Table Of ContentAndrology-Prelims.qxd 3/16/2005 10:48 AM Page i
Atlas of
Clinical Andrology
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Dedication
This Atlas is dedicated to all scientists conducting physiological and clinical
research leading to assisted conception and improved quality of life.
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Atlas of
Clinical Andrology
by
ESE Hafez and SD Hafez
Co-Directors, Reproductive Health Center
Kiawah Island, South Carolina, USA
CRC Press
Taylor & Francis Group
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Boca Raton, FL 33487-2742
© 2005 by Taylor & Francis Group, LLC
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Version Date: 20130415
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Contents
Acknowledgements vii
Preface ix
Introduction xi
SECTION I REPRODUCTIVE PHYSIOLOGY
1 Endocrinology of reproduction in men 3
2 Functional ultrastructure of testis and epididymis 15
3 Semen and the functional anatomy of sperm 29
4 Capacitation,acrosome reaction and fertilization 45
SECTION II REPRODUCTIVE PATHOLOGY
5 Testicular dysfunction and male infertility 61
6 Semen,sperm anomalies and infertility 81
7 Erectile dysfunction 99
8 Ejaculatory anomalies 109
SECTION III REPRODUCTIVE ANOMALIES
9 Immunological andrology 117
10 Andropause and osteoporosis 127
11 Prostate pathophysiology 135
12 Cardiovascular anomalies,infections and infectious diseases 147
SECTION IV ASSISTED REPRODUCTIVE TECHNOLOGY
13 Genetic andrology and genetic engineering 165
14 Molecular reproduction in men 181
15 Sperm processing 187
16 Micromanipulation and assisted conception 205
References 219
Index 227
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Acknowledgements
The authors are extremely grateful to Betty Hafez, Ms Dinah Alam for their sound advice and hard
executive editor of the international journal Archives work.We are greatly indebted to friends and col-
of Andrology,for her editorial skill and the very hard leagues who made the writing of this Atlas such a
work needed to coordinate all the activities related satisfying experience.
to review and proofread the manuscripts before Sincere thanks are due to the American Society of
publication.She was also responsible for summariz- Andrology,the Society for the Study of Reproduction
ing the tables in an easily readable form and for and the American Society of Andrology for giving
giving full descriptions to the captions of the figures. permission to use illustrations from their journals.
Without her efforts there would be no Atlas. In Dr Jane M. Morrell, R&D Manager of Nidacon AB
particular we thank Ms Cindy Lloyd of Yorktown International,of Göteborg,Sweden was kind enough
Street, James Island, SC for her elegant secretarial to provide us with original illustrations of the various
and clerical help.We are indebted to several academ- procedures used in the purification of semen sam-
ics who have allowed us to include their valuable ples,and,for freezing and thawing of human sperm,
illustrations and research results in the Atlas,particu- CryoProtec®. Finally, we would also like to thank
larly Professor Carl Pinkert (University of Alabama, those who answered our questions on the phone,via
Birmingham,Alabama,USA).We thank the staff of e-mail or in personal conversation.
the publishers Taylor & Francis Medical Books for
giving generously of their intellect and expertise.We ESE Hafez and SD Hafez
acknowledge especially Mr Nicholas J. Dunton and January 2005
vii
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Preface
Andrology,the science of the physiology,pathology The chapters of this Atlas are multidisciplinary in
and microbiology of male reproduction,is a field not nature, and in their range and depth they reflect
well established in medicine,in science or in the pub- our intention to bridge the gap between basic and
lic consciousness.Unlike gynecology,the science of clinical science.There are chapters devoted to lab-
andrology is a young discipline and is currently gener- oratory techniques,and morphological,anatomical,
ating some amazing new insights, as well as many biochemical,immunological,hereditary and microbi-
new puzzling questions.Only in the past 20–25 years ological parameters and their clinical application.
have researchers begun to specialize in andrology. Emphasis is placed on specific aspects as related to
Remarkable advances have been accomplished in health and disease in men,e.g.hereditary aspects of
assisted reproductive technology:in vitrofertilization prostate diseases, erectile dysfunction and unex-
micromanipulation of reproductive products,intracy- plained infertility.
toplasmic insemination, intrauterine insemination The Atlas covers three main areas in biomedical
and in vitro manipulation of semen. sciences:reproductive physiology,reproductive dys-
A few groups of enthusiastic researchers have function and modern assisted reproductive technol-
devoted special attention to human andrology, and ogy.Emphasis is placed on endocrine mechanisms of
rapid development is anticipated owing to the appli- the testes,spermatogenesis,sperm maturation,motil-
cation of modern technology,which has advanced so ity and transport in the male/female reproductive
spectacularly in recent years. tract, capacitation and fertilization.The functional
This Atlas includes the most recent research ultrastructure of spermatozoa is presented,as shown
findings in male endocrinology, neuroendocrinol- by transmission electron microscopy,scanning elec-
ogy, growth factors, sperm quality/fertility, male tron microscopy and atomic force microscopy.
immunology and molecular andrology. Recent
advances in molecular genetics have a significant ESE Hafez and SD Hafez
impact on the precision of assessing the psychopatho- Reproductive Health Center
logical processes of spermatogenesis,Sertoli cells,sem- Kiawah Island,
inal plasma, sperm capacitation and fertilization. South Carolina,USA
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Description:Andrology, the science of the physiology, pathology and molecular biology of male reproduction, is a relatively new specialty that has become increasingly important with the advent of modern assisted reproductive techniques (ART). The Atlas of Clinical Andrology describes both normal and abnormal re
