MALE INFERTILITY
Male infertilityBasuki B. PurnomoDepartment of UrologyMedical
School of Brawijaya UniversitySaiful Anwar General Hospital
Malang1eve^^InfertilityIs defined as the inability to conceive a
child after 1 year of unprotected sexual intecourse.Incidence: 15%
of coupleContribution to subfertility Female factors 50% Male
factors 20% Both male and female factors30% 2eve^^Anatomy of male
reproductive organs
3eve^^Physiology of ejaculationErectionEmisionEjaculation
4eve^^Physiology of ejaculation
5eve^^
6eve^^Etiology : pre testicularHypothalamic diseaseGonadotropic
deficiencyFertile eunuch syndrome Pituitary
diseaseHyperprolactinemiaPituitary insufficiencyExogenous or
endogenous hormone deficiencyEstrogensAndrogensGrowth hormone
deficiencyHypo-hyper thyroidism7eve^^Etiology :
testicularChromosomal causesKlinefelter syndromeXX male syndromeXYY
syndrome
GonadotoxinsRadiationDrugRenal failureLiver failureTestis
injuryTraumaTorsion CryptorchidismVaricocele
8eve^^Etiology : post testicularObstruction:Congenital
blockageAcquired blockageVasectomyHernia surgeryInfectionFunctional
blockageRetrograde ejaculationDisorders of sperm function or
motilityDisorders of coitusErectile dysfunctionsHypospadiasTime of
frequency9eve^^Vasectomy
10eve^^Evaluation Medical historyPhysical
examinationLaboratoriesSemen analysisHormonal assaysTesticular
biopsyImagingHead CT ScanSeminal vesiculography11eve^^Semen
analysis
morphologymotilityConcentration12eve^^Semen analysisVolume
semenTotal sperma (sperm concentration)
Motility Morfologi: bentuk normalAglutinasi
spermaPiospermi::
::::1,5-5 mL> 50 juta> 20 juta/mL> 50%>
60%--13eve^^Treatment Pre testicular?Testicular?Post
testicular?MedicalSurgicalAssisted reproductive techniqueDepend on
Etiology :Treatment options14eve^^Surgical Varicocele:
vasoligationObstruction of the vas: vaso-vasostomy,
vaso-epididimostomySperm alloplasticVerumontanum
resection15eve^^Vasectomy reversal (vaso-vasostomy)
16eve^^
