An overview of male infertility in the era of intracytoplasmic sperm injection

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

As a result of the technological advance provided by intracytoplasmic sperm injection (ICSI) in 1992, the evaluation and treatment of the infertile male has changed significantly. Many men who were previously thought to be irreversibly infertile have the potential to initiate their own biologic pregnancy. However, not all men having impaired semen parameters are ideal candidates for ICSI for numerous reasons including a lack of addressing the underlying problem causing the male infertility, unknown genetic consequences, and cost-effectiveness issues. In this era of ICSI, the fundamental approach to the male with suspected subfertility is unchanged and is based on a history, physical examination, and focused laboratory testing. The urologist should approach the patient with an intent to identify remediable causes of subfertility given the specific clinical situation. For instance, should a gentleman have his varicocele repaired or vasectomy reversed, or should he proceed directly with ICSI? If no factors can be improved in a timely manner, then ICSI should be considered using the available sperm. Examples of recent advances include the diagnosis and treatment of ejaculatory duct obstruction, indications and techniques for performing testis biopsy, and techniques for sperm harvesting. Potential genetic causes should be diagnosed and discussed with the patient. Cystic fibrosis gene mutations, karyotype abnormalities, and Y-chromosome microdeletions all have recently been identified as causative for male infertility in otherwise phenotypically normal men. While the long-term genetic consequences for these offspring are largely undefined, recent studies suggest that serious birth defects are not significantly increased in ICSI babies. An understanding of these advances by all physicians is important as we progress into the 21st century.

Original languageEnglish (US)
Pages (from-to)71-83
Number of pages13
JournalChinese Medical Journal (Taipei)
Volume64
Issue number2
StatePublished - 2001
Externally publishedYes

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Intracytoplasmic Sperm Injections
Male Infertility
Infertility
Spermatozoa
Ejaculatory Ducts
Vasectomy
Varicocele
Semen
Karyotype
Cystic Fibrosis
Physical Examination
Cost-Benefit Analysis
Testis
History
Physicians
Biopsy
Pregnancy
Mutation
Therapeutics
Genes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

An overview of male infertility in the era of intracytoplasmic sperm injection. / Kim, Edward.

In: Chinese Medical Journal (Taipei), Vol. 64, No. 2, 2001, p. 71-83.

Research output: Contribution to journalReview article

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