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1、AsianJournalofAndrology(2012)14,103–108ß2012AJA,SIMM&SJTU.Allrightsreserved1008-682X/12$32.00www.nature.com/ajaREVIEWMalefactorinfertilityandARTHermanTournayeForyears,themanagementandtreatmentofmalefactorinfertilityhasbeen‘experience’andnot‘evidence’bas
2、ed.Althoughnotevidence-based,currentclinicalpracticeinvolvesextensiveuseofassistedreproductivetechniques(ART).Wherespecifictreatmentsarenotindicatedorhavefailed,ARThavebecomepopularadjunctivetreatmentsforalleviatingmalefactorinfertility.Accordingtotheli
3、mitedevidenceavailable,intrauterineinsemination(IUI)maybeconsideredasafirst-linetreatmentinacoupleinwhichthefemalepartnerhasa6normalfertilitystatusandatleast1310progressivelymotilespermatozoaarerecoveredafterspermpreparation.Ifnopregnancyis6achievedafte
4、r3–6cyclesofIUI,optimizedinvitrofertilization(IVF)canbeproposed.Whenlessthan0.5310progressivelymotilespermatozoaareobtainedafterseminalfluidprocessingorspermarerecoveredsurgicallyfromthetestisorepididymis,intracytoplasmicsperminjection(ICSI)shouldbeperf
5、ormed.AlthoughtheoutcomeofnootherARThaseverbeenscrutinizedasmuchbefore,nolarge-scale‘macroproblems’haveasyetbeenobservedafterICSI.Yet,ICSIcandidatesshouldberigorouslyscreenedbeforeembarkingonIVForICSI,andthoroughlyinformedofthelimitationsofourknowledgeo
6、nthehereditaryaspectsofmaleinfertilityandthesafetyaspectsofART.AsianJournalofAndrology(2012)14,103–108;doi:10.1038/aja.2011.65;publishedonline19December2011Keywords:artificial;intracytoplasmicsperminjection;insemination;invitrofertilization;maleinfertil
7、ity;spermINTRODUCTIONofwhichARTisemployedtocircumventmalefactorinfertilityisIncontrasttowomen,onlyalimitednumberofmenwithprimarymadeaccordingtospermparameters,i.e.,totalmotilecount(TMC)malefactorinfertilityhavepotentiallytreatableconditions.Moreover,eit
8、herbeforeorafterspermpreparation.TMCisthetotalnumberofmeta-analysesshowthatcurrentempiricalmedicaltreatmentsforspermatozoaintheejaculateorpreparedsample(volume3concen-1,2unexplainedmaleinfertilityarenotbeneficial.However,assisted
