Male infertility problems of patients with strict sperm morphology between 5–14% may be missed with the current WHO guidelines

Jensen, Christian; Khan, Omar; Nagras, Z.; Sønksen, Jens; Fode, Mikkel; Østergren, Peter Busch; Shah, T.; Ohl, Dana A.; Collaborative, CopMich

doi:10.1080/21681805.2018.1548503

Cited by 15 publications

(17 citation statements)

References 7 publications

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“…In the last 40 years, the number of spermatozoa in the semen of male patients of childbearing potential has decreased by more than a half [5].…”

Section: Introductionmentioning

confidence: 99%

“…Incorrect lifestyles, pollution, and poor prevention are the main causes of a dramatical drop in the male fertility rates. According to the latest international reports, the rate of male infertility among the couples who seek advice from specialized centers to bear a child is 30-35%, and age is not the only liable factor; correctable causes include varicocele, which accounts for 30-35% of cases, and evidence of previous untreated or poorly followed cryptorchidism (5%) [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Infertility Worldwide: The Lack of Global Pediatric Andrologists and Prevention

Zampieri¹,

Federica²,

Patanè³

et al. 2020

Male Reproductive Health

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Andrology is the medical specialty dealing with men's health and reproductive system, including the genital, hormonal, reproductive, sexual, as well as psychological aspects, from birth to adulthood. Regular andrological checkups are essential both to reveal possible problems and to receive thorough advice and information so as to ensure that sexual and reproductive functions are well preserved. Estimates report that about one in three males suffers from andrological diseases, their rates varying according to the age: 27-30% of pediatric male subjects have reproductive and/or sexual conditions. In adulthood, 40% of men are affected by andrological diseases, in particular infertility and sexual problems. We studied medical literature about infertility, its prevention, and its treatment; our outcomes were to evaluate the role of research to prevent infertility especially in pediatric and adolescent age. The analysis of the data shows that in absolute numbers, the conditions directly associated with infertility are less studied than the treatment with medically assisted procreation. This research is intended as a warning to the countries worldwide: all those involved in the pediatric treatment area should be stimulated to act toward this goal, and each country should bear the responsibility of promoting and financing andrological screening campaigns.

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“…In the last 40 years, the number of spermatozoa in the semen of male patients of childbearing potential has decreased by more than a half [5].…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Infertility Worldwide: The Lack of Global Pediatric Andrologists and Prevention

Zampieri¹,

Federica²,

Patanè³

et al. 2020

Male Reproductive Health

View full text Add to dashboard Cite

show abstract

“…Therefore, the study of varicocele and of its consequences on fertility should be implemented, also favouring an andrological examination as a screening among adolescents (Jensen et al, 2018;WHO, 1992).…”

Section: Discussionmentioning

confidence: 99%

Varicocele in paediatric age: Is the scientific community on the correct pathway?

et al. 2020

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According to different series, the overall prevalence of adolescence varicocele ranges from 4.1% to 35.1% (Jacobson & Johnson, 2017). In particular, 35% of infertile males have varicocele (Gorelick & Goldstein, 1993). The interest about varicocele has changed since the 1950s, when the first relationship between varicocele and infertility was suggested (Tulloch, 1955). Attention to prevent infertility aims to have early treatment of this disease, thus interest has moved from adult to paediatric varicocele. Selecting articles about varicocele in adolescence since the 1950s, we found that almost half of medical literature articles have been published from 2000 onwards. The aim of the study is to analyse the general topics of interest regarding paediatric varicocele and any difference across countries and years. 2 | MATERIAL AND ME THODS We reviewed the literature about paediatric varicocele between 2000, January 1st and 2018, December, 31st. We performed a systematic review inserting into PUBMED database the keywords 'VARICOCELE AND ADOLESCENCE AND COUNTRY' where country was replaced by every country, with no exclusion. We considered also 'adolescence' as a keyword as well as 'children' and 'pediatric', since idiopathic varicocele mainly represents a disease of adolescent age; then, the age range reported in the papers was used as an inclusion and exclusion criterion to select the articles. At first, the duplicates, papers and articles published only in original language were excluded. Of the screened records, all the titles and abstracts were studied to evaluate for the eligibility criteria. In our review, we analysed all the published articles in order to select only the ones matching the correct subject, age range

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“…Overall, sperm morphology in isolation with an otherwise normal SA is likely a scenario that does not require referral to a reproductive urologist. The potential caveats to this recommendation are: (I) a significant portion of these patients, if not thoroughly evaluated by history and physical exam, may have a concomitant, unrecognized cause of male infertility (e.g., varicocele) and (II) the presence of globozoospermia is a separate, severe sperm morphology issue and requires ICSI (17).…”

Section: Semen Analysis (Sa) Abnormalitiesmentioning

confidence: 99%

Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist

et al. 2019

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Obstetricians and gynecologists, and in particular reproductive endocrinologists (REIs), are typically the gatekeepers and first-line providers for couples initially seeking an infertility evaluation. A timely referral to a reproductive urologist may improve pregnancy outcomes in certain clinical scenarios. This review examines the evidence behind circumstances requiring referral and delivers practice-based recommendations on commonly encountered scenarios in the clinic. Scenarios that should prompt referral to a reproductive urologist include semen analysis (SA) abnormalities (e.g., asthenozoospermia, azoospermia, globozoospermia, leukocytospermia, necrozoospermia, oligospermia), recurrent intrauterine insemination (IUI)/in vitro fertilization (IVF) failure, and idiopathic recurrent pregnancy loss (RPL). Conversely, deferment is appropriate in the cases of isolated teratozoospermia and subclinical varicocele. Men with infertility are also at higher risk for other comorbid conditions and should have at least a baseline evaluation by a primary care physician. Coordination of care between a REI and reproductive urologist is critical in several clinical scenarios and expedient referral can improve reproductive outcomes.

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Male infertility problems of patients with strict sperm morphology between 5–14% may be missed with the current WHO guidelines

Cited by 15 publications

References 7 publications

Infertility Worldwide: The Lack of Global Pediatric Andrologists and Prevention

Infertility Worldwide: The Lack of Global Pediatric Andrologists and Prevention

Varicocele in paediatric age: Is the scientific community on the correct pathway?

Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist

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