eMedicine Specialties > Urology > Male Infertility
Infertility, Male: Multimedia
Updated: Mar 26, 2008
Multimedia
 | Media file 1: Male infertility. Hypothalamic-pituitary-gonadal axis stimulatory and inhibitory signals. Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates the release of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) from the pituitary. FSH stimulates the Sertoli cells to facilitate sperm production, while LH stimulates testosterone release from the Leydig cells. Feedback inhibition is from testosterone and inhibin. |
 | Media file 2: Male infertility. Testicular histology magnified 500 times. Leydig cells reside in the interstitium. Spermatogonia and Sertoli cells lie on the basement membrane of the seminiferous tubules. Germ cells interdigitate with the Sertoli cells and undergo ordered maturation, migrating toward the lumen as they mature. |
 | Media file 3: Male infertility. Normal male ductal anatomy. |
 | Media file 4: Male infertility. Varicocele. A - Physical examination revealing the characteristic "bag of worms." B - Anatomy of the dilated pampiniform plexus of veins. |
 | Media file 5: Male infertility. Technique of open vasography: The vas distal to the site of incision is determined to be patent if saline is injected without resistance. Alternatively, radiographic contrast dye is injected through the vas deferens and radiography is performed, or blue dye may be injected and visualized in the urine to confirm patency. A vasovasostomy or vasoepididymostomy may then be performed at this level. |
 | Media file 6: Male infertility. Technique of microscopic varicocelectomy. The individual veins of the pampiniform plexus are isolated (top) and ligated, taking care to preserve the testicular artery (bottom) isolated using the intraoperative Doppler. |
 | Media file 7: Male infertility. Technique of vasovasostomy: Upper left is confirmation of sperm from the proximal vas deferens, proving proximal patency. Upper right is the inner layer anastomosis using interrupted #10-0 Prolene. Lower left is the inner layer anastomosis completed. Lower right is the outer layer anastomosis using #9-0 Prolene completed. |
 | Media file 8: Male infertility. Technique of vasoepididymostomy. Left upper is confirmation of mature sperm in epididymis. Right upper is the inner layer anastomosis of the end of the vas to the side of the epididymal tubule using interrupted #10-0 Prolene. Left lower is the inner layer completed. Right lower is the outer layer anastomosis using interrupted #9-0 Prolene completed. |
 | Media file 9: Male infertility. Technique of intracytoplasmic sperm injection (ICSI). A micropipette is used to inject a single sperm directly into an egg. |
More on Infertility, Male |
| Overview: Infertility, Male |
| Differential Diagnoses & Workup: Infertility, Male |
| Treatment & Medication: Infertility, Male |
| Follow-up: Infertility, Male |
 Multimedia: Infertility, Male |
| References |
| Further Reading |
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Keywords
male infertility, infertility, difficulty conceiving, sperm formation, ejaculate volume, sperm concentration, oligospermia, too few sperm, low sperm count, azoospermia, sperm transportation, no sperm in the ejaculate, sperm motility, sperm morphology, gonad, testis, testes, testicles, fertilization, impotence, semen analysis, spermatogenesis, cryptorchidism, diethylstilbestrol, DES, testicular torsion, retrograde ejaculation, in vitro fertilization, IVF, intracytoplasmic sperm injection, ICSI, testicular cancer, hypogonadotropism, testicular atrophy, cystic fibrosis, hypogonadism, anejaculation, electroejaculation, sperm retrieval, orchitis, varicocele, pretesticular infertility, testicular infertility, posttesticular infertility, primary infertility, secondary infertility, idiopathic hypogonadotropic hypogonadism, prolactinoma, Klinefelter syndrome, assisted reproduction, hypospermatogenesis, Sertoli-cell-only syndrome, germinal cell aplasia, varicocelectomy, testicular biopsy, vasovasostomy,vasoepididymostomy, transurethral resection of the ejaculatory ducts, TURED, artificial insemination
