Center for Reproductive Medicine and Andrology, University of Münster, Germany; Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia.
Int J Gynaecol Obstet. 2013 Dec;123 Suppl 2:S31-5. doi: 10.1016/j.ijgo.2013.09.001. Epub 2013 Sep 3.
Although the male reproductive function is impaired in about half of infertile couples, the evaluation of male infertility is underrated or neglected even today. In addition to a physical examination and imaging techniques, semen analysis as well as endocrine and genetic analyses should be part of the routine investigation. Few disorders have become subjects of rational treatment of the infertile male, even though, as examples, hypogonadotropic hypogonadism is treatable by gonadotropins and obstructive azoospermia by reconstructive surgery. Early treatment of maldescended testes and sexually transmitted diseases can prevent infertility. Similar pregnancy rates from patients with varicocele following surgery or counseling demonstrate the important role of the physician in the treatment of infertility. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Instead, symptomatic treatment by assisted reproductive techniques has become a central tool to overcome otherwise untreatable male infertility.
尽管约有一半的不孕夫妇存在男性生殖功能障碍，但即使在今天，男性不育的评估也被低估或忽视了。除了体格检查和影像学技术外，精液分析以及内分泌和遗传分析也应该是常规检查的一部分。尽管例如促性腺激素可治疗低促性腺激素性性腺功能减退症，重建手术可治疗梗阻性无精子症，但很少有疾病成为理性治疗不孕男性的对象。早期治疗隐睾和性传播疾病可以预防不孕。精索静脉曲张手术后或咨询后的患者妊娠率相似，这表明医生在治疗不孕方面的重要作用。在循证医学时代，大多数经验性治疗已被证明无效。相反，通过辅助生殖技术进行对症治疗已成为克服其他无法治疗的男性不育症的重要手段。
