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Surgery for male factor infertility 

Surgery for male factor infertility
Surgery for male factor infertility

John Reynard

, Stephen Mark

, Kevin Turner

, Noel Armenakas

, Mark Feneley

, and Mark Sullivan

Page of

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date: 23 October 2020

Aetiology and evaluation of male infertility 644

Surgical management of male factor infertility 646

A male factor alone is responsible for infertility in 20% of couples and is contributory in another 30%. Evaluation of both partners is an essential part of the assessment of any infertile couple. Take a full medical and surgical history. Focus on the fertility history of both partners, sexual history, paediatric and developmental history (testicular maldescent, inguino-scrotal surgery, onset of puberty), family history, exposure to gonadotoxins, drug history, infections (viral, mumps, epididymitis, STDs), previous urological surgery, trauma. Conduct a general physical examination focusing on secondary sexual characteristics. Examine the penis looking for hypospadias. Assess testicular and epididymal size, consistency, and symmetry. Feel for any abnormal swellings (testicular or paratesticular lumps, varicoceles) and confirm the presence of a vas on each side. Do a digital rectal examination, assess the prostate, and determine whether the seminal vesicles are palpable....

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