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John Reynard

, Simon F Brewster

, Suzanne Biers

, and Naomi Laura Neal

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date: 01 August 2021

Male factor infertility is outlined in an easily digestible format to provide clear information on this sometimes less familiar topic, starting with the basics of male reproductive physiology, the hypothalamic–pituitary–testicular axis, and spermatogenesis. This chapter includes a review of the aetiologies of abnormal sperm counts (with particular emphasis on azoospermia and oligospermia), relevant clinical assessment, and key male factor infertility investigations such as semen analysis, hormone measurement, karyotying, imaging, and testicular biopsy. The chapter explains the management options for the infertile male and couple, including information on the different assisted reproductive techniques. The chapter covers additional important clinical and exam topics, including varicoceles, indications for repair in males of different ages, red flag signs that should trigger further investigation, and the treatment options of embolization and surgical repair. The fourth edition also includes the addition of new material exploring the pros and cons of vasectomy and vasectomy reversal.

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