Fig. 15.1 Mechanism of DNA injury during cryopreservation Apoptosis markers (caspase activation, DNA damage and phosphatidylserine externalisation) have been linked to male infertility in numerous studies. Spermatozoa positive for active…
Fig. 14.1 Preparation of the sample for cryopreservation. The sample is placed in an incubator at 37 °C for complete liquefaction before conducting semen analysis [reprinted with permission, Cleveland Clinic Center…
Fig. 16.1 The overall risk analysis/management framework This simplified diagrammatic overview of risk analysis may seem somewhat facile in relation to an apparently simple process such as sperm banking where…
Fig. 1.1 The hypothalamic-pituitary-gonadal axis. The hypothalamus signals the anterior pituitary to release LH and FSH to, respectively, stimulate testosterone production and spermatogenesis in the testicles. This system is regulated…
Fig. 20.1 Germ cell transplantation. Germ cells obtained from a donor testis are transplanted into the recipient testis either directly or after propagation in vitro. To improve donor cell colonization…
Fig. 3.1 Needle aspiration biopsy (NAB) . A core of seminiferous tubules is pulled out of the testis using an 18 G scalp vein needle and fine microsurgical forceps Testicular Mapping…
Medication Administration Dosage/frequency Special considerations Selective estrogen receptor modulators (SERM) Oral Clomiphene citrate 25–50 mg daily, tamoxifen 20 mg daily Generally well tolerated. Off-label use for male infertility. More potent…
Fig. 4.1 Physiology of ejaculation. Sympathetic innervation originates from segments T10-L2 and reaches the pelvic plexus via the hypogastric nerve. Parasympathetic innervation arises from segments S2 to S4 and reaches…
Individual Institutional • Cost • No FPC by a physiciana • Insufficient time • No referral for FP by a physiciana • Scheduling concerns • Medical staff discomfort • Religious/ethical concerns • Lack of knowledge • Embarrassment • Lack of…
Patient • Stage of diagnosis • Performance status • Psychological distress • Access to resources • Health literacy • Cost Provider • Knowledge base • Inadequate education in training • Inadequate ongoing education • Low referral rates to reproductive specialists…
