Infertility: A Clinician’s Guide to Diagnosis and Treatment by Melvin L. Taymor

By Melvin L. Taymor

A little over 12 years in the past I wrote a small quantity entitled Infertility. It appeared to me at the moment that major advances within the box referred to as for the e-book of one of these quantity. the next is from the preface to that quantity: up to now 15 years huge development has been made within the box of infertility analysis and administration. it really is might be a paradox that a lot of this elevated wisdom has turn up as a result of Western medicine's preoccupation with the quest for a method to regulate copy. for that reason, we have now accomplished new insights into the physiologic mechanisms interested by copy, and we have now came upon larger tools for measuring physiologic alterations in reproductive wellbeing and fitness and illness. to those advances should be extra advancements within the usage of endoscopic and surgical options, within the prognosis and remedy of infections and endometriosis, and within the therapy of hormonal problems. in this interval, too, via workshops and meetings and in journals and texts, those most modern advances were made on hand to physi­ cians, a superb instance being the 2 volumes of growth in Infer­ tility, edited via Drs. Jan Behrman and Robert Kistner. As worthwhile as those guides are, they don't supply an total view of infertility diag­ nosis and management.

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Past History The male's history should be reviewed to learn both routine childhood diseases and severe atypical ones. A sustained chronic illness or dietary deficiency during the critical time of childhood or puberty may have adversely affected testicular development. Routine childhood diseases may have been associated with severe febrile episodes. The presence of mumps orchitis should be investigated. Was growth and development normal? Is there anything to suggest a childhood endocrine disorder that would affect development?

South Med J 63:34,1970 27. Kursch ED: What is the incidence of varicocele in a fertile population. Ferti! Steril48:5lO, 1987 28. Bibbo M, Gill WB, Azizi F, et al: Follow-up study of male and female offspring of DESexposed mothers. Obstet Gynecol49:1, 1977 29. Albert PS, Salerno RG, Kapoor SN, et al: The nitrofurans as sperm-immobilizing agents, their tissue toxicity and their clinical application in vasectomy. Fertil Steril 26:485, 1975 30. Makler A, Urbach Y, Lefler E, Merxbach I: Factors affecting sperm motility: VI.

The heart, lungs, and abdomen are routinely examined to rule out problems in these areas. The inguinal areas are examined. The testes are palpated for size, consistency, and the presence or 50 III. The Basic Workup absence of tumors, hydrocele, and spermatocele. The vas deferens is palpated on either side. The presence of a varicocele is determined; a Valsalva maneuver may often make a small varicocele more apparent. Finally, the prostate gland is palpated. If boggy or tender, a gentle massage is carried out to produce fluid for microscopic examination.

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