on conventional semen analysis, and its interpretation has a profound influence on subsequent management of patients. Despite poor correlation between conventional semen parameters and male fertility potential, inclusion of advanced semen quality tests to routine male infertility workup algorithms has not been widely accepted. Oxidative stress is one of the major mediators in various etiologies of male infertility; it has deleterious effects on spermatozoa, including DNA damage. Alleviation of oxidative stress constitutes a potential treatment strategy for male infertility. Measurement of seminal oxidative stress is of crucial role in the identification and monitoring of patients who may benefit from treatments. Various tests including reactive oxygen species (ROS) assay, total antioxidant capacity (TAC) assay or malondialdehyde (MDA) assay used by different laboratories have their own drawbacks. Oxidation-reduction potential (ORP) is a measure of overall balance between oxidants and antioxidants, providing a comprehensive measure of oxidative stress. The MiOXSYS™ System is a novel technology based on a galvanostatic measure of electrons; it presents static ORP (sORP) measures with static referring to the passive or current state of activity between oxidants and antioxidants. Preliminary studies have correlated sORP to poor semen qualities. It is potentially useful in prognostication of assisted reproductive techniques outcomes, screening of antioxidants either in vivo or during IVF cycles, identification of infertile men who may benefit from treatment of oxidative stress, and monitoring of treatment success. The simplified laboratory test requiring a small amount of semen would facilitate clinical application and research in the field. In this paper, we discuss the measurement of ORP by the MiOXSYS System as a real-time assessment of seminal oxidative stress, and argue that it is a potential valuable clinical test that should be incorporated into the male infertility workup and become an important guide to the treatment of oxidative stress-induced male infertility.

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“…Physicians treating infertile couples should exercise circumspection when interpreting the results of routine SA because it is only a tool among several others for determining clinical care. The male infertility evaluation has to be complemented with a proper physical examination, a comprehensive history taking, and relevant endocrine, genetic, and other investigations [46,47].…”

Section: Semen Analysismentioning

confidence: 99%

Engaging Practicing Gynecologists in the Management of Infertile Men

Agarwal

Hamada

Esteves³

2014

J Obstet Gynecol India

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In the modern era, contemporary management of male infertility has undergone groundbreaking changes with the introduction of new concepts, advanced testing, and therapeutic interventions. As practicing gynecologists are often the first physicians who encounter an infertile couple, it is essential that these clinicians are continuously updated about the new pearls and pitfalls of male infertility management. Semen analysis is commonly ordered by gynecologists. In 2010, the WHO released new cutoff reference values for the semen parameters adopting novel methodology, which has incited much debate. Reference values have been lowered in comparison with previous standards, with a direct clinical implication in decision-making strategies. Specialized sperm-function tests, such as sperm oxidative stress and sperm chromatin integrity assessments, became clinically available, thus offering an opportunity to better understand sperm dysfunctions concealed during routine semen analysis. Furthermore, the initial counseling of azoospermic men by an andrologically well educated gynecologist may alleviate the misconception and distress surrounding the false belief of sterility, and will clarify the 123 available options of percutaneous and microsurgical spermretrieval techniques and assisted conception outcome. Regarding varicocele, which is commonly seen in infertile males, it is now clear that the best treatment option for infertile men with clinical varicocele is the microsurgical vein ligation. Natural conception is significantly improved after varicocelectomy, and recent data suggest that such treatment optimizes reproductive outcome of couples undergoing ICSI or micro-TESE sperm retrieval. Lastly, new therapeutic interventions, including oral antioxidant therapy and lifestyle modifications, have gained increasing attention, as they aid in alleviating male infertility.

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What every gynecologist should know about male infertility: an update

Cited by 65 publications

References 96 publications

Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

Clinical relevance of routine semen analysis and controversies surrounding the 2010 World Health Organization criteria for semen examination

Oxidation-reduction potential of semen: what is its role in the treatment of male infertility?

Engaging Practicing Gynecologists in the Management of Infertile Men

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