[Assessment of the man in the infertile couple].

Évaluation de l’homme du couple infertile.
Male Humans Female Semen Infertility, Male / diagnosis Testis Testosterone Hypogonadism / diagnosis
Agénésie déférentielle Azoospermia Azoospermie CFTR Caryotype Chomosome Y microdeletions DNA fragmentation Deferential agenesis Fragmentation de l’ADN France genomics 2025 plan Infertilité masculine Karyotype Male infertility Microdélétions du chomosome Y Plan France génomique 2025 Varicocele Varicocèle

Journal

Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie
ISSN: 1166-7087
Titre abrégé: Prog Urol
Pays: France
ID NLM: 9307844

Informations de publication

Date de publication:
Nov 2023
Historique:
received: 27 08 2023
revised: 19 09 2023
accepted: 22 09 2023
medline: 29 11 2023
pubmed: 28 11 2023
entrez: 28 11 2023
Statut: ppublish

Résumé

Among couples consulting for infertility, there is a male component, either alone or associated with a female aetiology in around one in 2 cases. Bibliographic search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2023. The AFU recommends: (1) a complete medical history including: family history, patient history affecting fertility, lifestyle habits (toxicity), treatments, symptoms, sexual dysfunctions; (2) a physical examination including: BMI, signs of hypogonadism, secondary sexual characteristics, scrotal examination (volume and consistency of testes, vas deferens, epididymal or testicular nodules, presence of varicocele); (3) two spermograms, if abnormal on the first; (4) a systematic scrotal ultrasound,± an endorectal ultrasound depending on the clinic; (5) a hormonal work-up (testosterone, FSH; if testosterone is low: LH assay to differentiate between central or peripheral hypogonadism); (6) karyotype if sperm concentration≤10 million/mL; (7) evaluation of Y chromosome microdeletions if concentration≤1 million/mL; (8) evaluation of the CFTR gene in cases of suspected bilateral or unilateral agenesis of the vas deferens and seminal vesicles. The role and usefulness of direct and indirect tests to assess the effects of oxidative stress on sperm DNA will also be explained. This review complements and updates the AFU/SALF 2021 recommendations.

Sections du résumé

BACKGROUND BACKGROUND
Among couples consulting for infertility, there is a male component, either alone or associated with a female aetiology in around one in 2 cases.
MATERIAL AND METHODS METHODS
Bibliographic search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2023.
RESULTS RESULTS
The AFU recommends: (1) a complete medical history including: family history, patient history affecting fertility, lifestyle habits (toxicity), treatments, symptoms, sexual dysfunctions; (2) a physical examination including: BMI, signs of hypogonadism, secondary sexual characteristics, scrotal examination (volume and consistency of testes, vas deferens, epididymal or testicular nodules, presence of varicocele); (3) two spermograms, if abnormal on the first; (4) a systematic scrotal ultrasound,± an endorectal ultrasound depending on the clinic; (5) a hormonal work-up (testosterone, FSH; if testosterone is low: LH assay to differentiate between central or peripheral hypogonadism); (6) karyotype if sperm concentration≤10 million/mL; (7) evaluation of Y chromosome microdeletions if concentration≤1 million/mL; (8) evaluation of the CFTR gene in cases of suspected bilateral or unilateral agenesis of the vas deferens and seminal vesicles. The role and usefulness of direct and indirect tests to assess the effects of oxidative stress on sperm DNA will also be explained.
CONCLUSION CONCLUSIONS
This review complements and updates the AFU/SALF 2021 recommendations.

Identifiants

DOI: 10.1016/j.purol.2023.09.027 PMID: 38012906
pubmed: 38012906
pii: S1166-7087(23)00230-0
doi: 10.1016/j.purol.2023.09.027
pii:
doi:

Substances chimiques

Testosterone 3XMK78S47O

Types de publication

Review English Abstract Journal Article

Langues

fre

Sous-ensembles de citation

IM

Pagination

588-612

Informations de copyright

Copyright © 2023. Published by Elsevier Masson SAS.

Auteurs

A Faix (A)

Clinique Saint-Roch, 560, avenue du Colonel-Pavelet-dit-Villars, 34000 Montpellier, France.

C Methorst (C)

Service de médecine de la reproduction, hôpital des 4-villes, Saint-Cloud, France.

F Lamazou (F)

Clinique Pierre-Cherest, Paris, France.

F Vialard (F)

Service de génétique, CHU de Poissy Saint-Germain, UVSQ, Poissy, France.

E Huyghe (E)

Département d'urologie, hôpital de Rangueil, CHU de Toulouse, Toulouse, France; Service de médecine de la reproduction, hôpital Paule-de-Viguier, CHU de Toulouse, Toulouse, France; UMR DEFE, Inserm 1203, université de Toulouse, université de Montpellier, Toulouse, France. Electronic address: eric.huyghe@yahoo.fr.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › [Assessment of the man in the infertile couple].
questionsmedicales.fr › Liquides et sécrétions biologiques › Sécrétions corporelles › Sperme › [Assessment of the man in the infertile couple].
questionsmedicales.fr › Maladies urogénitales › Maladies urogénitales de l'homme › Maladies de l'appareil génital mâle › Infertilité masculine › [Assessment of the man in the infertile couple].
questionsmedicales.fr › Système endocrine › Glandes endocrines › Gonades › Testicule › [Assessment of the man in the infertile couple].
questionsmedicales.fr › Hormones gonadiques › Hormones sexuelles stéroïdiennes › Congénères de la testostérone › Testostérone › [Assessment of the man in the infertile couple].
questionsmedicales.fr › Maladies endocriniennes › Troubles gonadiques › Hypogonadisme › [Assessment of the man in the infertile couple].