UCLA conference. Infertility in the male
Swerdloff, R.S.; Overstreet, J.W.; Sokol, R.Z.; Rajfer, J.
Annals of Internal Medicine 103(6 ): 906-919
1985
ISSN/ISBN: 0003-4819 PMID: 3904561 Document Number: 244623
Male infertility is a common and distressing problem in which reproductive abnormalities frequently play an important role. Assessment requires an understanding of the control of spermatogenesis and factors responsible for normal sperm function. Standard tests for assessment of semen quality frequently fail to detect impaired function, but newer tests are now available to measure sperm movement and their ability to penetrate the ovum. Algorithmic approaches based on laboratory data can be used to characterize subgroups of infertile men, but many patients have subtle abnormalities. Treatment of male infertility is ideally directed to a specific pathogenic mechanism; nonspecific therapies have produced disappointing results. Surgery is indicated for certain types of ductal obstruction, but whether internal spermatic vein ligation should be used to treat varicocele remains uncertain.