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Men with a complete absence of normal sperm morphology exhibit high rates of success without assisted reproduction

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Asian Journal of Andrology 2017年第1期19卷 39-42页

作者： jason r.kovac ryan P Smith Miguel Cajipe Dolores J Lamb Larry I Lipshultz Center of reproductive Medicine and the Department of Molecular and Cellular Biology Scott Department of Urology Baylor College of Medicine Houston TX USA Department of Urology University of Virginia Charlottesville VA USA.

In couples with infertility, abnormal strict morphology of 0% normal forms （NF） is a criterion to proceed rapidly to in vitro fertilization （IVF）. Since no data currently exist, we investigated the outcomes for men with 0% NF to determine reproductive success without the use of assisted reproductive technologies （ArT）. A cohort of 24 men with 0% NF were identified （2010-2013） with 27 randomly selected men with 〉4% NF as controls. Patient charts were reviewed with men contacted and administered an Institutional review Board （IrB）-approved telephone questionnaire to ascertain outcomes. After a median follow-up time of 2.5 years, 29.2% of men with 0% NF did not require ArT for their first pregnancy （controls = 55.6%, P〈 0.05）. When all pregnancies were analyzed together, men with 0% NF achieved twenty pregnancies of which 75% did not require IVF （controls - thirty pregnancies; 76.7% did not require IVF）. The average age of men and female partners was similar between men with 0% NF and 〉4% NF. All men had normal follicle-stimulating hormone （FSH）, testosterone, prolactin, sex hormone-binding globulin （SHBG）, and estradiol. Although, global semen parameters were worse in men with 0% NF, when a first pregnancy was a natural conception （NC）, 100% of men with 0% NF （n = 7/7） and 37.5% of controls in = 3/8） went on to have a subsequent pregnancy via NC. Men with 0% NF conceived without IVF in 29.2% of cases compared to 55.6% of controls. Strict morphology should not be used to predict fertilization, pregnancy, or live birth potential. In men with 0% NF, alternative modalities should be considered before immediate IVF.

关键词： conception infertility intrauterine insemination in vitro fertilization strict morphology success

The effects of advanced paternal age on fertility

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Asian Journal of Andrology 2013年第6期15卷 723-728,I0005页

作者： jason r.kovac Josephine Addai ryan P Smith robert M Coward Dolores J Lamb Larry I Lipshultz Scott Department of Urology Department of Molecular and Cellular Biology The Center for Reproductive Medicine Baylor College of Medicine Houston TX 77030 USA

Modern societal pressures and expectations over the past several decades have resulted in the tendency for couples to delay conception. While women experience a notable decrease in oocyte production in their late thirties, the effect of age on spermatogenesis is less well described. While there are no known limits to the age at which men can father children, the effects of advanced paternal age are incompletely understood. This review summarizes the current state of knowledge regarding advanced paternal age and its implications on semen quality, reproductive success and offspring health. This review will serve as a guide to physicians in counseling men about the decision to delay paternity and the risks involved with conception later in life.

关键词： aging male fertility outcomes male infertility paternal age

Sperm morphology and reproductive success

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Asian Journal of Andrology 2016年第3期18卷 402-402页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scott Department of Urology Bayler College of Medicine HoustonTexas 77030 USA.

Drs. Sikka and HellstromI provide an excellent summary focusing on the basics of the endocrine evaluation of male fertility with a detailed look at the specifics of semen analyses. Discussing details such as concentration, motility and morphology, Sikka and Hellstrom expand on how these tests are conducted in a laboratory setting. An understanding of these particulars is valuable to the Andrologist who must subsequently synthesize these reports and relay them to patients in a simplistic manner.

关键词： VArICOCELECTOMY

The importance of understanding baseline reproductive function prior to the administration of exogenous testosterone

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Asian Journal of Andrology 2016年第3期18卷 381-381页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scott Department of Urology Baylor College of Medicine Houston Texas77030 USA

recent increases in the awareness of hypogonadism as a clinical condition have led to more men being managed with testosterone supplementation therapy （TST）. While highly effective at raising serum testosterone levels and controlling the symptoms of hypogonadism such as fatigue and low energy,1 the resultant suppression of the hypothalamic-pituitary-gonadal axis can lead to an inhibition of gonadotropins, including follicle-stimulating hormone （FSH） and luteinizing hormone （LH） and subsequent azoospermia.

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Use of testicular sperm to combat the negative effects of DNA fragmentation

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Asian Journal of Andrology 2016年第3期18卷 434-434页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scott Department of Urology Baylor College of Medicine HoustonTexas 77030 USA.

Numerous approaches to the detection of novel biomarkers for male fertility have been proposed. As reviewed in the manuscript by Bieniek et *** of seminal plasma has yielded numerous possible candidate biomarkers. Since semen analysis is a critical component in the initial workup for infertile males, seminal fluid biomarkers inherently have several distinct advantages.

关键词： HUMAN SPErMATOZOA EFFICIENT TrEATMENT INFErTILITY ICSI MATUrATION INTEGrITY SUBSETS DAMAGE

Factors to consider for informed consent prior to vasectomy reversal

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Asian Journal of Andrology 2016年第3期18卷 372-372页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scett Department of Urology Baylor College of Medicine Houston Texas77030 USA.

The manuscript by Drs. Patel and Smith1 presents an excellent summary on the preoperative work up for patients undergoing vasectomy reversal （Vr）, and describs factors that help predict success such as surgeon skill/experience, shorter obstructive interval, a partner＇s positive fertility history and younger female age53 While intraoperative decision-making is discussed in the text, it is important to ask why, with all the research available, do some physicians still feel comfortable only offering a vasovasostomy （VV）, irrespective of the microscopic characteristics of the vasal effluent.

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Azoospermia and the cancer patient： are there any options？

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Asian Journal of Andrology 2016年第3期18卷 409-409页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 indianapolis Indiana 46260USA Scott Department of Urology Baylor College of Medicine HoustonTexas 77030 USA.

The fact that most men are severely distressed by pharmaceutical and/ or surgical treatments resulting in functional castrations is inherently obvious. Unfortunately, significant male infertility, predictable after so... 详细信息

关键词： TESTICULAr SPErM EXTrACTION

Basic concepts and recent advancements in the study of male fertility

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Asian Journal of Andrology 2016年第3期18卷 331-331页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220Indianapolis Indiana 46260 USA Scott Departmentof Urology Baylor College of Medicine HoustonTexas 77030 USA

Many controversial topics regarding Andrology in general, and male infertility more specifically have been discussed and debated for decades. Numerous manuscripts and entire journals have been dedicated to the dissemination of standardized information with multiple reviews covering similar topics. This massive amount of data leads to difficulty identifying pertinent clinical practice guidelines.

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The importance of sexual function in men with spinal cord injuries

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Asian Journal of Andrology 2016年第3期18卷 391-391页

作者： jason r.kovac Larry I Lipshultz Men's Health Center 8240 Naab Road Suite 220 Indianapolis Indiana 46260USA Scott Department of Urology Baylor College of Medicine Houston Texas77030 USA

Spinal cord injuries （SCIs） are often devastating to patients and their families. In those men young enough to consider families and unfortunate enough to be unable to ejaculate, multiple options exist. The attached manuscript by Dr. Ibrahim et al. contains a detailed outline of a multitude of techniques available to the Andrologist to both evoke ejaculation and harvest sperm from these patients. The authors, pioneers in the field of male fertility research for SCI patients, detail very high success rates for penile vibratory stimulation （86% success if above T10, 15% if below） and electroejaculation （91.9% success）.

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