Male%20infertility Signs and Symptoms

Signs and Symptoms

Introduction

Male infertility as the sole cause accounts for 20%, & 30-40% as a contributory factor to infertility in couples

Definition

Infertility is the inability to conceive despite regular unprotected sexual intercourse for 1 year

Etiology

Hypothalamic pituitary disease (eg craniopharyngioma, Kallman syndrome, hyperprolactinemia, nutritional deficiencies, infiltrative disorders)
Primary testicular disease (eg Klinefelter’s syndrome, cryptorchidism, myotonic dystrophy, orchitis, testicular torsion)
Disorders of sperm production & transport
- Varicocele (most common known cause of male infertility)
- Cryptorchidism
- Obstructive azoospermia caused by abnormalities in the vas deferens, seminal vesicles, prostate, ejaculatory ducts
- Sexual dysfunction: premature ejaculation, erectile dysfunction, ejaculatory dysfunction secondary to spinal cord disease or autonomic dysfunction
- Germ cell malignancy & testicular microcalcification
Genetic disorders
- Cystic fibrosis
- Karyotypic chromosomal abnormalities
- Y-chromosome microdeletions
Idiopathic infertility - accounts for 30-40% of cases
- Cause of infertility is unclear, even w/ normal semen analysis & normal partner evaluation
Infections
Immune system disorders
Iatrogenic causes (post-chemotherapy, post-surgery)
Chronic illness [eg diabetes mellitus (DM), myocardial infarction, liver infection, chronic renal failure, rheumatoid arthritis, hepatic cirrhosis, bronchiectasis, sinusitis, dextrocardia]

Optimizing metastatic hormone-sensitive prostate cancer treatment in advanced prostate cancer

Assoc Prof. Darren Poon, Assoc Prof. Edmund Chiong, 14 Jan 2021

Metastatic hormone-sensitive prostate cancer (mHSPC) refers to the condition whereby patients have metastatic prostate cancer and no prior hormonal therapy or androgen deprivation therapy (ADT). Typically, patients with mHSPC have been treated with ADT alone, following which, the overwhelming majority develop castration resistance over time and head towards eventual mortality. In recent years, the publication of various landmark trials has prompted dramatic changes in the mHSPC treatment landscape, and had favourably impacted overall survival (OS) in these patients. At a recent webinar, A/Prof Darren Poon, Honorary Consultant in Clinical Oncology, Hong Kong Sanatorium & Hospital, and Honorary Clinical Associate Professor, Department of Clinical Oncology, The Chinese University of Hong Kong, reviewed treatment options in mHSPC, while A/Prof Edmund Chiong, Head and Senior Consultant, Department of Urology, National University Hospital, Singapore, presented a case which was discussed by an esteemed panel of experts. This webinar was jointly organized by the Singapore Society of Oncology and the Singapore Urological Association, and supported by Astellas.