Advertisement

Causes of Male Infertility

  • Herbert J. WiserEmail author
  • Jay Sandlow
  • Tobias S. Köhler
Chapter

Abstract

Of all sexually active couples, 12–15% are infertile. When broken down by gender, a male component can be identified 50% of the time either in isolation or in combination with a female factor. The majority of the causes of male infertility are treatable or preventable, so a keen understanding of these conditions is paramount. Despite advancements in assisted reproductive technologies, the goal of a male infertility specialist is not simply to retrieve sperm. Instead, the male infertility specialist attempts to optimize a male’s reproductive potential and thereby allow a couple to conceive successfully through utilization of less invasive reproductive techniques. Often, this involves the use of sperm or testicular tissue cryopreservation prior to fertility insult. At the same time, the male fertility specialist is wary of underlying or causal, potentially serious medical or genetic conditions that prompted reproductive evaluation. Previous research in a US male fertility clinic analyzing 1,430 patients identified causes of infertility from most to least common: varicocele, idiopathic, obstruction, female factor, cryptorchidism, immunologic, ejaculatory dysfunction, testicular failure, drug effects/radiation, endocrinology, and all others. The focus of this book on the role of reactive oxygen species (ROS) is easily applied to the majority of the listed conditions (described in detail in later chapters) which comprise this chapter’s overview of pre-testicular, testicular, and post-testicular causes of male infertility.

Keywords

Causes of male infertility Pre-testicular causes Testicular causes Pharmacologic causes Varicocele Cryptorchidism Testicular cancer Medications and infertility 

References

  1. 1.
    Mosher WE. Reproductive impairments in the United States, 1965–1982. Demography. 1985;22:415–30.PubMedGoogle Scholar
  2. 2.
    Tielemans E, Burdorf A, te Velde E, Weber R, van Kooij R, Heederik D. Sources of bias in studies among infertility clients. Am J Epidemiol. 2002;156:86–92.PubMedGoogle Scholar
  3. 3.
    Sigman M. Male Infertility. Med Health R I. 1997;80(12):406–9.PubMedGoogle Scholar
  4. 4.
    Buvat J. Hyperprolactinemia and sexual function in men: a short review. Int J Impot Res. 2003;15(5):373–7.PubMedGoogle Scholar
  5. 5.
    Carter JN, Tyson JE, Tolis G, et al. Prolactin-screening tumors and hypogonadism in 22 men. N Engl J Med. 1978;299(16):847–52.PubMedGoogle Scholar
  6. 6.
    Patel SS, Bamigboye V. Hyperprolactinaemia. J Obstet Gynaecol. 2007;27(5):455–9.PubMedGoogle Scholar
  7. 7.
    Fasano S, Meccariello R, Cobellis G, et al. The endocannabinoid system: an ancient signaling involved in the control of male fertility. Ann N Y Acad Sci. 2009;1163:112–24.PubMedGoogle Scholar
  8. 8.
    Rettori V, De Laurentiis A, Fernandez-Solari J. Alcohol and endocannabinoids: neuroendocrine interactions in the reproductive axis. Exp Neurol. 2010;224(1):15–22.PubMedGoogle Scholar
  9. 9.
    Hallinan R, Byrne A, Agho K, et al. Hypogonadism in men receiving methadone and buprenorphine maintenance treatment. Int J Androl. 2009;32(2):131–9.PubMedGoogle Scholar
  10. 10.
    Dodé C, Hardelin JP. Kallmann syndrome. Eur J Hum Genet. 2009;17:139–46.PubMedGoogle Scholar
  11. 11.
    Fechner A, Fong S, McGovern P. A review of Kallmann syndrome: genetics, pathophysiology, and clinical management. Obstet Gynecol Surv. 2008;63(3):189–94.PubMedGoogle Scholar
  12. 12.
    Hardelin JP, Dode C. The complex genetics of Kallmann syndrome: KAL1, FGFR1, FGF8, PROKR2, PROK2, et al. Sex Dev. 2008;2:181–93.PubMedGoogle Scholar
  13. 13.
    Kamischke A, Baumgardt A, Horst J, et al. Clinical and diagnostic features of patients with suspected Klinefelter Syndrome. J Androl. 2003;24:41–8.PubMedGoogle Scholar
  14. 14.
    Blanco J, Egozcue J, Vidal F. Meiotic behavior of the sex chromosomes in three patients with sex chromosome abnormalities (47, XXY, mosaic 46, XY/47, XXY, and 47, XYY) assessed by flourescence in-situ hybridization. Hum Reprod. 2001;16(5):887–92.PubMedGoogle Scholar
  15. 15.
    Bergere M, Wainer R, Nataf V, et al. Biopsied testis cells of four 47, XXY patients: fluorescence in-situ hybridization and ICSI results. Hum Reprod. 2002;17:32–7.PubMedGoogle Scholar
  16. 16.
    Wikström AM, Dunkel L. Testicular function in Klinefelter syndrome. Horm Res. 2008;69(6):317–26.PubMedGoogle Scholar
  17. 17.
    Nagler HM, Grotas AB. Varicocele. In: Lipshultz LI, Howards SS, Niederberger CS, editors. Infertility in the male. 4th ed. New York City, NY: Cambridge University; 2009.Google Scholar
  18. 18.
    World Health Organization. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril. 1992;57:1289–93.Google Scholar
  19. 19.
    MacLeod J. Seminal cytology in the presence of varicocele. Fertil Steril. 1965;16(6):735–57.PubMedGoogle Scholar
  20. 20.
    Paduch DA, Niedzielski J. Semen analysis in young men with varicocele: preliminary study. J Urol. 1996;156:778–90.Google Scholar
  21. 21.
    Hjollund NH, Storgaard L, Ernst E, et al. The relation between daily activities and scrotal temperature. Reprod Toxicol. 2002;16(3):209–14.PubMedGoogle Scholar
  22. 22.
    Ivell R. Lifestyle impact and the biology of the human scrotum. Reprod Biol Endocrinol. 2007;5:15.PubMedGoogle Scholar
  23. 23.
    Paul C, Murray AA, Spears N, et al. A single, mild, transient scrotal heat stress causes DNA damage, subfertility and impairs formation of blastocysts in mice. Reproduction. 2008;136(1):73–84.PubMedGoogle Scholar
  24. 24.
    Dada R, Gupta NP, Kucheria K. Spermatogenic arrest in men with testicular hyperthermia. Teratog Carcinog Mutagen. 2003;S1:235–43.Google Scholar
  25. 25.
    Esfandiari N, Saleh RA, Blaut AP, et al. Effects of temperature on sperm motion characteristics and reactive oxygen species. Int J Fertil Womens Med. 2002;47(5):227–33.PubMedGoogle Scholar
  26. 26.
    Bedford JM. Effects of elevated temperature on the epididymis and testis: experimental studies. Adv Exp Med Biol. 1991;286:19–32.PubMedGoogle Scholar
  27. 27.
    Hjollund NH, Bonde JP, Jensen TK, et al. Diurnal scrotal skin temperature and semen quality. The Danish first pregnancy planner study team. Int J Androl. 2000;23(5):309–18.PubMedGoogle Scholar
  28. 28.
    Wang C, McDonald V, Leung A, et al. Effect of increased scrotal temperature on sperm production in normal men. Fertil Steril. 1997;68(2):334–9.PubMedGoogle Scholar
  29. 29.
    Zorgniotti AW, MacLeod J. Studies in temperature, human semen quality, and varicocele. Fertil Steril. 1973;24(11):854–63.PubMedGoogle Scholar
  30. 30.
    Jung A, Eberl M, Schill WB. Improvement of semen quality by nocturnal scrotal cooling and moderate behavioral change to reduce genital heat stress in men with oligoasthenoteratozoospermia. Reproduction. 2001;121(4):595–603.PubMedGoogle Scholar
  31. 31.
    Goldstein M, Eid JF. Elevation of intratesticular and scrotal skin surface temperature in men with varicocele. J Urol. 1989;142(3):743–5.PubMedGoogle Scholar
  32. 32.
    Trsinar B, Muravec UR. Fertility potential after unilateral and bilateral orchidopexy for cryptorchidism. World J Urol. 2009;27(4):513–9.PubMedGoogle Scholar
  33. 33.
    Gracia J, Sánchez Zalabardo J, Sánchez García J, et al. Clinical, physical, sperm and hormonal data in 251 adults operated on for cryptorchidism in childhood. BJU Int. 2000;85(9):1100–3.PubMedGoogle Scholar
  34. 34.
    Lee PA, O’Leary LA, Songer NJ, et al. Paternity after unilateral cryptorchidism: a controlled study. Pediatrics. 1996;98:676–9.PubMedGoogle Scholar
  35. 35.
    Lee PA, O’Leary LA, Songer NJ, et al. Paternity after bilateral cryptorchidism. A controlled study. Arch Pediatr Adolesc Med. 1997;151(3):260–3.PubMedGoogle Scholar
  36. 36.
    Canavese F, Mussa A, Manenti M, et al. Sperm count of young men surgically treated for cryptorchidism in the first and second year of life: fertility is better in children treated at a younger age. Eur J Pediatr Surg. 2009;19(6):388–91.PubMedGoogle Scholar
  37. 37.
    Wiser A, Raviv G, Weissenberg R, et al. Does age at orchidopexy impact on the results of testicular sperm extraction? Reprod Biomed Online. 2009;19(6):778–83.PubMedGoogle Scholar
  38. 38.
    Cooper ER. The histology of the retained testis in the human subject at different ages and its comparison to the testis. J Anat. 1929;64:5–10.PubMedGoogle Scholar
  39. 39.
    Murphy F, Paran TS, Puri P. Orchidopexy and its impact on fertility. Pediatr Surg Int. 2007;23(7):625032. Epub 13 Mar 2007.Google Scholar
  40. 40.
    Setchell BP. The Parkes Lecture: heat and the testis. J Reprod Fertil. 1998;114(2):179–94.PubMedGoogle Scholar
  41. 41.
    Leissner J, Filipas D, Wolf HK, et al. The undescended testis: considerations and impact on fertility. BJU Int. 1999;83(8):885–91.PubMedGoogle Scholar
  42. 42.
    Hadziselimovic F, Zivkovic D, Bica DTG, et al. The importance of mini-puberty for fertility in cryptorchidism. J Urol. 2005;174:1536–9.PubMedGoogle Scholar
  43. 43.
    Kurpisz M, Havryluk A, Nakonechnyj A, et al. Cryptorchidism and long-term consequences. Reprod Biol. 2010;10(1):19–35.PubMedGoogle Scholar
  44. 44.
    Jørgensen N, Meyts ER, Main KM, Skakkebaek NE. Testicular dysgenesis syndrome comprises some but not all cases of hypospadias and impaired spermatogenesis. Int J Androl. 2010;33(2):298–303. Epub 4 Feb 2010.PubMedGoogle Scholar
  45. 45.
    Abe T, Takaha N, Tsujimura A, et al. Leydig cell tumor of the testis presenting male infertility: a case report. Hinyokika Kiyo. 2003;49(1):39–42.PubMedGoogle Scholar
  46. 46.
    Shiraishi Y, Nishiyama H, Okubo K, et al. Testicular Leydig cell tumor presenting as male infertility: a case report. Hinyokika Kiyo. 2009;55(12):777–81.PubMedGoogle Scholar
  47. 47.
    Chovelidze S, Kochiashvili D, Gogeschvili G, et al. Cases of Leydig cell tumor in male infertility. Georgian Med News. 2007;143:76–9.PubMedGoogle Scholar
  48. 48.
    Hayashi T, Arai G, Hyochi N, et al. Suppression of spermatogenesis in ipsilateral and contralateral testicular tissues in patients with seminoma by human chorionic gonadotropin beta subunit. Urology. 2001;58(2):251–7.PubMedGoogle Scholar
  49. 49.
    Ho GT, Gardner H, DeWolf WC, et al. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol. 1992;148(3):821–5.PubMedGoogle Scholar
  50. 50.
    Carmignani L, Gadda F, Paffoni A, et al. Azoospermia and severe oligospermia in testicular cancer. Arch Ital Urol Androl. 2009;81(1):21–3.PubMedGoogle Scholar
  51. 51.
    Rowley MJ, Leach DR, Warner GA, et al. Effect of graded doses of ionizing radiation on the human testis. Radiat Res. 1974;59(3):665–78.PubMedGoogle Scholar
  52. 52.
    Paulsen CA. The study of radiation effects on the human testis: including histologic, chromosomal and hormonal aspects. Final progress report of AEC contract AT(45-1)-2225, Task Agreement 6. RLO-2225-2. 1973.Google Scholar
  53. 53.
    Speiser B, Rubin P, Casarett G. Aspermia following lower truncal irradiation in Hodgkin’s disease. Cancer. 1973;32(3):692–8.PubMedGoogle Scholar
  54. 54.
    Ash P. The influence of radiation on fertility in man. Br J Radiol. 1980;53:271–8.PubMedGoogle Scholar
  55. 55.
    Giwercman A, von der Maase H, Berthelsen JG, et al. Localized irradiation of testes with carcinoma in situ: effects of Leydig cell function and eradication of malignant germ cells in 20 patients. J Clin Endocrinol Metab. 1991;73(3):596–603.PubMedGoogle Scholar
  56. 56.
    Shapiro E, Kinsella TJ, Makuch RW, et al. Effects of fractionated irradiation on endocrine aspects of testicular function. J Clin Oncol. 1985;3(9):1232–9.PubMedGoogle Scholar
  57. 57.
    Spitz S. The histological effects of nitrogen mustard on human tumours and tissues. Cancer. 1948;1(3):383–98.PubMedGoogle Scholar
  58. 58.
    Watson AR, Rance CP, Bain J. Long term effects of cyclophosphamide on testicular function. BMJ. 1985;291:1457–60.PubMedGoogle Scholar
  59. 59.
    Pryzant RM, Meistrich ML, Wilson G, et al. Long-term reduction in sperm count after chemotherapy with and without radiation therapy for non-Hodgkin’s lymphomas. J Clin Oncol. 1993;11(2):239–47.PubMedGoogle Scholar
  60. 60.
    da Cunha MF, Meistrich ML, Fuller LM, et al. Recovery of spermatogenesis after treatment for Hodgkin’s disease: limiting dose of MOPP chemotherapy. J Clin Oncol. 1984;2(6):571–7.PubMedGoogle Scholar
  61. 61.
    Meistrich ML, Chawla SP, Da Cunha MF, et al. Recovery of sperm production after chemotherapy for osteosarcoma. Cancer. 1989;63(11):2115–23.PubMedGoogle Scholar
  62. 62.
    Pectasides D, Pectasides M, Farmakis D. Testicular function in patients with testicular cancer treated with Bleomycin-Etoposide-Carboplatin (BEC90) combination chemotherapy. Eur Urol. 2004;45(2):187–93.PubMedGoogle Scholar
  63. 63.
    Pont J, Albrect W. Fertility after chemotherapy for testicular germ cell cancer. Fertil Steril. 1997;68:1–5.PubMedGoogle Scholar
  64. 64.
    Ishikawa T, Kamidono S, Fujisawa M. Fertility after high-dose chemotherapy for testicular cancer. Urology. 2004;63:137–40.PubMedGoogle Scholar
  65. 65.
    Sakamoto H, Oohta M, Inoue K, et al. Testicular sperm extraction in patients with persistent azoospermia after chemotherapy for testicular germ cell tumor. Int J Urol. 2007;14(2):167–70.PubMedGoogle Scholar
  66. 66.
    Ferlin A, Raicu F, Gatta V, Zuccarello D, Palka G, Foresta C. Male infertility: role of genetic background. Reprod Biomed Online. 2007;14(6):734–45.PubMedGoogle Scholar
  67. 67.
    Foresta C, Moro E, Ferlin A. Y chromosome microdeletions and alterations of spermatogenesis. Endocr Rev. 2001;22(2):226–39.PubMedGoogle Scholar
  68. 68.
    Vogt PH. Azoospermia factor (AZF) in Yq11: towards a molecular understanding of its function for human male fertility and spermatogenesis. Reprod Biomed Online. 2005;10(1):81–93.PubMedGoogle Scholar
  69. 69.
    Stahl PJ, Masson P, Mielnik A, et al. A decade of experience emphasizes that testing for Y microdeletions is essential in American men with azoospermia and severe oligozoospermia. Fertil Steril. 2010;94(5):1753–6.PubMedGoogle Scholar
  70. 70.
    Bojesen A, Gravholt CH. Klinefelter syndrome in clinical practice. Nat Clin Pract Urol. 2007;4(4):192–204.PubMedGoogle Scholar
  71. 71.
    Ferlin A, Garolla A, Foresta C. Chromosome abnormalities in sperm of individuals with constitutional sex chromosomal abnormalities. Cytogenet Genome Res. 2005;111:310–6.PubMedGoogle Scholar
  72. 72.
    Zhou-Cun A, Yang Y, Zhang SZ, et al. Chromosomal abnormality and Y chromosome microdeletion in Chinese patients with azoospermia or severe oligozoospermia. Yi Chuan Xue Bao. 2006;33(2):111–6.PubMedGoogle Scholar
  73. 73.
    Foresta C, Garolla A, Bartoloni L, Bettella A, Ferlin A. Genetic abnormalities among severely oligospermic men who are candidates for intracytoplasmic sperm injection. J Clin Endocrinol Metab. 2005;90(1):152–6.PubMedGoogle Scholar
  74. 74.
    Schiff JD, Palermo GD, Veeck LL, et al. Intracytoplasmic sperm injection in men with Klinefelter syndrome. J Clin Endocrinol Metab. 2005;90(11):6263–7.PubMedGoogle Scholar
  75. 75.
    O’FlynnO’Brien KL, Varghese AC, Agarwal A. The genetic causes of male factor infertility: a review. Fertil Steril. 2010;93(1):1–12.Google Scholar
  76. 76.
    Shafik A. Contraceptive efficacy of polyester-induced azoospermia in normal men. Contraception. 1992;45(5):439–51.PubMedGoogle Scholar
  77. 77.
    Munkelwitz R, Gilbert BR. Are boxer shorts really better? A critical analysis of the role of underwear type in male subfertility. J Urol. 1998;160(4):1329–33.PubMedGoogle Scholar
  78. 78.
    Bonde JP. Semen quality in welders exposed to radiant heat. Br J Ind Med. 1992;49(1):5–10.PubMedGoogle Scholar
  79. 79.
    Jung A, Schuppe HC. Influence of genital heat stress on semen quality in humans. Andrologia. 2007;39:203–15.PubMedGoogle Scholar
  80. 80.
    Agarwal A, Deepinder F, Sharma RK, et al. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008;89:124–8.PubMedGoogle Scholar
  81. 81.
    Agarwal A, Desai NR, Makker K, et al. Effects of radiofrequency electromagnetic waves (RF-EMW) from cellular phones on human ejaculated semen: an in vitro pilot study. Fertil Steril. 2009;92:1318–25.PubMedGoogle Scholar
  82. 82.
    Collodel G, Capitani S, Pammolli A, et al. Semen quality of male idiopathic infertile smokers and nonsmokers: an ultrastructural study. J Androl. 2010;31:108–13.PubMedGoogle Scholar
  83. 83.
    Calogero A, Polosa R, Perdichizzi A, et al. Cigarette smoke extract immobilizes human spermatozoa and induces sperm apoptosis. Reprod Biomed Online. 2009;19:564–71.PubMedGoogle Scholar
  84. 84.
    Gaur DS, Talekar MS, Pathak VP. Alcohol intake and cigarette smoking: impact of two major lifestyle factors on male fertility. Indian J Pathol Microbiol. 2010;53:35–40.PubMedGoogle Scholar
  85. 85.
    Künzle R, Mueller MD, Hänggi W, et al. Semen quality of male smokers and nonsmokers in infertile couples. Fertil Steril. 2003;79:287–91.PubMedGoogle Scholar
  86. 86.
    Brandes SB, Buckman RF, Chelsky MJ, et al. External genitalia gunshot wounds: a ten-year experience with fifty-six cases. J Trauma. 1995;39:266–71.PubMedGoogle Scholar
  87. 87.
    Cass AS, Ferrara L, Wolpert J, et al. Bilateral testicular injury from external trauma. J Urol. 1988;140:1435–6.PubMedGoogle Scholar
  88. 88.
    Kuhlmann J, Bohme H, Tauber R. Bilateral testicular gunshot injuries. Urologe A. 2005;44:918–20.PubMedGoogle Scholar
  89. 89.
    Tomomasa H, Oshio S, Amemiya H, et al. Testicular injury: late results of semen analyses after uniorchiectomy. Arch Androl. 1992;29:59–63.PubMedGoogle Scholar
  90. 90.
    Lin WW, Kim ED, Quesada ET, et al. Unilateral testicular injury from external trauma: evaluation of semen quality and endocrine parameters. J Urol. 1998;159:841–3.PubMedGoogle Scholar
  91. 91.
    Kukadia AN, Ercole CJ, Gleich P, et al. Testicular trauma: potential impact on reproductive function. J Urol. 1996;156:1643–6.PubMedGoogle Scholar
  92. 92.
    Philip J, Selvan D, Desmond A. Mumps orchitis in the non-immune postpubertal male: a resurgent threat to male fertility? BJU Int. 2006;97:138–41.PubMedGoogle Scholar
  93. 93.
    Masarani M, Wazait H, Dinneen M. Mumps orchitis. J R Soc Med. 2006;99:573–5.PubMedGoogle Scholar
  94. 94.
    Osegbe DN. Testicular function after unilateral bacterial epididymo-orchitis. Eur Urol. 1991;19:204–8.PubMedGoogle Scholar
  95. 95.
    Schuppe HC, Meinhardt A, Allam JP, et al. Chronic orchitis: a neglected cause of male infertility? Andrologia. 2008;40:84–91.PubMedGoogle Scholar
  96. 96.
    Zariwala MA, Knowles MR, Omran H. Genetic defects in ciliary structure and function. Annu Rev Physiol. 2007;69:423–50.PubMedGoogle Scholar
  97. 97.
    Leigh MW, Pittman JE, Carson JL, et al. Clinical and genetic aspects of primary ciliary dyskinesia/Kartagener syndrome. Genet Med. 2009;11:473–87.PubMedGoogle Scholar
  98. 98.
    Terada T, Hatakeyama S. Morphological evidence for two types of idiopathic “Sertoli-cell-only” syndrome. Int J Androl. 1991;14(2):117–26.PubMedGoogle Scholar
  99. 99.
    Weller O, Yogev L, Yavetz H, et al. Differentiating between primary and secondary Sertoli-cell-only syndrome by histologic and hormonal parameters. Fertil Steril. 2005;83(6):1856–8.PubMedGoogle Scholar
  100. 100.
    Collins JA, Burrows EA, Yeo J, et al. Frequency and predictive value of antisperm antibodies among infertile couples. Hum Reprod. 1993;8(4):592–8.PubMedGoogle Scholar
  101. 101.
    Menge AC, Medley NE, Mangione CM, et al. The incidence and influence of antisperm antibodies in infertile human couples on sperm-cervical mucus interactions and subsequent fertility. Fertil Steril. 1982;38:439–46.PubMedGoogle Scholar
  102. 102.
    Sinisi AA, Di Finizio B, Pasquali D, et al. Prevalence of antisperm antibodies by SpermMARtest in subjects undergoing a routine sperm analysis for infertility. Int J Androl. 1993;16:311–4.PubMedGoogle Scholar
  103. 103.
    Heidenreich A, Bonfig R, Wilbert DM, et al. Risk factors for antisperm antibodies in infertile men. Am J Reprod Immunol. 1994;31:69–76.PubMedGoogle Scholar
  104. 104.
    Walsh T, Turek P. Immunologic infertility. In: Lipshultz LI, Howards SS, Niederberger CS, editors. Infertility in the male. 4th ed. New York City, NY: Cambridge University; 2009.Google Scholar
  105. 105.
    Meinertz H, Linnet L, Fogh-Andersen P, et al. Antisperm antibodies and fertility after vasovasostomy: a follow-up study of 216 men. Fertil Steril. 1990;54:315–21.PubMedGoogle Scholar
  106. 106.
    Hammiche F, Laven J, Boxmeer J, et al. Semen quality decline among men below 60 years of age undergoing IVF or ICSI treatment. J Androl. 2010;32:70–6. Epub ahead of print.PubMedGoogle Scholar
  107. 107.
    Belloc S, Benkhalifa M, Junca AM, et al. Paternal age and sperm DNA decay: discrepancy between chromomycin and aniline blue staining. Reprod Biomed Online. 2009;19:264–9.PubMedGoogle Scholar
  108. 108.
    Escobar MA, Grosfeld JL, Burdick JJ, et al. Surgical considerations in cystic fibrosis: a 32-year evaluation of outcomes. Surgery. 2005;138:560–71.PubMedGoogle Scholar
  109. 109.
    Wilschanski M, Corey M, Durie P, et al. Diversity of reproductive tract abnormalities in men with cystic fibrosis. JAMA. 1996;276:607–8.PubMedGoogle Scholar
  110. 110.
    Lissens W, Mercier B, Tournaye H, et al. Cystic fibrosis and infertility caused by congenital bilateral absence of the vas deferens and related clinical entities. Hum Reprod. 1996;S4:55–78.Google Scholar
  111. 111.
    Donat R, McNeill AS, Fitzpatrick DR, et al. The incidence of cystic fibrosis gene mutations in patients with congenital bilateral absence of the vas deferens in Scotland. Br J Urol. 1997;79:74–7.PubMedGoogle Scholar
  112. 112.
    Sokol RZ. Infertility in men with cystic fibrosis. Curr Opin Pulm Med. 2001;7:421–6.PubMedGoogle Scholar
  113. 113.
    Dörk T, Dworniczak B, Aulehla-Scholz C, et al. Distinct spectrum of CFTR gene mutations in congenital absence of vas deferens. Hum Genet. 1997;100:365–77.PubMedGoogle Scholar
  114. 114.
    Gaillard DA, Carré-Pigeon F, Lallemand A. Normal vas deferens in fetuses with cystic fibrosis. J Urol. 1997;158:1549–52.PubMedGoogle Scholar
  115. 115.
    Radpour R, Gourabi H, Gilani M, et al. Correlation between CFTR gene mutations in Iranian men with congenital absence of the vas deferens and anatomical genital phenotype. J Androl. 2008;29:35–40.PubMedGoogle Scholar
  116. 116.
    Donohue RE, Fauver HE. Unilateral absence of the vas deferens. A useful clinical sign. JAMA. 1989;261:1180–2.PubMedGoogle Scholar
  117. 117.
    Shapiro E, Goldfarb DA, Ritchey ML. The congenital and acquired solitary kidney. Rev Urol. 2003;5:2–8.PubMedGoogle Scholar
  118. 118.
    Handelsman DJ, Conway AJ, Boylan LM, et al. Young’s syndrome. Obstructive azoospermia and chronic sinopulmonary infections. N Engl J Med. 1984;310:3–9.PubMedGoogle Scholar
  119. 119.
    Domingo C, Mirapeix RM, Encabo B, et al. Clinical features and ultrastructure of primary ciliary dyskinesia and Young syndrome. Rev Clin Esp. 1997;197:100–3.PubMedGoogle Scholar
  120. 120.
    Goeminne PC, Dupont LJ. The sinusitis-infertility syndrome: Young’s saint, old devil. Eur Respir J. 2010;35:698.PubMedGoogle Scholar
  121. 121.
    Arya AK, Beer HL, Benton J, et al. Does Young’s syndrome exist? J Laryngol Otol. 2009;123:477–81.PubMedGoogle Scholar
  122. 122.
    Smith JF, Walsh TJ, Turek PJ. Ejaculatory duct obstruction. Urol Clin North Am. 2008;35:221–7.PubMedGoogle Scholar
  123. 123.
    Paick JS, Kim SH, Kim SW. Ejaculatory duct obstruction in infertile men. BJU Int. 2000;85:720–4.PubMedGoogle Scholar
  124. 124.
    Carson CC. Transurethral resection for ejaculatory duct stenosis and oligospermia. Fertil Steril. 1984;41:482–4.PubMedGoogle Scholar
  125. 125.
    Wieder JA, Lynne CM, Ferrell SM, et al. Brown-colored semen in men with spinal cord injury. J Androl. 1999;20:594–600.PubMedGoogle Scholar
  126. 126.
    Labrecque M, Nazerali H, Mondor M, et al. Effectiveness and complications associated with 2 vasectomy occlusion techniques. J Urol. 2002;168:2495–8.PubMedGoogle Scholar
  127. 127.
    Freund MJ, Weidmann JE, Goldstein M, et al. Microrecanalization after vasectomy in man. J Androl. 1989;10:120–32.PubMedGoogle Scholar
  128. 128.
    Cruickshank B, Eidus L, Barkin M. Regeneration of vas deferens after vasectomy. Urology. 1987;30:137–42.PubMedGoogle Scholar
  129. 129.
    Hallan RI, May AR. Vasectomy: how much is enough? Br J Urol. 1988;62:377–9.PubMedGoogle Scholar
  130. 130.
    Adams CE, Wald M. Risks and complications of vasectomy. Urol Clin North Am. 2009;36:331–6.PubMedGoogle Scholar
  131. 131.
    Sokal DC, Labrecque M. Effectiveness of vasectomy techniques. Urol Clin North Am. 2009;36:317–29.PubMedGoogle Scholar
  132. 132.
    Cook LA, Van Vliet H, Lopez LM, et al. Vasectomy occlusion techniques for male sterilization. Cochrane Database Syst Rev. 2007;2:CD003991.PubMedGoogle Scholar
  133. 133.
    Jee SH, Hong YK. One-layer vasovasostomy: microsurgical versus loupe-assisted. Fertil Steril. 2010;94(6):2308–11. Epub 13 Jan 2010.PubMedGoogle Scholar
  134. 134.
    Belker AM, Thomas Jr AJ, Fuchs EF, et al. Results of 1,469 microsurgical vasectomy reversals by the Vasovasostomy Study Group. J Urol. 1991;145:505–11.PubMedGoogle Scholar
  135. 135.
    Nagler HM, Jung H. Factors predicting successful microsurgical vasectomy reversal. Urol Clin North Am. 2009;36:383–90.PubMedGoogle Scholar
  136. 136.
    Magheli A, Rais-Bahrami S, Kempkensteffen C, et al. Impact of obstructive interval and sperm granuloma on patency and pregnancy after vasectomy reversal. Int J Androl. 2010;41(1):52–7.Google Scholar
  137. 137.
    Witt MA, Heron S, Lipshultz LI. The post-vasectomy length of the testicular vasal remnant: a predictor of surgical outcome in microscopic vasectomy reversal. J Urol. 1994;151:892–4.PubMedGoogle Scholar
  138. 138.
    Hollingsworth MR, Sandlow JI, Schrepferman CG, et al. Repeat vasectomy reversal yields high success rates. Fertil Steril. 2007;88:217–9.PubMedGoogle Scholar
  139. 139.
    Talbot HS. The sexual function in paraplegia. J Urol. 1955;73:91–100.PubMedGoogle Scholar
  140. 140.
    Utida C, Truzzi JC, Bruschini H, et al. Male infertility in spinal cord trauma. Int Braz J Urol. 2005;31:375–83.PubMedGoogle Scholar
  141. 141.
    Narayan P, Lange PH, Fraley EE. Ejaculation and fertility after extended retroperitoneal lymph node dissection for testicular cancer. J Urol. 1982;127:685–8.PubMedGoogle Scholar
  142. 142.
    Lange PH, Narayan P, Vogelzang NJ, et al. Return of fertility after treatment for nonseminomatous testicular cancer: changing concepts. J Urol. 1983;129:1131–5.PubMedGoogle Scholar
  143. 143.
    Pizzocaro G, Salvioni R, Zanoni F. Unilateral lymphadenectomy in intraoperative stage I nonseminomatous germinal testis cancer. J Urol. 1985;134:485–9.PubMedGoogle Scholar
  144. 144.
    Richie JP. Clinical stage 1 testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol. 1990;144:1160–3.PubMedGoogle Scholar
  145. 145.
    Donohue JP, Foster RS, Rowland RG, et al. Nerve-sparing retroperitoneal lymphadenectomy with preservation of ejaculation. J Urol. 1990;144:287–91.PubMedGoogle Scholar
  146. 146.
    Heidenreich A, Albers P, Hartmann M, et al. Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the German Testicular Cancer Study Group. J Urol. 2003;169:1710–4.PubMedGoogle Scholar
  147. 147.
    Pettus JA, Carver BS, Masterson T, et al. Preservation of ejaculation in patients undergoing nerve-sparing postchemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer. Urology. 2009;73:328–31.PubMedGoogle Scholar
  148. 148.
    Hellstrom WJ, Sikka SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol. 2006;176:1529–33.PubMedGoogle Scholar
  149. 149.
    Marks LS, Gittelman MC, Hill LA, et al. Rapid efficacy of the highly selective alpha1A-adrenoceptor antagonist silodosin in men with signs and symptoms of benign prostatic hyperplasia: pooled results of 2 phase 3 studies. J Urol. 2009;181:2634–40.PubMedGoogle Scholar
  150. 150.
    Hisasue S, Furuya R, Itoh N, et al. Ejaculatory disorder caused by α-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission. Int J Urol. 2006;13:1311–6.PubMedGoogle Scholar
  151. 151.
    Kobayashi K, Masumori N, Hisasue S, et al. Inhibition of seminal emission is the main cause of an ejaculation induced by a new highly selective α1A-blocker in normal volunteers. J Sex Med. 2008;5:2185–90.PubMedGoogle Scholar
  152. 152.
    Smith SM, O’Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002;181:49–55.PubMedGoogle Scholar
  153. 153.
    Loh C, Leckband SG, Meyer JM, et al. Risperidone-induced retrograde ejaculation: case report and review of the literature. Int Clin Psychopharmacol. 2004;19:111–2.PubMedGoogle Scholar
  154. 154.
    Haefliger T, Bonsack C. Atypical antipsychotics and sexual dysfunction: five case-reports associated with risperidone. Encéphale. 2006;32:97–105.PubMedGoogle Scholar
  155. 155.
    Agarwal A, Deepinder F, Cocuzza M, et al. Effect of vaginal lubricants on sperm motility and chromatin integrity: a prospective comparative study. Fertil Steril. 2008;89:375–9.PubMedGoogle Scholar
  156. 156.
    Kutteh WH, Chao CH, Ritter JO, et al. Vaginal lubricants for the infertile couple: effect on sperm activity. Int J Fertil Menopausal Stud. 1996;41:400–4.PubMedGoogle Scholar
  157. 157.
    Anderson L, Lewis SE, McClure N. The effects of coital lubricants on sperm motility in vitro. Hum Reprod. 1998;13:3351–6.PubMedGoogle Scholar
  158. 158.
    Nangia AK, Likosky DS, Wang D. Distribution of male infertility specialists in relation to the male population and assisted reproductive technology centers in the United States. Fertil Steril. 2010;94(2):599–609.PubMedGoogle Scholar

Further Reading

  1. Blau H, Freud E, Mussaffi H, et al. Urogenital abnormalities in male children with cystic fibrosis. Arch Dis Child. 2002;87:135–8.PubMedGoogle Scholar
  2. Chen-Mok M, Bangdiwala SI, Dominik R, et al. Termination of a randomized controlled trial of two vasectomy techniques. Control Clin Trials. 2003;24:78–84.PubMedGoogle Scholar
  3. Fejes I, Závaczki Z, Koloszár S, et al. Hypothesis: safety of using mobile phones on male fertility. Arch Androl. 2007;53:105–6.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Herbert J. Wiser
    • 1
    Email author
  • Jay Sandlow
    • 2
  • Tobias S. Köhler
    • 1
  1. 1.Division of UrologySouthern Illinois UniversitySpringfieldUSA
  2. 2.Department of UrologyMedical College of WisconsinMilwaukeeUSA

Personalised recommendations