Editors Kamini A Rao DGO DORCP DCh FRCOG (UK), MCh (UK), FICOG, PGDMLE (Law)
Medical Director, Bangalore Assisted Conception Centre 6/7 Kumara Krupa Road High Grounds
Bengaluru, Karnataka, India
Ashok Agarwal PhD, HCLD (ABB)
Director, Andrology Laboratory and Reproductive Tissue Bank
Director, Center for Reproductive Medicine and ART Training
Professor, Cleveland Clinic Lerner College of Medicine Case Western Reserve University, Staff, Glickman Urological and Kidney Institute, Ob-Gyn and Wenen's Health Institute, Anatomic Pathology and Immunology, Cleveland Clinic 9500 Euclid Avenue Desk A 19.1
Cleveland, Ohio 44195, USA
MS Srinivas PhD
Scientific Director and Chief Embryologist Bangalore Assisted Conception Centre,
Bengaluru, Karnataka, India
Jitendar P Vij
Jaypee Brothers Medical Publishers (P) Ltd
Corporate Office
4838/24 Ansari Road, Daryaganj, New Delhi - 110002, India, Phone: +91-11-43574357, Fax: +91-11-43574314
Registered Office
B-3 EMCA House, 23/23B Ansari Road, Daryaganj, New Delhi - 110 002, India
Phones: +91-11-23272143, +91-11-23272703, +91-11-23282021
+91-11-23245672, Rel: +91-11-32558559, Fax: +91-11-23276490, +91-11-23245683
e-mail: jaypee@jaypeebrothers.com, Website: www.jaypeebrothers.com
Offices in India
- Ahmedabad, Phone: Rel: +91-79-32988717, e-mail: ahmedabad@jaypeebrothers.com
- Bengaluru, Phone: Rel: +91-80-32714073, e-mail: bangalore@jaypeebrothers.com
- Chennai, Phone: Rel: +91-44-32972089, e-mail: chennai@jaypeebrothers.com
- Hyderabad, Phone: Rel:+91-40-32940929, e-mail: hyderabad@jaypeebrothers.com
- Kochi, Phone: +91-484-2395740, e-mail: kochi@jaypeebrothers.com
- Kolkata, Phone: +91-33-22276415, e-mail: kolkata@jaypeebrothers.com
- Lucknow, Phone: +91-522-3040554, e-mail: lucknow@jaypeebrothers.com
- Mumbai, Phone: Rel: +91-22-32926896, e-mail: mumbai@jaypeebrothers.com
- Nagpur, Phone: Rel: +91-712-3245220, e-mail: nagpur@jaypeebrothers.com
Overseas Offices
- North America Office, USA, Ph: 001-636-6279734,
- Central America Office, Panama City, Panama, Ph: 001-507-317-0160,e-mail: cservice@jphmedical.comWebsite: www.jphmedical.com
- Europe Office, UK, Ph: +44 (0) 2031708910, e-mail: info@jpmedical.biz
Andrology Laboratory Manual
© 2010, Jaypee Brothers Medical Publishers (P) Ltd
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the editors and the publisher.
First Edition: 2010
9788184489019
Typeset at JPBMP typesetting unit
Printed at Ajanta Offset
5CONTRIBUTORS- Ahmed M Ragheb md, m sc
- Fellow in Male Infertility
- Glickman Urological and Kidney Institute, Cleveland Clinic
- 9500 Euclid Avenue, Cleveland, OH 44195, USA
- Alberto M Torres-Cantero md, mph, ph
- Professor
- Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Campus de Espinardo, Murcia, Spain
- Alex C Varghese
- Scientific Director and Chief
- Embryologist Fertility Clinic and IVF Division AMRI Medical Centre (A Unit of AMRI Hospitals) 97A, Southern Avenue, Kolkata, West Bengal, India
- Andrew Luu
- Center for Reproductive Medicine
- Cleveland Clinic 9500 Euclid Avenue, Desk A19.1 Cleveland, Ohio 44195 USA
- Ang Wen Jeat
- Melaka Manipal Medical College,
- Jalan Batu Hampar, Bukit Baru 75150, Melaka, Malaysia
- Anjali Chandra
- Research Fellow Cleveland Clinic 9500 Euclid Avenue, Desk A19.1 Cleveland, Ohio, 44195 USA
- Antonio Tavares md
- Director
- Rubinstein Urological Clinic Rubinstein Urological Clinic
- Estrada Pau Ferro 204 AP 101 BL 1 Jacarepagua, Rio De Janeiro, Brazil
- Ashok Agarwal phd hcld (abb)
- Director
- Andrology Laboratory and Reproductive Tissue Bank, Director, Center for Reproductive Medicine and ART Training, Professor, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University Staff, Glickman Urological and Kidney Institute, Ob-Gyn and Women's Health Institute, Anatomic Pathology and Immunology Cleveland Clinic 9500 Euclid Avenue, Desk A 19.1 Cleveland, Ohio, 44195 USA
- Ashok Bhattacharyya
- Department of Biochemistry, University of Calcutta, Kolkata, West Bengal, India
- Baidyanath Chakravarty
- Director
- Institute of Reproductive Medicine, Kolkata
- West Bengal, India
- Baiju PA
- Consultant
- Bangalore Assisted Conception Centre, 6/7, Kumara Krupa Road, High Grounds, Bengaluru, Karnataka, India
- Daniel R Franken
- Reproductive Biology Research Laboratory, Department of Obstetrics and Gynaecology, Tygerberg 7505, South Africa
- Edmund Sabanegh jr md
- Director
- Center for Male Fertility Glickman Urological and Kidney
- Institute Cleveland Clinic 9500 Euclid Avenue/Q100
- Cleveland, OH United States
- Eleonora Bedin Pasqualotto md, phd
- Professor of Gynecology
- University of Caxias do Sul, RS, Brazil, Chief Obstetrics and Gynecology department, General Hospital, University of Caxias do Sul, RS, Brazil Researcher II, Brazilian Counsel of Scientific and Technological Develop-ment (CNPq) Director Conception - Center for Human Reproduction Rua Pinheiro Machado, 2569, Sl 23/24, Bairro Sao Pelegrino, Caxias do Sul, RS, Brazil
- Fabio Firmbach Pasqualotto md, phd
- Professor of Urology
- University of Caxias do Sul, RS, Brazil, Professor of postgraudation, Institute of Biotechnology, University of Caxias do Sul, RS, Brazil, Researcher I, Brazilian Counsel of Scientific and Technological Development (CNPq) Director
- Conception – Center for Human Reproduction, Rua Pinheiro
- Machado, 2569, Sl 23/24, Bairro Sao Pelegrino, Caxias do Sul, RS Brazil
- Fnu Deepinder
- Department of Internal Medicine
- St Joseph's Hospital, Resurrection Health Care System,
- University of Illinois, USA
- Furquan Pathan
- Melaka Manipal Medical College,
- Jalan Batu Hampar, Bukit Baru 75150, Melaka, Malaysia
- Hans-Juergen Glander
- Department of Dermatology/Andrology Unit, European Academy of Andrology (EAA) Training Center, University of Leipzig, Ph.-Rosenthal-Str 23-25, Leipzig 04103, Germany
- Jaime Mendiola msc phd
- Research Fellow
- Division of Preventive Medicine and Public Health, School of Medicine, University of Murcia, Campus de Espinardo, Murcia, Spain
- James Savia
- Research Fellow,
- Cleveland Clinic 9500 Euclid Avenue-Q100 Cleveland, OH, United States
- John C Kefer md, phd
- Clinical Fellow, Center for Male Fertility Glickman Urological and Kidney Institute Cleveland Clinic 9500 Euclid Avenue/Q100, Cleve land, OH United States
- Kamini A Rao
- Medical Director
- Bangalore Assisted Conception Centre, 6/7, Kumara Krupa Road, High Grounds, Bengaluru, Karnataka, India
- Kelly S Athayde mt, ts (abb) ms
- Embryologist Incharge, Fertility Unlimited, Inc., Adjunct
- Instructor Ob-Gyn, Northeastern Ohio Univer-sities Colleges of Medicine and Pharmacy Neoucom, 468 E Market Street
- Akron, Ohio, USA
- Kerstin Poenicke
- Department of Andrology, University of Leipzig, Leipzig, Germany
- Luana Venturin Lara
- Biologist, Conception – Center for Human Reproduction, Rua Pinheiro Machado, 2569, Sl 23/24, Bairro Sao Pelegrino, Caxias do Sul, RS Brazil
- Meena Chimote
- Medical Director
- Vasundara Clinic and Assisted Conception Centre, Nagpur, India
- Monis Bilal Shamsi msc
- Sundararajan Venkatesh M Pharm Lab for Molecular Reproduction and Genetics, Anatomy Department, AIIMS, New Delhi, India
- MS Srinivas phd
- Scientific Director and Chief
- Embryologist, Bangalore Assisted Conception Centre, Bengaluru, Karnataka, India
- Natachandra Chimote
- Scientific Director
- Vasundara Clinic and Assisted Conception Centre, Nagpur, India
- Parag Nandi
- Research Fellow
- Department of Environmental Sciences, University of Calcutta, Kolkata, West Bengal, India
- Philip Kumanov
- Clinical Center of Endocrinology and Gerontology Medical
- University Sofia 6 Damian Gruev Str. 1303 Sofia, Bulgaria
- Rakesh Sharma
- Center for Reproductive Medicine
- Cleveland Clinic 9500 Euclid Avenue, Desk A19.1 Cleveland, Ohio 44195 USA
- Reda Mahfouz
- Center for Reproductive Medicine
- Cleveland Clinic 9500 Euclid Avenue, Desk A19.1 Cleveland, Ohio 44195 USA
- Rima Dada md, phd (genetics)
- Associate Professor
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
- Rupin Shah
- Consultant
- Andrology and Microsurgeon, Lilavathi Hospital and Research Centre, Mumbai Maharashtra, India
- Sathish Adiga
- Associate Professor
- Department of Obstetrics and Gynecology Division of Reproductive Medicine Department of Obstetrics and Gynecology
- Kasturba Medical College, Manipal, India
- Shukla Kundu
- Research fellow
- Department of Biochemistry, University of Calcutta, Kolkata, West Bengal, India
- Sonja Grunewald
- Physician
- University of Leipzig Department of Dermatology, Venerology and Allergology European Training Center of Andrology
- Philipp-Rosenthal-Strasse 23-25 04103 Leipzig, Germany
- Sundararajan Venkatesh
- Lab for Molecular Reproduction and Genetics Anatomy Department, AIIMS
- New Delhi, India
- Uwe Paasch
- Andrologist (EAA) Senior Physician
- University of Leipzig
- Department of Dermatology, Venerology and Allergology,
- European Training Center of Andrology
- Division of Dermato-pathology
- Division of Aesthetics and Laserdermatology
- Philipp-Rosenthal-Strasse 23-2504103
- Leipzig, Germany
- Vasan SS
- Director
- Manipal Andrology and Reproductive Services (MARS)
- Director
- Ankur - (Centre for Men's Health, Fertility and Reproductive Health, Neurourology and Continence)
- Head
- NU Hospitals Centre for Male Reproduction and Erectile dysfunction
- Vijay Mangoli
- Fertility Clinic and IVF Centre, Kwality House, Mumbai, Maharashtra, India
- Vineet Malhotra
- Assistant Urologist and Research Fellow Lilavathi Hospital and Research Centre, Mumbai Maharashtra, India
It gives me great pleasure to write the foreword to this book Andrology Laboratory Manual. Its aim is to provide detailed information for the interdisciplinary team of specialists from the clinical members: gynecologists, endocrinologists and urologists to the clinical scientists and embryologists. It encompasses both the latest laboratory techniques and clinical treatments. Our fundamental knowledge is rejuvenated with a concise overview of spermatogenesis, sperm maturation and the genetics of male infertility. Our understanding of the complexity and vulnerability of these processes is enhanced by up-to-date information of the latest advances in male infertility evaluation. Chapters for clinicians include novel information on endocrine disorders, compromising lifestyle factors, sexual dysfunction and surgical sperm retrieval techniques. Chapters for scientists focus on laboratory skills in sperm preparation, protection from infection and cryopreservation. Its format makes it useful as an introductory text and also as an everyday reference resource for those working in the field of Clinical Andrology. I recommend it as a useful, accessible book for every fertility center.
Sheena EM Lewis
Professor of Reproductive Medicine
Centre for Public Health
Queen's University of Belfast
Institute of Clinical Science
Northern Ireland, UK
11PREFACEToday one can find a good number of books written on infertility, but very few which are devoted solely to male infertility and its investigations and management. Most of the books on andrology concentrate on the scientific and some specific aspects of clinical andrology without much attention to male infertility.
Application of Assisted Reproductive Technologies (ART) in dealing with male infertility is in the hands of gynecologists, physicians, urologists and embryologists. This book is an excellent reference for beginners and also for those who are practicing reproductive medicine to update their knowledge in the field of male infertility investigation and management. More importantly, the book elaborates the laboratory aspects in detail, providing reliable information to clinicians to decide the course of therapy to deal with male infertility effectively.
The Andrology Laboratory Manual covers a wide variety of topics including basic sperm biology, male reproductive endocrinology, physiology of sperm maturation and fertilization, genetics issues of male infertility, cryopreservation, surgical sperm retrieval, sexual dysfunction and the effect of environmental factors on semen parameters. Contributions from renowned national and international experts in the field have ensured a standard of excellence comparable to the best in the field.
This volume will serve as a textbook for newcomers to andrology while also providing the experienced physician with a valuable reference manual. It will appeal to all concerned with male reproductive health—andrologists, urologists, embryologists, endocrinologists, gynecologists, as well as basic scientists. The end aim of the book is to help in optimizing results and generate ART treatment of high quality and we hope that it works towards this end.
Kamini A Rao
Ashok Agarwal
MS Srinivas
13ACKNOWLEDGMENTSThe editors would like to thank all those involved with the writing and publication of this book. The authors of various chapters who have taken time out from their busy schedules to contribute generously, we thank them for their excellent and well-researched articles. A special thanks goes out to Dr Alex for his excellent contributions as well as his unstinting efforts and involvement in every stage of bringing out this book.