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Expenence with 3,520 Infertile Male Patients and A Clinical Perspective : 남성불임증 3,520례의 치험과 임상적 전망

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Authors

Lee, Hee Yong

Issue Date
1986-03
Publisher
Seoul National University College of Medicine
Citation
Seoul J Med, Vol.27 No.1, pp. 1-18
Keywords
Male infertilityCausative factorsEvaluation parametersSpermatogenesisSpermiogrammeResults of treatments
Abstract
The author's experience with a total of 3,520 infertile male patients during the
period from 1955 to 1984 were reviewed based on the pathophysiology, etiology, evaluation
and management. These infertile males corresponded to 4.2% of total male outpatients of the
Department. Duration of barren marital life was 4.5 years. Completion of spermatogenesis
from spermatogonium to spermatozoon requires 74±5 days. Causes of male infertility were
faulty sperm production in 33%, faulty sperm transportation in 35%, faulty semen composition
in 7%, faulty ejaculation in 3%, and idiopathic cause which is an eponym for ignorance in
22%. Normal testicular size of Korean males is 19m!. A man with a testicular size of 10 ml or
less should be suspected as suffering from faulty spermatogenesis. Normal spermiogramme of
our series reveals that volume is 2.6 ml; counts, 120 X 106/ml; motility, 60%; viability, 64%;
activity grade, 3; motility index, 180; and morphology, 80%. Medical treatment was attempted
to 723 subfertile males using 12 different pharmacological compounds for average of 6
months (2 treatment courses). Semen parameters improved in 28% and pregnancy resulted in
14% after the pharmacotherapy. Surgical therapy was applied to 1,119 patients. In vasovasostomy
group (699 patients), anatomical success rates were 90% and functional success rates,
51% by microsurgical anastomosis technique. In epididymovasostomy group (281 patients),
patency rates were 37% and pregnancy rates, 20% by microsurgery. In varicocelectomy
group, spermiogramme improved in 30% and pregnancy occurred in 20% of the patients who
had the varicocelectomy. However, 33% of the patients with varicocele who did not have
varicocelectomy could impregnate their wives. The author is quite confident that the urologist
who is skilled in andrology can provide better and more rational care for these infertile males.
ISSN
0582-6802
Language
English
URI
https://hdl.handle.net/10371/5491
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