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Spermiogramm und Seminalplasma

Der andrologische Faktor

Semen analysis and seminal plasma

The male factor

  • Leitthema
  • Published:
Gynäkologische Endokrinologie Aims and scope

Zusammenfassung

Das Spermiogramm liefert als wenig standardisierte Methode nur grobe Informationen zur Diagnostik männlicher Subfertilität. Daher sollte außer bei hoch pathologischen Werten das Spermiogramm nicht als alleinige Entscheidungsgrundlage für die Therapie dienen. Therapeutisch können neben der ICSI (intrazytoplasmatische Spermieninjektion) bei einer männlichen Infertilität auch mit intrauterinen Inseminationen gute Ergebnisse erzielt werden. In Fällen, bei denen selbst die ICSI-Methode versagt, scheint die IMSI-Technik (intrazytoplasmatische, morphologische selektierte Spermieninjektion) vielversprechend zu sein. Unabhängig von der Behandlungsmethode ist es von entscheidender Bedeutung, eine möglichst gute Samenprobe zu gewinnen. Dabei ist es möglich, mit einfachen Methoden wie einer Verkürzung der Abstinenzzeit oder einer Probengewinnung zu Hause die Samenqualität entscheidend zu verbessern. Neueste Erkenntnisse zeigen, dass die Anwendung von Seminalplasma in der Reproduktionsmedizin das Endometrium rezeptiver macht und somit die Implantation des Embryos unterstützen kann. Auch Geschlechtsverkehr um den Zeitpunkt des Embryotransfers scheint die Behandlung positiv zu beeinflussen.

Abstract

Semen analysis is routinely used to evaluate the male partner in infertile couples. Unfortunately, sperm measurements that discriminate between fertile and infertile men are not well defined. Treatment decisions should therefore not be based exclusively on semen analysis, except for those cases with very poor sperm parameters. Treatments such as intra-uterine insemination (IUI) or intracytoplasmic sperm injection (ICSI) can usually be performed with sufficient pregnancy rates. In couples in which even ICSI fails, intracytoplasmatic, morphogically selected sperm injection (IMSI) seems to be promising. Collecting a semen sample with high quality is always important for male patients in assisted reproduction technology (ART) programs. Sperm quality can be improved using simple methods, such as modifying sexual abstinence or collecting semen samples at home. There is new evidence that the use of seminal plasma in ART treatment may improve endometrial receptivity and consequently implantation. Sexual intercourse around the time of embryo transfer also seems to improve the clinical outcome of ART.

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Authors and Affiliations

  1. Abteilung Gynäkologische Endokrinologie und Reproduktionsmedizin, Universitätsklinik für Frauenheilkunde, Effingerstraße 102, 3010, Bern, Schweiz

    M. Nitzschke & M. von Wolff

  2. Abteilung Gynäkologische Endokrinologie und Fertilitätsstörungen, Universitäts-Frauenklinik Heidelberg, Heidelberg, Deutschland

    T. Strowitzki

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  1. M. Nitzschke
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  2. T. Strowitzki
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  3. M. von Wolff
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Correspondence to M. Nitzschke.

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Nitzschke, M., Strowitzki, T. & von Wolff, M. Spermiogramm und Seminalplasma. Gynäkologische Endokrinologie 7, 80–86 (2009). https://doi.org/10.1007/s10304-008-0299-9

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  • DOI: https://doi.org/10.1007/s10304-008-0299-9

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