Analysis of medical treatment of male infertility

Kamischke, Axel; Nieschlag, Eberhard

doi:10.1093/humrep/14.suppl_1.1

Cited by 121 publications

(57 citation statements)

References 112 publications

(107 reference statements)

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“…Kamischke and Nieschlag claimed that varicocele repair had no improvement in male fertility [38]. However our data shows that the percentage of spontaneous pregnancies was 31-40%.…”

contrasting

confidence: 65%

Outcome of Varicocelectomy with Different Degrees of Clinical Varicocele in Infertile Male

Reddy

Shaik

Surayapalem

et al. 2015

Advances in Andrology

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Aim. To evaluate the prevalence and effect of varicocele repair on sperm motility, sperm concentration, testicular volume, and pregnancy rate in different degrees of clinical varicocele. Material and Methods. The case records were retrospectively evaluated for 482 infertile patients with varicocele who underwent varicocelectomy from December 2008 to December 2013. Semen analysis of patient at preoperative and 3-, 6-, and 12-month postoperative period was done. Varicocele was graded as per the World Health Organization grading (WHO 1993) system and included in the study. Testicular volume was noted by ultrasonography in pre-and postoperative period in one-year follow-up. Pregnancy rate was calculated at 3, 6, and 12 months of follow-up. Results. Significant differences were seen in sperm motility and concentration of patients with Grade 3 varicocele as compared with Grade 1 and Grade 2 varicocele. Significant increase in testicular volume was present after one year in Grade 3 varicocele in the postoperative period. There was significant correlation between the testicular volume and the sperm concentration. Percentage of spontaneous pregnancy in 1 year after varicocele treatment was 32 to 41% of cases. Conclusion. Varicocelectomy significantly improved sperm motility, concentration, and testicular volume. There were 32 to 41% of infertile patients who achieved pregnancy spontaneously.

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“…Kamischke and Nieschlag claimed that varicocele repair had no improvement in male fertility [38]. However our data shows that the percentage of spontaneous pregnancies was 31-40%.…”

contrasting

confidence: 65%

Outcome of Varicocelectomy with Different Degrees of Clinical Varicocele in Infertile Male

Reddy

Shaik

Surayapalem

et al. 2015

Advances in Andrology

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“…Unfortunately, FSH therapy is relatively costly and involves repeated injections which may reflect on patient preference and compliance. Several other researchers [4,5] tried to treat male infertility with FSH in unselected patients, however none reported increased pregnancy rates. Therefore, FSH therapy cannot be recommended in unselected men.…”

Section: Gonadotropin Therapymentioning

confidence: 99%

An Evidence-Based Perspective to the Medical Treatment of Male Infertility: A Short Review

Ghanem

Shamloul

2009

Urol Int

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Introduction: Evidence-based medicine (EBM) is the integration of best research evidence with clinical expertise and patient preferences and values. Aim: This narrative review aims to assist the physicians to make informed decisions based on the best available evidence in the area of male infertility and the patients’ own preferences and values. Methods: In this review we present the current state of knowledge and uncertainties about the medical management of male infertility. We describe the best available evidence from systematic reviews, randomized controlled studies and observational studies where appropriate. Results: Data from the literature suggest that gonadotropin treatment of male infertility can lead to a significant increase in pregnancy rates, however larger studies are needed to confirm such findings. Studies including combinations of antiestrogens, antioxidants and androgens are promising but need confirmation with further research. Conclusions: Most current combination therapies consist of orphan medications without industry support. Andrology research centers and other dedicated departments and units need to conduct randomized controlled trials of sufficient duration, sample number and robust design for groups most likely to benefit from antiestrogens, L-carnitine, antioxidants, and combination therapy. The ease of administration, low cost and mild side effects of antiestrogens justify their utility despite insufficient evidence of effect as monotherapies. Randomized controlled trials assessing other forms of medical therapy and combination therapy are available but are still in the preliminary stages.

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“…Remarkably, although, male infertility is an important health issue, there are no drug treatments to enhance sperm function that have been shown to be effective in randomized controlled trials (Kamischke & Nieschlag 2002, cf. Greco et al 2005.…”

Section: New Paradigms In Male Sub-fertilitymentioning

confidence: 99%

Counting sperm does not add up any more: time for a new equation?

Lefièvre¹,

Bedu-Addo²,

Conner³

et al. 2007

Reproduction

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Although sperm dysfunction is the single most common cause of infertility, we have poor methods of diagnosis and surprisingly no effective treatment (excluding assisted reproductive technology). In this review, we challenge the usefulness of a basic semen analysis and argue that a new paradigm is required immediately. We discuss the use of at-home screening to potentially improve the diagnosis of the male and to streamline the management of the sub-fertile couple. Additionally, we outline the recent progress in the field, for example, in proteomics, which will allow the development of new biomarkers of sperm function. This new knowledge will transform our understanding of the spermatozoon as a machine and is likely to lead to non-ART treatments for men with sperm dysfunction. Reproduction (2007) 133 675-684

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Analysis of medical treatment of male infertility

Cited by 121 publications

References 112 publications

Outcome of Varicocelectomy with Different Degrees of Clinical Varicocele in Infertile Male

Outcome of Varicocelectomy with Different Degrees of Clinical Varicocele in Infertile Male

An Evidence-Based Perspective to the Medical Treatment of Male Infertility: A Short Review

Counting sperm does not add up any more: time for a new equation?

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