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Impaired male fertility contributes to at least 50% of cases of couple infertility. Azoospermia is found in 1-2% of the male population. In the diagnostic workup, genetic and endocrine as well as lifestyle factors may be considered. Spermatozoa can be retrieved surgically in many cases of azoospermia, aspermia and difficult cases of retrograde ejaculation. Such spermatozoa can be used for injection into the oocytes of the female partners by intracytoplasmic sperm injection. Treatment with follicle stimulating hormone is only indicated in hypogonadotrophic hypogonadism. This review is a summarisation of the current male infertility treatment modalities.

Non-obstructive azoospermia (NOA) is a severe form of male infertility. The only option to help men with NOA to become biological fathers is to surgically extract spermatozoa from the testicles, and in this review different modalities are discussed. Microdissection testicular sperm extraction seems to achieve better sperm retrieval rates compared with both testicular sperm aspiration and testicular sperm extraction. However, there are significant limitations in the current literature, and without prospective randomised trials it is not possible to define the optimal sperm retrieval technique for the management of NOA.

The quantity of interest, experience, and barriers to research in non-university hospitals in Denmark is undocumented. Therefore, a questionnaire was distributed to all employees at non-university hospitals in two Danish regions. The results showed that a substantial number of medical doctors were engaged in ongoing research. 24% of the respondents were supervisors in research projects, and 19% conducted contract research. Thus, Danish non-university hospitals have employees with both interest and experience in medical research. The four most commonly stated barriers for research were lack of time, funding, supervision, and training courses.

In recent years approximately 8% of the newborn Danes have been conceived by infertility treatment, and approximately half of the cases are due to male subfertility. Male infertility can be caused by several factors, and only in about half of the cases is it possible to disclose an aetiological explanation. It is important to elucidate possible reasons for male infertility as low semen quality might be a symptom of pituitary dysfunction, genetic disorders or testicular cancer.

Introduction: According to recently passed Danish legislation, all Danish hospitals are obliged to take part in scientific research. As data on financial support for research activities are lacking, we assessed the resources allocated to research from the budget of the central hospital management as a percentage of the total budget at Danish regional hospitals in 2007., Material and Methods: A postal survey was conducted at 13 hospitals in the Western part of Denmark. The questionnaire comprised items in the following major categories: 1) budget allocated specifically for research and travel grants; 2) employment of scientific and technical support staff; 3) facilities and equipment for research; and 4) research dissemination., Results: Questionnaires were returned from 11 hospitals. Six hospitals reported to have dedicated fixed amounts on the budget for research, exact figures were reported in four cases only equivalent to 0.1%, 0.3%, 0.3% and 0.6% of the total budget. Most hospitals had associate professors, but only five had full professors. Seven hospitals supplied laboratories and technical facilities, eight hospitals held staff-meetings on a regular basis and four published an annual report on research activities., Conclusion: In the majority of regional hospitals in Western Denmark, less than 0.3% of the total budget administered by the central hospital management was allocated specifically for research. These figures, however, may not be accurate as individual departments may allocate additional resources from local budgets. We recommend that regional hospitals define research strategies and allocate the necessary funding in their budgets.

Introduction: The purpose of this study was to investigate the frequency of potential drug-drug interactions (DDIs) within the first 24 hours of admission to an intensive care unit, and to determine which drugs were involved in potential DDIs along with the clinical relevance of the identified DDIs., Methods: Drug data from all intensive care patients (n = 102) admitted during a three-month period in the spring 2007 were investigated. Potential DDIs were evaluated using the drug interaction system of Micromedex., Results: Four patients were excluded because their treatment only included one drug. A total of 98 patients were treated with an average of ten drugs per patient. Among the enrolled patients, we found 242 potential DDIs, corresponding to an average of 2.5 DDIs per patient. The drugs most frequently involved in potential DDIs included antithrombotic drugs, opioids, loop diuretics, ACE inhibitors, beta blockers, NSAIDs, corticosteroids, quinolon antibiotics, cardiac glycosides, thiazide diuretics, -anaesthetics, antidepressants, anticonvulsants and sedatives., Discussion: The number of DDIs per patient found in this study is high compared with the results of a recent Norwegian study. The majority of the identified DDIs were normal combinations of drugs, which are managed through monitoring of the patient and discontinuing of the offending drug if necessary. It is therefore important to revise the patient's medication daily., Conclusion: A total of 71% of the 98 enrolled patients were exposed to one or more potential DDIs. We found an average of 2.5 potential DDIs per patient. Antithrombotic drugs, opioids and loop diuretics were most frequently involved in potential DDIs. The clinical relevance varied because the majority of the identified potential DDIs were normal drug combinations.

Four patients treated laparoscopically for ventral hernia (LVH) using W3 mesh (Cousin Biotech, France) and Protack (Tyco Healthcare, USA) were reoperated laparoscopically after 5, 6, 14 and 23 months for recurrent hernia (two cases) and a new hernia proximal to the primary mesh (two cases). In all patients we found adhesions toward the mesh and fixation devices that increased in severity and extent with time, rendering dissection difficult and dangerous. These findings cause concern and suggest that current validation methods for materials used in LVH should be re-evaluated.

Introduction: This study describes the results obtained with a small IVF/ICSI-transport programme carried out between a private specialist clinic and a public IVF-clinic., Materials and Methods: All women treated in the specialist clinic over a three and a half years period were entered. Ovarian stimulation, oocyte aspiration, and the follow-up after fertilisation were carried out in the specialist clinic, whereas fertilisation, culture and embryo transfer were performed in the public IVF clinic 25 km away. The oocytes were transported in an insulated box kept at 37 degrees C., Results: Totally 314 stimulation cycles were performed with 68% IVF, 19% ICSI, and 13% cycles with cryopreserved oocytes (FER). The material comprises 259 oocyte aspirations with a total of 1969 oocytes, 1229 were fertilised. Oocyte and transfer-data are given in Table 2. The pregnancy rate was 29% for IVF and 27.1% for ICSI, but only 12.2% in FER., Discussion: These results are consistent with that of other private and public IVF treatments in Denmark, where differences in population and oocyte handling are comparable (Table 3). As reported from the Netherlands, the UK, and Argentina (Table 4) transportation of oocytes does not seem to damage their potential for fertilisation and implantation.

Azoospermia can be due to a genetic defect (abnormal karyotype, Y chromosome micro-deletion or cystic fibroses carrier), genital tract infection or trauma. Examination of azoospermic men includes ultrasound examination of the scrotal contents, prostate and seminal vesicles, hormone analysis, genetic examinations and testis biopsy. Some patients with obstructive azoospermia can be cured surgically. If passage can not be established through the genital tract, sperm can be obtained from the epididymis or testis for micro-insemination of oocytes from the female partner. No increased occurrence of malformations among children born after micro-insemination has been found, but an increased occurrence of severe reduced semen quality may be expected, when the "ICSI boys" grow up. Freezing of additional sperm or testis tissue is recommended.

A phenotypical girl aged 16 years with primary amenorrhoea had an XY-karyotype and reacted positively to serologically demonstrable H-Y antigen. The left gonad was an immature testis while the right was a streak gonad with a gonadoblastoma. The value of H-Y antigen determinations in the diagnosis and choice of treatment is discussed.