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Related Concept Videos

Infertility in Males01:23

Infertility in Males

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Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...
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The intricate hormonal interplay essential for male reproductive health begins with the release of gonadotropin-releasing hormone (GnRH) by the hypothalamus. This hormone prompts the pituitary gland to secrete follicle-stimulating hormone (FSH) and luteinizing hormone (LH). LH targets the Leydig cells in the testes, stimulating them to produce and release testosterone. In concert with testosterone, FSH acts on the Sertoli cells within the seminiferous tubules to facilitate the release of...
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Spermatogenesis is the process by which haploid sperm cells are produced in the male testes. It starts with stem cells located close to the outer rim of seminiferous tubules. These spermatogonial stem cells divide asymmetrically to give rise to additional stem cells (meaning that these structures “self-renew”), as well as sperm progenitors, called spermatocytes. Importantly, this method of asymmetric mitotic division maintains a population of spermatogonial stem cells in the male...
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Men's health issues are increasingly recognized as significant, with several conditions posing common threats. Among these, testicular cancer is especially prevalent in younger men, particularly those aged 20 to 35 years. The disease often manifests as a painless mass in the testicles, sometimes accompanied by a sensation of heaviness or a dull ache.
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Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
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A tough, fibrous membrane, the tunica albuginea, covers the testes, extending inward to form fibrous partitions or septa, dividing them into internal compartments called lobules. Each lobule has 1 to 3 tightly coiled seminiferous tubules where sperm production occurs. These tubules merge into a tubular network at the back of the testis, known as the rete testis. It connects to 15 to 20 efferent ductules, leading to the epididymis.
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Testosterone and Male Infertility.

Samuel J Ohlander1, Mark C Lindgren1, Larry I Lipshultz1

  • 1Division of Male Reproductive Medicine and Surgery, Scott Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.

The Urologic Clinics of North America
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Summary

Treating male hypogonadism requires identifying the cause. For those on testosterone therapy, stopping it and using hormone injections can restore fertility and sperm production.

Keywords:
ExogenousHypogonadismHypogonadotropicInfertilitySpermatogenesisTestosterone

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Area of Science:

  • Reproductive endocrinology
  • Male infertility
  • Hormone therapy

Background:

  • Hypogonadism significantly affects male fertility.
  • Accurate diagnosis is crucial for effective treatment and counseling.
  • Exogenous testosterone therapy can suppress natural hormone production.

Purpose of the Study:

  • To outline management strategies for hypogonadal males on testosterone therapy.
  • To detail methods for restoring the hypothalamic-pituitary-gonadal axis and spermatogenesis.
  • To identify therapeutic options for optimizing semen parameters.

Main Methods:

  • Discontinuation of exogenous testosterone.
  • Administration of subcutaneous human chorionic gonadotropin (hCG).
  • Use of oral follicle-stimulating hormone (FSH)-inducing agents.
  • Potential supplemental therapy with recombinant FSH.

Main Results:

  • Cessation of testosterone and hormonal support can reestablish the HPG axis.
  • Spermatogenesis can be restored in hypogonadal males.
  • Recombinant FSH may be required for optimal semen parameters in some cases.

Conclusions:

  • Management of hypogonadal males on testosterone requires a multi-step approach.
  • Restoring the natural hormonal axis is key to improving fertility potential.
  • Personalized therapeutic strategies are necessary for optimal outcomes.