Male Sterility and Motility Disorders

This conference, dedicated to the etiology and treatment of motility disor­ ders in spermatozoa and male sterility, attracted some of the finest investiga­ tors in the field. Standards were immensely high throughout, and discussions were meaningful and detailed. Analyses on disorders in sperm motility de­ mand a broad-based approach, involving cytologists, geneticists, andrologists, and embryologists, because the topic has many clinical and scientific over­ tones. Human spermatozoa are at the mercy of so many factors as they form and mature in the testis and epididymis. Their survival and fundamental char­ acteristics are essential for fertilization, and the male genome imposes its influence on the embryo as it becomes active in male pronuclei very soon after sperm entry into the oocyte. All of these fundamental aspects of sperm biology demanded a broad breadth of topics in the symposium. The opening session quickly got down to fundamentals with contributions from J.-L. Gatti, J.G. Alvarez, C. Gagnon, and H. Breitbart. They discussed the mechanism and regulation of motility, the metabolic strategy of human spermatozoa, the effects of exogenous fac­ tors such as antibodies, infections, and toxins, and finally the role of intracel­ lular calcium on sperm motility. To these topics, the postcoffee session on the first morning described the genetics of motility disorders and the etiology and management of necrozoospermia. The excellent presentation provided the background detail of the symposium and opened the way for the discus­ sion of various clinical aspects of the topic.

Contenu

I. The Immotile Sperm: Etiology.- 1. Motility Update.- 2. Metabolic Strategy in Human Spermatozoa: Its Impact on Sperm Motility.- 3. Extrinsic Factors Affecting Sperm Motility: Immunological and Infectious Factors and Reactive Oxygen Species.- 4. Intracellular Calcium and Sperm Motility.- 5. Genetic Aspects of Sperm Motility Disorders.- 6. Necrospermia: Etiology and Management.- II. Therapeutic Possibilities for Motility Disorders.- 7. In Vivo Therapies for Asthenozoospermia.- 8. In Vitro Therapy for Sperm Motility: Specific and Nonspecific Treatments.- III. ICSI Option for Immotile Sperm.- 9. Injection Procedures of Immotile Sperm: Selection, Tail Breakage, and Viscous Solutions.- 10. Fertilizing Capability of Frozen-Thawed Immotile Sperm.- 11. Clinical Aspects of ICSI with Immotile Sperm.- 12. Intracytoplasmic Sperm Injection in Difficult Cases: The Egyptian Experience.- 13. Difficult Cases in ICSI (Male Factors).- 14. ICSI in Difficult Cases: Total Absence of Both Motile and Normal Spermatozoa.- 15. Difficult ICSI Cases: An Israeli Survey.- IV. Testicular Sperm: Physiological to Pathological Aspects.- 16. Growth Factors in Testis Development and Function.- 17. Microinsemination Using Spermatogenic Cells in Mammals.- 18. Cell Loss During Spermatogenesis: Apoptosis or Necrosis?.- 19. Regulation of Apoptosis in the Testis.- V. Testicular Sperm Retrieval.- 20. Thermic and Metabolic Microsensors for Testicular Sperm Extraction (TESE) Before ICSI.- 21. ICSI with Epididymal and Testicular Sperm Retrieval.- 22. Pathophysiologic Changes after Testicular Sperm Extraction: Patterns and Avoidance of Testicular Injury.- 23. Cytological Evaluation of Germinal Populations as Part of a Testicular Sperm Retrieval Strategy.- VI. Conceptus Quality in ICSI with Testicular Sperm and Ethical Problems of ART.- 24. Genetic Aspects of Male Sterility.- 25. Conceptus Quality from ICSI with Testicular Sperm.- 26. Genetic Problems and Congenital Malformations in 1987 ICSI Children.- 27. Ethical Dilemmas in Assisted Reproduction.- Author Index.