Search

Copyright of Die Gynäkologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gynäkologische Endokrinologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Basic & Clinical Andrology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Basic & Clinical Andrology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In boys born with a classic form of congenital adrenal hyperplasia due to severe 21-hydroxylase deficiency (HCS/ DC-21OH), there is adrenal insufficiency and a high risk of infertility in adulthood. Infertility in these men is explained by three mechanisms, which may be interrelated: 1) deficiency of pituitary gonadotropins LH and FSH, which are inhibited by the anti-gonadotropic effect of elevated steroid precursors such as progesterone, 17-hydroxyprogesterone and androgen precursors via their extra-adrenal conversion to testosterone and estradiol 2) obstructions to the testicular excretory tracts (rete testis), 3) destruction of normal testicular parenchyma, and hence seminiferous tubules, secondary to both testicular ischemia induced by compression of hilar vessels and tumor invasion. The latter two mechanisms are linked to the appearance of bilateral testicular tumors of adrenal origin. These tumors, known as testicular adrenal rest tumors (TART), are prevalent in adolescence and adulthood, but can occur as early as childhood. They should be systematically detected by testicular palpation and ultrasound. Their presence is a detrimental factor in terms of fertility, and must therefore be managed early and actively by experts in the field. The high prevalence of infertility in men born with HCS/DC-21OH raises the question of fertility preservation. Fertility preservation is systematically proposed in expert centers as soon as a sperm analysis is performed. A sperm analysis with preservation of frozen spermatozoa should be proposed from puberty onwards, especially if intra-testicular adrenal inclusions have been detected. Awareness of the major risk of infertility in men born with severe 21-hydroxylase deficiency, among pediatric and adult endocrinologists as well as urologists/andrologists and reproductive physicians, is imperative to improve management in adulthood and prevent infertility. [ABSTRACT FROM AUTHOR]

Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Gynäkologische Endokrinologie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In case of infertility due to obstructive azoospermia (OA), 2 main attitudes can be discussed: perform reconstructive surgery or perform epididymal or testicular sperm extraction followed by intracytoplasmic sperm injection (ICSI). Reconstructive surgeries include vasovasostomy (VV) and vasoepididymostomy (VE) and are the only option leading to natural conception. They cannot be considered in cases of bilateral absence of the vas deferens, or in cases of staged obstructions. They are particularly effective in cases of short obstructions such as after vasectomy. The average patency rate after vasectomy reversal is about 80 %, with an average pregnancy rate of about 50%. Obstruction interval, presence of a granuloma, surgeon experience, and sperm discovery intraoperatively are the main predictors of postoperative patency and postoperative fertility. In addition, female factors of hypofertility, including the age, are strongly correlated with the occurrence of pregnancy. In the case of OA, sperm retrieval techniques usually find enough sperm to perform ICSI. The incidence of postoperative hematoma, pain and infections are low regardless of the technique used (MESA, PESA, TESE, TESA). There is no significant difference in pregnancy rates with testicular and epididymal sperm in men with OA. However, MESA may result in higher live birth rates. In cases of distal obstructive AO (ejaculatory duct obstruction, prostatic cyst), endoscopies may be considered for curative purposes with high postoperative patency rates. In conclusion, the physician should present to the couple whose partner has OA the different possibilities available to them and involve them as much as possible in the choice of the most appropriate procedure to conceive. [ABSTRACT FROM AUTHOR]

Sujet tabou, perçu comme une malédiction ou une honte, l'infertilité masculine constitue un véritable problème de santé publique au Maroc. Cette situation a pour conséquence de rendre incomplète l'information disponible sur l'infertilité expliquant la difficulté de sa prise en charge globale. Le but de ce travail est de déterminer la prévalence des causes de l'infertilité masculine et préciser ses caractères cliniques et biologiques. Il s'agit d'une étude transversale descriptive et analytique, portant sur 150 patients vus en consultation d'urologie et gynécologie obstétrique pour infertilité conjugale du couple entre 2018 et 2020. L'âge moyen de nos patients était de 37,5 ans avec des extrêmes de 25 et 50 ans. L'infertilité était de type primaire dans 88 % des cas. La durée moyenne d'évolution de l'infertilité était de 7,5 ans. Les antécédents d'infection urogénitale étaient retrouvés chez 9,33 % des patients. La notion de professions à risque était retrouvée chez 10,30 % des patients. L'examen clinique complété par l'échographie doppler du contenu scrotal retrouvait comme principale anomalie la varicocèle chez 42 % des cas. Le spermogramme était perturbé dans 71 % des cas. Les principales anomalies étaient une oligospermie (34 %), asthénospermie dans 25 % des cas et une azoospermie dans 11,3 % des cas. Les causes d'infertilité masculine sont multiples chez un même individu, justifiant une enquête clinique et paraclinique méthodique pour les reconnaître et agir sur chacune d'elles. Les caractères de la société marocaine rendent difficile la prise en charge et la recherche scientifique dans l'infertilité masculine. A taboo subject, perceived as a curse or a shame, male infertility is a real public health problem in Morocco. This situation results in incomplete information on infertility, which explains the difficulty of its comprehensive management. The aim of this study is to determine the prevalence of the causes of male infertility and to specify its clinical and biological characteristics. This is a descriptive and analytical cross-sectional study of 150 patients seen in urology and obstetrics gynaecology consultations for conjugal infertility between 2018 and 2020. The mean age of our patients was 37.5 years with extremes of 25 and 50 years. Infertility was primary in 88 % of cases. The average duration of infertility was 7.5 years. A history of urogenital infection was found in 9.33 % of patients. The notion of high-risk professions was found in 10.30 % of patients. The clinical examination, supplemented by ultrasound scrotal examination, revealed varicocele as the main anomaly in 42 % of cases. The spermogram was disturbed in 71 % of cases. The main anomalies were oligospermia (34 %), asthenospermia in 25 % of cases and azoospermia in 11.3 % of cases. The causes of male infertility are multiple in the same individual, justifying a methodical clinical and paraclinical investigation to recognise them and act on each of them. The characteristics of Moroccan society make it difficult to take charge of and conduct scientific research into male infertility. [ABSTRACT FROM AUTHOR]

Copyright of Der Gynäkologe is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Basic & Clinical Andrology is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

INTRODUCTION: l´infertilité du couple est devenue ces dernières années un problème de santé publique, dont l´origine peut être féminine masculine ou mixte. L´origine masculine est incriminée dans 40% des cas. Au Maroc, la plus part des publications ont été axées sur les étiologies et les facteurs de risque de l´infertilité masculine. L´objectif de notre étude est l´évaluation de la prévalence de l´infertilité masculine et le profil des paramètres spermatiques chez les hommes infertiles ou à risque d´infertilité au sein d´un hôpital tertiaire à Rabat. METHODES: analyse de 482 patients adressés pour bilan d´infertilité du couple ou dans le cadre du bilan préopératoire d´une varicocèle ou d´une ectopie testiculaire. Les données démographiques, les facteurs de risque d´infertilité, le caractère primaire ou secondaire de l´infertilité ont été enregistrées pour chaque patient. Les paramètres spermatiques ont été étudiés et interprétés selon les normes actualisées de l´OMS en 2010 avec études des facteurs associés à leur perturbation. RESULTATS: l´âge moyen des patients était de 35.35± 8.81 ans. L´infertilité était primaire dans 61,8%. Les facteurs de risque d´infertilité les plus fréquemment retrouvés sont le tabac suivi par la varicocèle et l´infection. Le spermogramme était perturbé dans 53,1%. L´anomalie la plus fréquente était la perturbation de la vitalité (36,9%) suivie par la concentration spermatique (29,7%) et lamorphologie (29,3%). L´âge était le seul facteur ayant un impact significatif sur le spermogramme (p=0,002). Les anomalies de la mobilité se voient à partir de 31 ans, la vitalité est perturbée à 34 ans, la morphologie à 35 ans et la concentration à 37 ans. L´azoospermie a été retrouvée dans 16,4% essentiellement associée à l´infertilité primaire. L´oligo-asthéno-tératospermie était l´association la plus représentée (26,2%). CONCLUSION: l´infertilité masculine est fréquente dans notre contexte, l´âge étant son principal facteur de risque. La mobilité est le paramètre le plus précocement atteint.

Background: Among couples consulting for infertility, there is a male component, either alone or associated with a female aetiology in around one in 2 cases., Material and Methods: Bibliographic search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2023., Results: The AFU recommends: (1) a complete medical history including: family history, patient history affecting fertility, lifestyle habits (toxicity), treatments, symptoms, sexual dysfunctions; (2) a physical examination including: BMI, signs of hypogonadism, secondary sexual characteristics, scrotal examination (volume and consistency of testes, vas deferens, epididymal or testicular nodules, presence of varicocele); (3) two spermograms, if abnormal on the first; (4) a systematic scrotal ultrasound,± an endorectal ultrasound depending on the clinic; (5) a hormonal work-up (testosterone, FSH; if testosterone is low: LH assay to differentiate between central or peripheral hypogonadism); (6) karyotype if sperm concentration≤10 million/mL; (7) evaluation of Y chromosome microdeletions if concentration≤1 million/mL; (8) evaluation of the CFTR gene in cases of suspected bilateral or unilateral agenesis of the vas deferens and seminal vesicles. The role and usefulness of direct and indirect tests to assess the effects of oxidative stress on sperm DNA will also be explained., Conclusion: This review complements and updates the AFU/SALF 2021 recommendations., (Copyright © 2023. Published by Elsevier Masson SAS.)

Background: Testicular and epididymal sperm extraction surgery is a frequent procedure. However, to date, there has been no French consensus on the technique to be preferred in the various situations of male infertility and on the best way to perform them. We therefore decided to proceed with a formalized expert consensus, using the method recommended by the French National Authority for Health. The aim was to provide the French urology community with practical advice on how best to perform these procedures., Methods: Twenty-six international experts met online for the consensus. A research committee carried out a comprehensive literature review and prepared the 55 statements submitted to the rating group. After 2 rounds of scoring, 50 recommendations were validated in March 2023, having achieved a consensus of more than 85% among the experts., Results: The consensus covered (1) preparation for sperm extraction surgery, (2) the different sperm extraction surgery techniques (Microsurgical epididymal sperm aspiration [MESA], Percutaneous epididymal sperm aspiration [PESA], Conventional Testicular Sperm Extraction [TESE], Microsurgical Testicular Sperm Extraction [micro-TESE]), (3) advice to be given to the patient concerning the postoperative period, before presenting the results of the sperm extraction surgeries., Conclusions: The expert consensus meeting on the performance of sperm extraction surgery presented a set of clinical guidelines based on the available literature and expert opinion. These guidelines should have a favourable effect on the development of this activity in France., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

Background: Following on from the Rapport vers une stratégie nationale de lutte contre l'infertilité (Report on a national strategy to combat infertility) submitted to the French Minister of Health in 2022, whose objective 13 is: to better identify and diagnose male infertility, we wanted to clarify with reproductive specialists what role the urologist should play in the management of the infertile couple., Methods: An expert consensus was reached with the Pedagogical Committee and pilots of the Transversal Specialized Training in Reproductive Medicine and Biology - Andrology, and with the presidents, board and scientific council of the French Federation for Reproductive Study (FFER)., Results: In the case of infertility in a couple, the fertility of both partners should be assessed from the outset, and in the event of abnormality or failure of ART, the patient should be referred to a uro-andrologist for expert management. The uro-andrologist will set up medical or surgical treatments to improve the prognosis of the man's fertility, in conjunction with the entire ART team. It is also important for the urologist/andrologist to take charge of the man's health before conception, because of the benefits for the patient himself and for his offspring., Conclusion: This expert consensus has shed light on the role of the uro-andrologist in the ART pathway, on the need for training in Andrology and on the medical demography required., (Copyright © 2023 Elsevier Masson SAS. All rights reserved.)

The aim of this study was to establish the prevalence of chromosomal abnormalities and microdeletions on the Y chromosome in Tunisian infertile men with severe oligozoospermia or non-obstructive azoospermia. In cases of azoospermia, we aimed also to correlate histological results after negative testicular sperm extraction with the type of Y chromosome microdeletion. 84 infertile patients and 52 controls were screened for karyotypic abnormalities using G-banding and Yq chromosome microdeletions using multiplex PCR. 7 infertile males (8.3%) carried chromosomal abnormalities and 8 (9.5%) presented Y chromosome microdeletions. The frequency of chromosome abnormalities in azoospermic patients was 11.1% vs 3.3% in the severe oligozoospermic group. Klinefelter syndrome was the most frequent chromosomal abnormalities in 85.7% of cases. Only one patient had a 46,X,del Y/45,X karyotype. The frequency of microdeletions was 11.1% in the azoospermic group and 6.7% in the severe oligozoospermic group. Six out of 84 (7.14%) of the infertile patients had microdeletions in the AZFc region, one azoospermic male had microdeletion in the AZFbc regions and one in the AZFb region, no deletions in the AZFa region. Among the 6 azoospermic patients with microdeletions: 4 had Sertoly cell only syndrome (SCOS) and 2 had maturation arrest (MA). Genetic abnormalities in infertile Tunisian patients are similar to those reported in other countries. The knowledge of the existence of genetic abnormalities and microdeletions is useful to provide a correct diagnosis and it allows the clinician to refer the patient to adequate assisted reproduction technique and examine the value of testicular biopsy pertinence. [ABSTRACT FROM AUTHOR]

Introduction: Male infertility has a heterogeneous etiology, most commonly caused by spermatogenesis disorders clinically manifested by oligo-azoospermia. In about 30% of cases of male infertility associated with oligo-azoospermia a genetic cause can be detected. The Purpose: To determine chromosomal variations, Y-chromosome microdeletion of the AZF and cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in infertile men, before assisted reproductive techniques (ART). Materials and methods: A group of 45 infertile men were investigated during genetic counseling among infertile couples referred for ART treatment. Criteria for including patients were fulfilled if they presented with azoospermia, raised or normal levels of FSH, LH and testosterone. G-banding of metaphase chromosomes karyotype analysis were performed in all azoospermic patients. Genomic DNA was isolated and used to analyze AZF microdeletions and CFTR gene by PCR. The regions and sequence-tagged sites of AZFa (SY86, SY84), AZFb (SY127, SY134), and AZFc (SY254, SY255) were sequenced by multiplex PCR. Two common mutations of the CFTR gene were tested ΔF508 and G542X. Results: Of 45 cases of infertile men with azoospermia, 34 had normal karyotype (46,XY). In 11 cases chromosomal abnormalities have been found, including 7 patients with Klinefelter syndromes (47,XXY), 1 patient with karyotype 46,XX, 1 patients with balanced autosomal rearrangement 46,XY,der(5),t(9;5) and 2 persons with chromosomal polymorphism 46,XYqh+, 46,XY,14ps+. Deletions of Y chromosome were seen in the AZFc regions of 2 patients with features of normal karyotype, deleted markers were sY254 and sY255. Microdeletions were detected in each region of AZFa-sY84, sY86; AZFb-sY124, sY134; AZFc-sY254, sY255, and presence of gene SRY and ZFY in the patient with XX male syndrome. Two men have been found as carriers of a CFTR gene mutation ΔF508; for calculating the risk of recurrence in off spring were also investigated their spouses, who were homozygous. Conclusions: This study highlights for all couples with the diagnosis of male infertility with azoospermia the need of genetic testing and counseling prior to employment of assisted reproduction techniques. This is important for providing a firm diagnosis and fertility treatment to couples with infertility. [ABSTRACT FROM AUTHOR]

The improvement in the management of patients infected by HBV (hepatitis B virus) HCV (hepatitis C virus) and especially HIV (Human immune-deficiency virus), has led to a better life quality and an increased in life expectancy. This progress has justified the use of assisted reproductive techniques (ART) to these patients in reproductive age who want to conceive. The challenge is to prevent viral transmission to the healthy partner and children which has become feasible by the use of non-infected spermatozoa. In discordant couples, a distinct circuit is obligatory. While not allowed before, a very recent French law passed in June 2017 has permitted the use of testicular biopsy to HIV or HCV-infected azoospermic patients. [ABSTRACT FROM AUTHOR]

Background: Infections in the urogenital tract are accepted causes of male infertility. Epidemiologic data indicate 6-10 % of all males undergoing andrological work-up for infertility having an infectious etiology.Topics: This review gives a comprehensive overview on the most important urogenital tract infections (prostatitis, epididymitis, orchitis, male accessory gland infection-MAGI) and the impact on fertility. In males suffering infertility, evidence is also presented regarding an infectious etiology. [ABSTRACT FROM AUTHOR]

Résumé Cette revue fait le point sur les mesures médicales d’optimisation du recueil de spermatozoïdes dans les azoospermies non obstructives (ANO). Le traitement substitutif des insuffisances gonadotropes permet d’obtenir des spermatozoïdes dans l’éjaculat dans 90 % des cas s’il est suffisamment prolongé, le recours à la TESE est indiqué en cas de persistance de l’azoospermie à 2 ans de traitement continu. Quelques publications font état d’un possible effet des traitements hormonaux (FSH, hCG, anti-œstrogènes, inhibiteurs de l’aromatase) dans les troubles primitifs de la spermatogenèse, mais essentiellement dans des cas sélectionnés pour leur histologie favorable et leur bilan hormonal normal. L’effet reste incertain pour les cas non sélectionnés. L’optimisation par traitement de varicocèle apparaît significative. Les autres mesures de prise en charge ne reposent pas encore sur des preuves. Medical optimisation of sperm retrieval in non-obstructive azoospermia is reviewed. Gonadotropin treatment of hypogonadotropic hypogonadism allows obtaining sperms in the ejaculate in about 90% of cases provided the duration of treatment was long enough. TESE is indicated in case of persistent azoospermia at 2 years of continuous treatment. Some publications reported a possible effect of hormonal treatments (FSH, hCG, anti-estrogens, aromatase inhibitors) in primary spermatogenic failure, but mainly in cases selected for their favourable histology and normal hormonal levels. The effect on unselected cases remains doubtful. Conversely, the effect of the treatment of varicoceles is significant. Other medical treatments or advises need further investigations. [ABSTRACT FROM AUTHOR]

Abstract: Male infertility is the cause in half of all childless partnerships. Numerous factors contribute to male infertility, including chromosomal aberrations and gene defects. Few data exist regarding the association of these chromosomal aberrations with male infertility in Arab and North African populations. We therefore aimed to evaluate the frequency of chromosomal aberrations in a sample of 476 infertile men with non-obstructive azoospermia (n =328) or severe oligozoospermia (n =148) referred for routine cytogenetic analysis to the department of cytogenetics of the Pasteur Institute of Tunis. The overall incidence of chromosomal abnormalities was about 10.9%. Out of the 52 patients with abnormal cytogenetic findings, sex chromosome abnormalities were observed in 42 (80.7%) including Klinefelter syndrome in 37 (71%). Structural chromosome abnormalities involving autosomes (19.2%) and sex chromosomes were detected in 11 infertile men. Abnormal findings were more prevalent in the azoospermia group (14.02%) than in the severe oligozoospermia group (4.05%). The high frequency of chromosomal alterations in our series highlights the need for efficient genetic testing in infertile men, as results may help to determine the prognosis, as well as the choice of an assisted reproduction technique. Moreover, a genetic investigation could minimize the risk of transmitting genetic abnormalities to future generations. [Copyright &y& Elsevier]

Copyright of Ginecología y Obstetricia de México is the property of Federacion Mexicana de Ginecologia y Obstetricia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Chromosomal abnormalities are common in patients with oligozoospermia or azoospermia. We report the case of a 32-year patient, with male phenotype, and without hormonal or morphological abnormalities, with a severely reduced spermatogenesis. It was revealed a 45,X/46,XY gonadal dysgenesis. We have reviewed the various problems inherent in the discovery of this rare gonadal dysgenesis, including genetic, cancer and fertility risks. [Copyright &y& Elsevier]

Abstract: Until few years ago, Klinefelter syndrome with a homogenous 47.XXY caryotype was considered a model of absolute male sterility. In this review, we will discuss the fertility issue following TEsticular Sperm Extraction-IntraCytoplasmic Sperm Injection (TESE-ICSI) and the potential advantage of searching for and cryopreserving spermatozoa in adolescent instead of adult patients. [Copyright &y& Elsevier]

Copyright of Medizinische Genetik is the property of De Gruyter and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Y chromosome microdeletions are met in about 10-15% of men with azoospermia or severe oligospermia. They can be easily identified through polymerases chain reaction (PCR). Three loci of spermatogenesis have been cartographiated and called "azoospermia factors" (AZFa, AZFb, AZFc). The deletions remarked in these zones remove one or more of the genes candidate (DAZ, RBMY, USP9Y and DBY) and produce severe testiculopathies which lead to infertility. [ABSTRACT FROM AUTHOR]

Copyright of Der Urologe A is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)