Advertisement

Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I

      Purpose

      The summary presented herein represents Part I of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part I outlines the appropriate evaluation of the male in an infertile couple. Recommendations proceed from obtaining an appropriate history and physical exam (Appendix I), as well as diagnostic testing, where indicated.

      Materials/Methods

      The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January, 2000 through May, 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions. (Table 1) This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology.

      Results

      This Guideline provides updated, evidence-based recommendations regarding evaluation of male infertility as well as the association of male infertility with other important health conditions. The detection of male infertility increases the risk of subsequent development of health problems for men. In addition, specific medical conditions are associated with some causes for male infertility. Evaluation and treatment recommendations are summarized in the associated algorithm. (Figure 1)

      Conclusion

      The presence of male infertility is crucial to the health of patients and its effects must be considered for the welfare of society. This document will undergo updating as the knowledge regarding current treatments and future treatment options continues to expand.
      Diagnóstico y tratamiento de la infertilidad masculina: guía de la AUA/ ASRM parte 1.

      Objetivo

      El resumen representa la Parte I de una serie de dos partes dedicada al diagnóstico y tratamiento de la infertilidad masculina: Guía de la AUA/ASRM. La primera parte describe la evaluación apropiada del hombre en una pareja infértil. Las recomendaciones pasan por la realización de una historia y un examen físico apropiados (Apéndice I), así como pruebas de diagnóstico, cuando esté resulte indicado.

      Materiales/Métodos

      El equipo del Centro de Práctica Basada en la Evidencia del Instituto de Investigación de Cuidados de Emergencia buscó en PubMed, Embase y Medline desde enero de 2000 hasta mayo de 2019. Cuando existían pruebas suficientes, se asignaba al conjunto de pruebas una calificación de A (alta), B (moderada) o C (baja) para el apoyo de las recomendaciones fuertes, moderadas o condicionales. En ausencia de pruebas suficientes, se proporciona información adicional en forma de Principios Clínicos y Opiniones de Expertos. (Cuadro 1). Este resumen se publica simultáneamente en Fertility and Sterility y The Journal of Urology.

      Resultados

      Esta guía proporciona recomendaciones actualizadas y basadas en la evidencia sobre la evaluación de la infertilidad masculina, así como la asociación de la infertilidad masculina con otras condiciones de salud importantes. La detección de la infertilidad masculina aumenta el riesgo de posterior desarrollo de los problemas de salud de los hombres. Además, determinadas afecciones médicas se asocian con algunas causas de la infertilidad masculina. La evaluación y las recomendaciones de tratamiento se resumen en el algoritmo asociado. (Figura 1)

      Conclusión

      La presencia de la infertilidad masculina es crucial para la salud de los pacientes y sus efectos deben ser considerados para el bienestar de sociedad. Este documento se actualizará a medida que continúe el conocimiento sobre los tratamientos actuales y las opciones de tratamiento futuras para expandirse.

      Keywords

      To read this article in full you will need to make a payment

      Subscribe:

      Subscribe to Fertility and Sterility
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • The optimal evaluation of the infertile male: Aua best practice statement, 2010
        Practice committee of the american society for reproductive medicine. Diagnostic evaluation of the infertile male: A committee opinion.
        Fertil Steril. 2012; 98: 294
        • Honig S.C.
        • Lipshultz L.I.
        • Jarow J.
        Significant medical pathology uncovered by a comprehensive male infertility evaluation.
        Fertil Steril. 1994; 62: 1028
        • Kolettis P.N.
        • Sabanegh E.S.
        Significant medical pathology discovered during a male infertility evaluation.
        J Urol. 2001; 166: 178
        • Bach P.V.
        • Patel N.
        • Najari B.B.
        • et al.
        Changes in practice patterns in male infertility cases in the united states: The trend toward subspecialization.
        Fertil Steril. 2018; 110: 76
        • Salonia A.
        • Matloob R.
        • Gallina A.
        • et al.
        Are infertile men less healthy than fertile men? Results of a prospective case-control survey.
        Eur Urol. 2009; 56: 1025
        • Negri L.
        • Benaglia R.
        • Fiamengo B.
        • et al.
        Cancer risk in male factor-infertility.
        Placenta. 2008; 29: 178
        • Hanson H.A.
        • Anderson R.E.
        • Aston K.I.
        • et al.
        Subfertility increases risk of testicular cancer: Evidence from population-based semen samples.
        Fertil Steril. 2016; 105: 322
        • Mancini M.
        • Carmignani L.
        • Gazzano G.
        • et al.
        High prevalence of testicular cancer in azoospermic men without spermatogenesis.
        Hum Reprod. 2007; 22: 1042
        • Raman J.D.
        • Nobert C.F.
        • Goldstein M.
        Increased incidence of testicular cancer in men presenting with infertility and abnormal semen analysis.
        J Urol. 2005; 174: 1819
        • Eisenberg M.L.
        • Betts P.
        • Herder D.
        • et al.
        Increased risk of cancer among azoospermic men.
        Fertil Steril. 2013; 100: 681
        • Glazer C.H.
        • Bonde J.P.
        • Eisenberg M.L.
        • et al.
        Male infertility and risk of nonmalignant chronic diseases: A systematic review of the epidemiological evidence.
        Semin Reprod Med. 2017; 35: 282
      1. Welcome to reprotox.
        (08/28/2020)
        • Guzick D.S.
        • Overstreet J.W.
        Factor-Litvak P et al: Sperm morphology, motility, and concentration in fertile and infertile men.
        N Engl J Med. 2001; 345: 1388
        • Behre H.M.
        • Bergmann M.
        • Simoni M.
        • et al.
        Primary testicular failure. [updated 2015 aug 30].
        MDText.com, Inc., South Dartmouth, MA2000
        • Chillon M.
        • Casals T.
        • Mercier B.
        • et al.
        Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens.
        N Engl J Med. 1995; 332: 1475
        • Yu J.
        • Chen Z.
        • Ni Y.
        • et al.
        Cftr mutations in men with congenital bilateral absence of the vas deferens (cbavd): A systemic review and meta-analysis.
        Hum Reprod. 2012; 27: 25
        • Mak V.
        • Zielenski J.
        • Tsui L.C.
        • et al.
        Proportion of cystic fibrosis gene mutations not detected by routine testing in men with obstructive azoospermia.
        Jama. 1999; 281: 2217
        • Elmer DeWitt M.
        • Greene D.J.
        • Gill B.
        • et al.
        Isolated right varicocele and incidence of associated cancer.
        Urology. 2018; 117: 82
        • Kolettis P.N.
        • Sandlow J.I.
        Clinical and genetic features of patients with congenital unilateral absence of the vas deferens.
        Urology. 2002; 60: 1073
        • Schlegel P.N.
        • Shin D.
        • Goldstein M.
        Urogenital anomalies in men with congenital absence of the vas deferens.
        J Urol. 1996; 155: 1644
        • Weiske W.H.
        • Salzler N.
        • Schroeder-Printzen I.
        • et al.
        Clinical findings in congenital absence of the vasa deferentia.
        Andrologia. 2000; 32: 13