About 13–15% of couples have male infertility, a
multifactorial condition that contributes to roughly half of all reported cases
of infertility globally. Its aetiologies include genetic, endocrine,
anatomical, infectious, immunological, environmental, and idiopathic causes.
Genetic abnormalities, dysregulation of the hypothalamic-pituitary-gonadal
axis, varicocele-associated oxidative stress, previous cryptorchidism, genital
tract infections, and antisperm reactions are the main causes of its
pathogenesis, which disrupts spermatogenesis and sperm transport.
Oxidative stress and hormonal imbalance are common routes
shared by environmental pollutants, obesity, heat exposure, and lifestyle
variables. Dopamine agonists for hyperprolactinemia; gonadotropin therapy with
hCG and FSH in hypogonadotropic hypogonadism; varicocele repair in men with
palpable varicoceles and abnormal semen parameters; avoidance of exogenous
testosterone or anabolic steroids in men pursuing fertility; and selective
oestrogen receptor modulators like clomiphene and tamoxifen in idiopathic
oligozoospermia with suboptimal testosterone.
Although there is still little data based on guidelines,
antioxidants, including CoQ10, L-carnitine, and vitamins C and E, may lessen
oxidative stress. The results of severe oligozoospermia and azoospermia have
been transformed by assisted reproductive technologies like IVF and
intracytoplasmic sperm injection, which are complemented by surgical methods,
including orchiopexy, repair for blockage, and sperm retrieval procedures.
Probiotic manipulation of the gut-testis axis, stem cell transplantation,
immunomodulators, and nutraceuticals are emerging topics that hold promise for
the future. To maximise reproductive results for men and couples, management
ultimately calls for a customised, evidence-based, multidisciplinary approach
that incorporates established therapies, emerging research, and guideline
recommendations.
Author(s) Details
Roshan Reddy
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Rajan Ravichandran
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Vivek Meyyappan
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Velmurugan
Palaniyandi
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Hariharasudhan Sekar
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Sriram Krishnamoorthy
Department of Urology and Renal Transplantation, Sri Ramachandra Institute
of Higher Education & Research Chennai, India.
Please see the book here :- https://doi.org/10.9734/bpi/mono/978-93-47485-93-0/CH2
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