O A FFICE NDROLOGY Contributors KAREN E. ADAMS, MD,FACOG, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR DAVID E. BATTAGLIA,PhD, Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR KEITH L. BLAUER,MD, Reproductive Care Center, Salt Lake City, UT EMMETT F. BRANIGAN,MD, Bellingham IVF and Infertility Center, Bellingham, WA LISA V. BROCK, Attorney General’s Office, State of Washington, Olympia, WA WILLIAM BYRD,PhD,HCLD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX GRACE M. CENTOLA,PhD,HCLD(ABB), Offices for Fertility and Reproductive Medicine, New York, NY; Professional ReproLab Consulting, Macedon, NY EUGENE F. FUCHS, MD, Department of Surgery, Division of Urology, Oregon Health and Science University, Portland, OR WAYNE J.G. HELLSTROM,MD,Department of Urology, Tulane University School of Medicine, New Orleans, LA ARON JOHNSON,Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR DAVID S. KARABINUS,PhD, Genetics and IVF Institute, Fairfax, VA DOLORES J. LAMB,PhD,HCLD,Scott Department of Urology, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX LARRY I. LIPSHULTZ,MD,Scott Department of Urology, Baylor College of Medicine, Houston, TX KIRK C. LO, MD, Scott Department of Urology, Baylor College of Medicine, Houston, TX ANNA C. MASTROIANNI, University of Washington School of Law and Institute for Public Health Genetics, Seattle, WA. R. DALE MCCLURE,MD,FRCS(C) Section of Urology, Virginia Mason Medical Center, Seattle, WA SHARON T. MORTIMER,PhD,Oozoa Biomedical Inc., West Vancouver, BC, Canada KINLOCH NELSON, MD, Virginia Urology, Hanover Medical Park, Mechanicsville, VA ROBERT D. OATES,MD, Department of Urology, Boston University School of Medicine, Boston, MA DARIUS A. PADUCH,MD,Department of Urology, Weill Medical College of Cornell University, New York, NY ix O A FFICE NDROLOGY Edited by P E. P , HILLIP ATTON MD and D E. B , AVID ATTAGLIA PhD Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR © 2005 Humana Press Inc. 999 Riverview Drive, Suite 208 Totowa, New Jersey 07512 www.humanapress.com For additional copies, pricing for bulk purchases, and/or information about other Humana titles, contact Humana at the above address or at any of the following numbers: Tel: 973-256-1699;Fax: 973-256-8341; E-mail:[email protected] or visit our website at humanapress.com All rights reserved. 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Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1 eISBN: 1-59259-876-5 Library of Congress Cataloging-in-Publication Data Office andrology / edited by Phillip E. Patton, and David E.Battaglia. p. ; cm. -- (Contemporary endocrinology) Includes bibliographical references and index. ISBN 1-58829-318-1 (alk. paper) 1. Andrology. 2. Infertility, Male. I. Patton, Phillip E. II. Battaglia, David Edward. III. Series: Contemporary endocrinology (Totowa, N.J.) [DNLM: 1. Infertility, Male--diagnosis. 2. Genital Diseases, Male. 3. Infertility, Male--therapy. 4. Insemination, Artificial. WJ 709 O32 2005] RC875.O35 2005 612.6'1--dc22 2004027128 Preface The investigation and management of male infertility can be a formidable diagnostic challenge to family physicians, urologists, and reproductive specialists alike. For the first time, health care providers can access a comprehensive resource that covers a broad spectrum of relevant clinical issues related to male infertility disorders. InOffice Andrology, a variety of topics including basic sperm biology, male reproductive endocrinology, immunology, specialized sperm testing, and genetic issues of male infertility are reviewed by recognized experts in the field. In addition, this book features a pragmatic review of the investigation, diagnostic testing, and management of the infertile male. Controversial medical and surgical treatment options are focus areas that should assist the practicing clinician. For the reproductive specialist, the text covers timely topics, including gender selection, HIV discordance couples, and posthumous reproduction in a thoughtful and comprehensive manner. The goal of Office Andrology is to provide a practical guide for those requiring concise answers to both the urbane and complex scenarios attendant on male infertility. Practitioners wishing a greater understanding of the available diag- nostic and treatment options will find Office Andrology especially useful in their clinical practice. Phillip E. Patton, MD David E. Battaglia, PhD v Contents Preface..........................................................................................v Contributors.................................................................................ix 1 Essentials of Sperm Biology ..................................................1 Sharon T. Mortimer 2 Endocrinology of Male Infertility ........................................11 R. Dale McClure 3 Sperm Preparation for Insemination ....................................39 Grace M. Centola 4 Specialized Sperm Testing: Pros and Cons.........................53 Kirk C. Lo, Aron Johnson, Larry I. Lipshultz, and Dolores J. Lamb 5 Genetic Testing for Male Infertility.....................................73 Robert D. Oates 6 Optimizing Success in a Donor Insemination Program.......91 Phillip E. Patton 7 Ethical and Legal Considerations of Donor Insemination in the United States.........................................................109 Karen E. Adams 8 Laboratory Accreditation....................................................127 William Byrd 9 Office Evaluation of Male Infertility .................................141 Darius A. Paduch and Eugene F. Fuchs 10 Varicocele and Infertility....................................................155 Ulrike Zenke and Paul Turek 11 Strategic Therapies for Ejaculatory Disorders and Erectile Dysfunction in the Infertile Man....................................169 Mustafa F. Usta and Wayne J. G. Hellstrom 12 Vasectomy Reversal ...........................................................183 Eugene F. Fuchs and Darius A. Paduch vii viii Contents 13 Infection and Male Infertility .............................................189 Emmett F. Branigan 14 Obstructive and Nonobstructive Azoospermia..................201 Kinloch Nelson and Peter Schlegel 15 Testis Biopsy and the Infertile Male..................................215 Sherman J. Silber 16 Intracytoplasmic Sperm Injection: The Process, the Outcomes, and the Controversies ............................241 David E. Battaglia 17 Treatment of Human Immunodeficiency Virus-Discordant Couples..............................................255 Joseph E. Peña and Mark V. Sauer 18 Sperm and Egg Retrieval for Posthumous Reproduction: Practical, Ethical, and Legal Considerations...............267 Lisa V. Brock and Anna C. Mastroianni 19 Gender Selection: Separating Fact From Fiction. ............285 David S. Karabinus and Keith L. Blauer Index.........................................................................................303 Contributors KAREN E. ADAMS, MD,FACOG, Department of Obstetrics and Gynecology, Oregon Health and Science University, Portland, OR DAVID E. BATTAGLIA,PhD, Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR KEITH L. BLAUER,MD, Reproductive Care Center, Salt Lake City, UT EMMETT F. BRANIGAN,MD, Bellingham IVF and Infertility Center, Bellingham, WA LISA V. BROCK, Attorney GeneralÕs Office, State of Washington, Olympia, WA WILLIAM BYRD,PhD,HCLD, Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, Dallas, TX GRACE M. CENTOLA,PhD,HCLD(ABB), Offices for Fertility and Reproductive Medicine, New York, NY; Professional ReproLab Consulting, Macedon, NY EUGENE F. FUCHS,MD, Department of Surgery, Division of Urology, Oregon Health and Science University, Portland, OR WAYNE J.G. HELLSTROM,MD,Department of Urology, Tulane University School of Medicine, New Orleans, LA ARON JOHNSON, Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR DAVID S. KARABINUS,PhD, Genetics and IVF Institute, Fairfax, VA DOLORES J. LAMB,PhD,HCLD,Scott Department of Urology, Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX LARRY I. LIPSHULTZ, MD,Scott Department of Urology, Baylor College of Medicine, Houston, TX KIRK C. LO,MD, Scott Department of Urology, Baylor College of Medicine, Houston, TX ANNA C. MASTROIANNI, Attorney General’s Office, State of Washington, Olympia, WA. R. DALE MCCLURE,MD,FRCS(C) Section of Urology, Virginia Mason Medical Center, Seattle, WA SHARON T. MORTIMER,PhD,Oozoa Biomedical Inc., West Vancouver, BC, Canada KINLOCH NELSON, MD, Virginia Urology, Hanover Medical Park, Mechanicsville, VA ROBERT D. OATES,MD, Department of Urology, Boston University School of Medicine, Boston, MA DARIUS A. PADUCH, MD,Department of Urology, Weill Medical College of Cornell University, New York, NY ix x Contributors PHILLIP E. PATTON,MD, Department of Obstetrics and Gynecology, Oregon Health and Science University, University Fertility Consultants, Portland, OR JOSEPH E. PEÑA,MD, Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, New York, NY MARK V. SAUER,MD, Department of Obstetrics and Gynecology, Columbia Presbyterian Medical Center, New York, NY PETER SCHLEGEL,MD,Department of Urology, Weill Medical College of Cornell University, New York, NY SHERMAN J. SILBER,MD, Infertility Center of St. Louis, St. Luke’s Hospital, St. Louis, MO and Department of OB-GYN Infertility Center, New York, NY PAUL TUREK,MD, Department of Urology, University of California San Francisco, San Francisco, CA MUSTAFA F. USTA,MD, Department of Urology, Tulane University School of Medicine, New Orleans, LA ULRIKE ZENKE,MD, Department of Urology, University of California San Francisco, San Francisco, CA