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Male Infertility

Overview of Current Approaches To the Evaluation and Management Of Male Infertility

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Infertility is clinically defined as the inability of a couple to achieve conception after one year of regular, unprotected intercourse. It is currently believed that male factors contribute to 40% to 60% of infertility cases (Schlegel, 2009). This article seeks to provide an overview of the evaluation and management of male factor infertility. There are many different possible etiologies of impaired fertility in men, and because treatment efforts must be closely tailored to individual presentations, it is important to conduct a thorough initial evaluation of each case, which typically involves a focused history, physical examination, and laboratory testing. A thorough history can provide many useful insights into possible causes of a patient’s infertility. In obtaining a detailed sexual and fertility history, it is important to assess how long the couple has been trying to conceive, frequency of intercourse, and any previous fertility of either partner,...

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The Management Of Retrograde Ejaculation: A Systematic Review And Update.

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Abstract

OBJECTIVE: To determine the best management of retrograde ejaculation to optimize the chance of conception.

DESIGN: Systematic review.

SETTING: Tertiary reproductive medicine center.

PATIENT(S): Subfertile men with retrograde ejaculation.

METHOD(S): Systematic search of studies using search terms "management" or "therapy" or "treatment" and "retrograde ejaculation." We excluded case reports and papers not in English.

MAIN OUTCOME MEASURE(S): Pregnancy and live birth rates and rates of achievement of antegrade ejaculation.

RESULT(S): Thirty-four studies met our criteria. Studies were mostly observational. Descriptions of predictive and confounding variables were often insufficient. The treatment options included urinary sperm retrieval and medical management with anticholinergics and sympathomimetics. Successful pregnancies and live births were also achieved using surgical techniques and electroejaculation; however, numbers were small.

CONCLUSION(S): Many treatment options exist in the management of retrograde ejaculation; however, current literature is insufficient to allow firm...

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