ADVANCES IN THE EVALUATION AND TREATMENT OF THE INFERTILE MAN

Numerous advances in technology have been made in the last several yea rs in the diagnosis and treatment of the infertile man. Using case pre sentations, this article highlights these important new developments a nd reviews the basics of a comprehensive male infertility evaluation. The use of ultrasound as a critical, indispensable, yet noninvasive to ol in the evaluation of possible male reproductive tract obstruction i s discussed. Since assisted reproductive techniques (ARTs) have become increasingly important in the management of the otherwise untreatable infertile man, specialized testing of sperm function, e.g., the sperm penetration assay (SPA), and strict morphology assessment are often u seful prior to the initiation of some of these assisted reproductive p rocedures such as intrauterine insemination (IUI) or in vitro fertiliz ation (IVF). Testicular touch preparation cytology and image analysis are also important additions to routine testicular biopsy for quantify ing the extent of spermatogenesis. Finally, the revolutionary microman ipulation procedure of intracytoplasmic sperm injection (ICSI) has for ever changed the practice of andrology by enabling men previously thou ght to be irreversibly infertile the chance to initiate their own biol ogic pregnancy.