ExcelMale
Menu
Home
What's new
Latest activity
Forums
New posts
Search forums
What's new
New posts
Latest activity
Videos
Lab Tests
Doctor Finder
Buy Books
About Us
Men’s Health Coaching
Log in
Register
What's new
Search
Search
Search titles only
By:
New posts
Search forums
Menu
Log in
Register
Navigation
Install the app
Install
More options
Contact us
Close Menu
Forums
Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Infertility in men: assessment and treatment
JavaScript is disabled. For a better experience, please enable JavaScript in your browser before proceeding.
You are using an out of date browser. It may not display this or other websites correctly.
You should upgrade or use an
alternative browser
.
Reply to thread
Message
<blockquote data-quote="madman" data-source="post: 236972" data-attributes="member: 13851"><p><strong>Infertility in men: assessment and treatment (2022)</strong></p><p><em>By Ramjan S Mohamed, Danai T Balfoussia & Channa N Jayasena</em></p><p></p><p></p><p><strong>An overview of the causes and endocrinology of male infertility considering the available treatment options, the role of medicines, and how pharmacists can support patients.</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong><u>CPD module</u> </strong></p><p><strong></strong></p><p><strong>After reading this article, test your knowledge by completing the CPD questions and receive a certificate as a record of your learning. </strong></p><p><strong></strong></p><p><strong>After reading this article, you should be able to:</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong><em>-Recognise the contribution of medication to male factor infertility; </em></strong></p><p></p><p><em><strong>-Be aware of drugs that are potentially teratogenic and advise patients to seek advice from their specialist team prior to attempting conception; </strong></em></p><p><em><strong></strong></em></p><p><em><strong>-Understand the rationale and evidence base of medical treatments for male factor infertility; </strong></em></p><p></p><p><strong><em>-Appreciate the duration and potential side effects of pharmacological treatment of male factor infertility.</em></strong></p><p></p><p></p><p></p><p></p><p><em><strong>Infertility is the inability to conceive after one year of regular unprotected intercourse. </strong>It is estimated that infertility affects one in seven heterosexual couples in the UK, with 30% of these cases being attributed to the man[1]. In a quarter of cases, no identifiable cause is found and male factor subfertility is classed as idiopathic[2].</em></p><p><em></em></p><p><em><strong>Sperm production is hormonally driven and precisely controlled. In normal physiology, sperm is produced when gonadotrophin-releasing hormone (GnRH), a neuropeptide secreted from specialized neurons of the hypothalamus, stimulates follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion from the anterior pituitary gland.<u> LH in turn stimulates Leydig cells in the testes to synthesize testosterone while FSH acts on Sertoli cells in the testes to promote spermatogenesis</u>. <u>The final maturation of the spermatozoa is dependent on intra-testicular testosterone</u>[3].</strong></em></p><p><em><strong></strong></em></p><p><em><strong><u>Disrupted testicular maturation or hormonal imbalances affecting any stage of spermatogenesis can result in infertility</u>. Male factor subfertility is often medically or surgically treatable and can be connected to the use of certain drugs or medicines.</strong></em></p><p></p><p><strong>This article provides an overview of the pathophysiology of male infertility, as well as the diagnosis and assessment, and treatment options, highlighting opportunities for pharmacist involvement.</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong><u>Causes of male infertility </u></strong></p><p></p><p>Causes of male infertility may be classified into four broad groups (see Figure):</p><p></p><p><strong><em>1. Impaired sexual function; </em></strong></p><p><strong><em>2. Primary testicular defects; </em></strong></p><p><strong><em>3. Endocrinopathies that reduce spermatogenesis; </em></strong></p><p><em><strong>4. Defects in sperm transportation[4]. </strong></em></p><p></p><p></p><p><strong><u>Idiopathic primary testicular dysfunction</u> remains the most common cause of male factor infertility[5].</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Impaired sexual function</strong></p><p></p><p> </p><p><strong>*Primary testicular defects</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Endocrinopathies</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Congenital causes of hypogonadotropic hypogonadism</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Acquired causes of hypogonadotropic hypogonadism </strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Defects in sperm transportation</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Teratogenicity of certain medications</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Clinical features</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Diagnosis and assessment</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Management</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Conservative management</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Medical</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Medical therapy for erectile dysfunction</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Medical therapy for hypogonadotropic hypogonadism</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Medical therapy for oligospermia and non-obstructive azoospermia</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>*Surgical</strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong></strong></p><p><strong>Conclusion </strong></p><p><strong></strong></p><p><strong><em>Male infertility is relatively common and should be approached in a sensitive manner. Medication can contribute to male factor subfertility through different mechanisms and pharmacists should be vigilant of this. Whilst antioxidants are safe, the evidence base supporting their use as a means of enhancing fertility is limited. The only licensed male medical treatment is for hypogonadotropic hypogonadism. Use of SERMs, AIs, and hCG for oligospermia or prior to surgical sperm retrieval for non-obstructive azoospermia is off-license and with limited evidence to support its use.</em></strong></p></blockquote><p></p>
[QUOTE="madman, post: 236972, member: 13851"] [B]Infertility in men: assessment and treatment (2022)[/B] [I]By Ramjan S Mohamed, Danai T Balfoussia & Channa N Jayasena[/I] [B]An overview of the causes and endocrinology of male infertility considering the available treatment options, the role of medicines, and how pharmacists can support patients. [U]CPD module[/U] After reading this article, test your knowledge by completing the CPD questions and receive a certificate as a record of your learning. After reading this article, you should be able to: [I]-Recognise the contribution of medication to male factor infertility; [/I][/B] [I][B]-Be aware of drugs that are potentially teratogenic and advise patients to seek advice from their specialist team prior to attempting conception; -Understand the rationale and evidence base of medical treatments for male factor infertility; [/B][/I] [B][I]-Appreciate the duration and potential side effects of pharmacological treatment of male factor infertility.[/I][/B] [I][B]Infertility is the inability to conceive after one year of regular unprotected intercourse. [/B]It is estimated that infertility affects one in seven heterosexual couples in the UK, with 30% of these cases being attributed to the man[1]. In a quarter of cases, no identifiable cause is found and male factor subfertility is classed as idiopathic[2]. [B]Sperm production is hormonally driven and precisely controlled. In normal physiology, sperm is produced when gonadotrophin-releasing hormone (GnRH), a neuropeptide secreted from specialized neurons of the hypothalamus, stimulates follicle-stimulating hormone (FSH) and luteinizing hormone (LH) secretion from the anterior pituitary gland.[U] LH in turn stimulates Leydig cells in the testes to synthesize testosterone while FSH acts on Sertoli cells in the testes to promote spermatogenesis[/U]. [U]The final maturation of the spermatozoa is dependent on intra-testicular testosterone[/U][3]. [U]Disrupted testicular maturation or hormonal imbalances affecting any stage of spermatogenesis can result in infertility[/U]. Male factor subfertility is often medically or surgically treatable and can be connected to the use of certain drugs or medicines.[/B][/I] [B]This article provides an overview of the pathophysiology of male infertility, as well as the diagnosis and assessment, and treatment options, highlighting opportunities for pharmacist involvement. [U]Causes of male infertility [/U][/B] Causes of male infertility may be classified into four broad groups (see Figure): [B][I]1. Impaired sexual function; 2. Primary testicular defects; 3. Endocrinopathies that reduce spermatogenesis; [/I][/B] [I][B]4. Defects in sperm transportation[4]. [/B][/I] [B][U]Idiopathic primary testicular dysfunction[/U] remains the most common cause of male factor infertility[5]. *Impaired sexual function[/B] [B]*Primary testicular defects *Endocrinopathies *Congenital causes of hypogonadotropic hypogonadism *Acquired causes of hypogonadotropic hypogonadism *Defects in sperm transportation *Teratogenicity of certain medications *Clinical features *Diagnosis and assessment *Management *Conservative management *Medical *Medical therapy for erectile dysfunction *Medical therapy for hypogonadotropic hypogonadism *Medical therapy for oligospermia and non-obstructive azoospermia *Surgical Conclusion [I]Male infertility is relatively common and should be approached in a sensitive manner. Medication can contribute to male factor subfertility through different mechanisms and pharmacists should be vigilant of this. Whilst antioxidants are safe, the evidence base supporting their use as a means of enhancing fertility is limited. The only licensed male medical treatment is for hypogonadotropic hypogonadism. Use of SERMs, AIs, and hCG for oligospermia or prior to surgical sperm retrieval for non-obstructive azoospermia is off-license and with limited evidence to support its use.[/I][/B] [/QUOTE]
Insert quotes…
Verification
Post reply
Share this page
Facebook
Twitter
Reddit
Pinterest
Tumblr
WhatsApp
Email
Share
Link
Sponsors
Forums
Testosterone Replacement, Low T, HCG, & Beyond
Clomid for PCT, fertility or low T
Infertility in men: assessment and treatment
This site uses cookies to help personalise content, tailor your experience and to keep you logged in if you register.
By continuing to use this site, you are consenting to our use of cookies.
Accept
Learn more…
Top