The pathophysiology of varicocele-associated male infertility

Schoor, Richard A.; Elhanbly, Samir; Niederberger, Craig S.

doi:10.1007/s11934-001-0035-7

Cited by 52 publications

(37 citation statements)

References 47 publications

(25 reference statements)

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“…[19] Of the 72 cases with varicocele, 7 cases (9.7%) harbored microdeletion of the AZF loci [ Table 1]. Of these 7 cases, 6 cases had unilateral left-sided varicocele and 1 case had bilateral varicocele.…”

Section: Resultsmentioning

confidence: 99%

Azoospermia factor deletions in varicocele cases with severe oligozoospermia

Dada¹,

Shamsi²,

Sidhu³

et al. 2007

Indian J Med Sci

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Section: Resultsmentioning

confidence: 99%

Azoospermia factor deletions in varicocele cases with severe oligozoospermia

Dada¹,

Shamsi²,

Sidhu³

et al. 2007

Indian J Med Sci

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“…There is abundant clinical evidence in humans for adverse effects of increased ambient temperature on spermatogenesis (3)(4)(5)(6)(7). Varicocele and undescended testis are well-recognised causes of male infertility associated with abnormal spermatogenesis, but lifestyle factors such as the taking of hot baths, sauna use, wearing tight fitting underpants and prolonged sedentary occupations all conspire to raise scrotal skin temperature.…”

Section: Introductionmentioning

confidence: 99%

Factors controlling testis descent

Hughes¹,

Acerini²

2008

European Journal of Endocrinology

140

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Descent of the testis from an intra-abdominal site in foetal life to an extracorporeal location after birth is a mandatory developmental process to ensure that the mature testis promotes normal spermatogenesis. The two phases of transabdominal and inguinoscrotal descent occur approximately during the first and last thirds of gestation respectively. Key anatomical events to release the testis from its urogenital ridge location and to guide the free gonad into the scrotum are the degeneration of the cranio-suspensory ligament and a thickening of the gubernaculum. Androgens play a role in both these processes, particularly with respect to enabling the testis to traverse the inguinal canal in the final phase of descent. Experiments in animals suggest that androgens mediate this effect via the release of calcitonin gene-related peptide by the genitofemoral nerve, but direct evidence for such a mechanism is lacking in humans. The transabdominal phase of descent is under the control of insulinlike 3 (INSL3), a product of the Leydig cells. Definitive evidence of its role in rodent testis descent is illustrated by the phenotype of bilateral cryptorchidism in Insl3K/K null mice. Circulating levels of INSL3 are higher in boys at puberty, are undetectable in girls and are lower in boys with undescended testes. A minority also have a mutation either in the INSL3 gene or affecting its receptor gene, relaxin/insulin-like family peptide receptor 2 (LGRF8). Other factors that may play a role in testis descent include the anti-Mullerian hormone and members of the HOX gene family. Evidence that the prevalence of undescended testis may be increasing provides a phenotypic readout for the effects of postulated chemicals in the environment interfering in some way with the action of factors that control testis descent. Epidemiological studies point to profound geographical variations in prevalence in countries such as Denmark and Finland. Associations have been found with levels of chemicals labelled as endocrine disruptors being higher in breast milk samples from mothers with cryptorchid boys when compared with controls. The adverse effects of these compounds (e.g. bisphenol A) can be replicated in the offspring of dams exposed during pregnancy. A sensitive marker of an anti-androgen effect of a compound is a reduction in the anogenital distance, an anthropometric measurement that is significantly greater in males compared with females. The observation of an association between the anogenital distance in infant boys and the level of pesticides in the urine of their mothers in late gestation indicates that this has the potential to be a useful surrogate marker of the effects of environmental chemicals on testis descent in human population studies. The rightful place for the testis at birth is in the scrotum in order to provide the temperature differential essential for normal spermatogenesis. Appropriate screening programmes and early surgical intervention are the prerequisites to ensure optimal fertility in adulthood and a con...

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“…La varicocele entraine donc des lesions evoluant progressivement vers une destruction des fonctions exocrines du testicule [5,10]. L'intervention sur les varicoceles chez des patients infertiles permet une bonne recuperation de la fonction de reproduction pour 60% des patients [3, 10,11,16,18,32], et meme une elevation du nombre de grossesse spontanee [3,32].…”

Section: Discussionunclassified

“…Les troubles de la fertilite lies & la varicocele seraient dus au reflux de substances toxiques provenant du rein ou de la surrenale, a de troubles hormonaux, a une hyperpression dans la veine funiculaire, a une hypoxie testiculaire due a la stase veineuse, et & des troubles de la regulation thermique au niveau des bourses [8,25,32].…”

Section: Discussionunclassified

Aetiology of male secondary infertility

Darcq

Hermabessière

2006

Androl.

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The pathophysiology of varicocele-associated male infertility

Cited by 52 publications

References 47 publications

Azoospermia factor deletions in varicocele cases with severe oligozoospermia

Azoospermia factor deletions in varicocele cases with severe oligozoospermia

Factors controlling testis descent

Aetiology of male secondary infertility

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