İnfertil Çiftin Değerlendirilmesi
Özet
İnfertilite dünya genelinde üreme çağındaki çiftlerin %8 ila 12'sinin etkilendiği önemli bir sağlık sorunudur. İnfertilitenin yaklaşık olarak %50 nedeni ise erkek faktör kaynaklı görülmektedir. Erkek infertilite nedenleri arasında; sistemik hastalıklar, endokrinolojik nedenler, çeşitli maligniteler, genetik hastalıklar görülebilmektedir. İnfertil erkeklerin %30 unda ise herhangi bir neden bulunmaksızın infertilite görülebilmektedir ve idiyopatik erkek infertilitesi olarak adlandırılmaktadır. Diğer yandan infertiliteye; ovulasyon bozuklukları, tubal patolojiler, endometriozis, yaş vb. gibi kadın faktörler de neden olabilmektedir. Bu nedenlerle infertilitenin değerlendirilmesinde kadın ve erkek partner ayrı ayrı değerlendirilmelidir. Bu bölümde infertilitenin değerlendirilmesinde dikkat edilmesi gereken hususlardan bahsedilmiştir.
Infertility is an important health problem affecting 8 to 12% of couples of reproductive age worldwide. Approximately 50% of infertility is caused by male factors. Among the causes of male infertility; Systemic diseases, endocrinological causes, various malignancies and genetic diseases can be seen. Infertility can be seen in 30% of infertile men without any cause and is called idiopathic male infertility. On the other hand, infertility may also be caused by female factors such as: ovulation disorders, tubal pathologies, endometriosis, age, etc. For these reasons, the male and female partners should be evaluated separately in the evaluation of infertility. In this section, the points that should be taken into consideration in the evaluation of infertility are mentioned.
Referanslar
Niederberger CS, Ohlander SJ, Pagani RL. Male Infertility. In: Partin AW, Dmochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh Urology. Vol 2. 12th ed. Philadelphia, Elsevier; 2020, pp 6588-6880.
Recent advances in medically assisted conception: report of a WHO scientific group. World Health Organ Tech Rep Ser. 1992;820(820):1–111. [PubMed: 1642014]
Recent advances in medically assisted conception: report of a WHO scientific group. World Health Organ Tech Rep Ser. 1992;820(820):1–111. [PubMed: 1642014]
Ozkan S, Murk W, Arici A. Endometriosis and infertility: epidemiology and evidence-based treatments. Ann N Y Acad Sci. 2008;1127:92–100. doi:10.1196/annals.1434.007 [PubMed: 18443335]
Fainberg J, Kashanian JA. Recent advances in understanding and managing male infertility. F1000Res. 2019 May 16;8:F1000 Faculty Rev-670. doi: 10.12688/f1000research.17076.1. PMID: 31143441; PMCID: PMC6524745.
Agarwal A, Deepinder F, Cocuzza M, et al. Effect of vaginal lubricants on sperm motility and chromatin integrity: a prospective comparative study. Fertil Steril 2008;89:375-379.
Rao PK, Sabanegh ES. Genitourinary sarcoidosis, Rev Urol 2009;11:108-113.
Kanakis GA, Nieschlag E. Klinefelter syndrome: more than hypogonadism. Metabolism. 2018 Sep;86:135-144. doi: 10.1016/j.metabol.2017.09.017. Epub 2018 Jan 31. PMID: 29382506.
Sharma A, Minhas S, Dhillo WS, et al. Male infertility due to testicular disorders. J Clin Endocrinol Metab. 2021 Jan 23;106(2):e442-e459. doi: 10.1210/clinem/dgaa781. PMID: 33295608; PMCID: PMC7823320.
Agarwal A, Deepinder F, Cocuzza M, et al. Efficacy of varicocelectomy in improving semen parameters: new meta-analytical approach. Urology 2007;70:532-538.
Wang C, Mbizvo M, Festin MP, Björndahl L, et al.; other Editorial Board Members of the WHO Laboratory Manual for the Examination and Processing of Human Semen. Evolution of the WHO "Semen" processing manual from the first (1980) to the sixth edition (2021). Fertil Steril. 2022 Feb;117(2):237-245. doi: 10.1016/j.fertnstert.2021.11.037. Epub 2022 Jan 5. PMID: 34996596; PMCID: PMC8842884.
Sussman EM, Chudnovsky A, Niederberger CS. Hormonal evaluation of the infertile male: has it evolved? Urol Clin North Am. 2008 May;35(2):147-55, vii. doi: 10.1016/j.ucl.2008.01.010. PMID: 18423236.
Turek PJ, Male Infertility. In: Strauss JF, Barbieri RL. Yen &Jaffe's Reproductive Endocrinology E-Book:Physiology, Pathophysiology, and Clinical Management. 7th ed. Elsevier Health Sciences, 2013. pp 538-550.
Barratt CLR, Björndahl L, De Jonge CJ, et al. Erkek kısırlığının tanısı: Küresel DSÖ rehberliğinin zorluklarının ve gelecekteki araştırma fırsatlarının geliştirilmesini destekleyen kanıtların analizi. Hum Reprod Güncellemesi 2017; 23:660.
Bonomi M, Rochira V, Pasquali D, et al. ; Klinefelter ItaliaN Group (KING). Klinefelter syndrome (KS): genetics, clinical phenotype and hypogonadism. J Endocrinol Invest. 2017 Feb;40(2):123-134. doi: 10.1007/s40618-016-0541-6. Epub 2016 Sep 19. PMID: 27644703; PMCID: PMC5269463.
Denschlag D, Tempfer C, Kunze M, et al. Assisted reproductive techniques in patients with Klinefelter syndrome: a critical review. Fertil Steril. 2004 Oct;82: 775-9
Oates RD. The genetic basis of male reproductive failure. Urol Clin North Am 2008;35:257-270.
Mittal PK, Little B, Harri PA, Miller FH, et al. Role of Imaging in the Evaluation of Male Infertility. Radiographics. 2017 May-Jun;37(3):837-854. doi: 10.1148/rg.2017160125. Epub 2017 Apr 14. PMID: 28410062.
Smith DA, Webb LG, Fennell Al, et al. Early evidence kits in sexual assault: an observational study of spermatozoa detection in urine and other forensic specimens. Forensic Sei Med Pathol 2014;10:336-
Zini A, Libman J. Sperm DNA damage: importance in the era of assisted reproduction. Curr Opin Urol. 2006;16(6):428–34.