[Cytological, etiological and prognostic aspects of male infertility. Attempt at classification apropos of 1,303 cases].
Study of 1303 cases of male sub-fertility led to a certain number of practical conclusions: - From a diagnostic viewpoint, the "fertility" of an individual, which is difficult to assess, depends more on the motility than the number of spermatozoa. This is most faithfully reflected in the crossed penetration test which defines the quality of penetration of a control mucus. The value of electron microscopic cytological study in the case of total asthenospermia or major monomorphous teratospermia, reflecting an irreversible constitutional abnormality of the ultrastructure of the spermatozoon, is emphasised. - From a therapeutic viewpoint, recent progress has involved the technique of surgical treatment for varicocoele as well as hormone therapy. It is essential not to neglect empirical "minor aids" indicated in the case of unexplained abnormalities (homologous artifical insemination in the case of abnormalities in the volume of the ejaculate, retard androgen therapy in the case of polyzoospermia). - From a prognostic viewpoint. The distinction must be drawn between aetiologies of good prognosis (80% of our success) responsible for transient abnormalities in spermatogenesis (infections, metabolic disturbances, varicocoele) and aetiologies with an unfavourable prognosis since they cause tubulopathies of greater or lesser severity with a lesional impairment of spermatogenesis.
[Cytological, etiological and prognostic aspects of male infertility. Attempt at classification apropos of 1,303 cases]. Study of 1303 cases of male sub-fertility led to a certain number of practical conclusions: - From a diagnostic viewpoint, the "fertility" of an individual, which is difficult to assess, depends more on the motility than the number of spermatozoa. This is most faithfully reflected in the crossed penetration test which defines the quality of penetration of a control mucus. The value of electron microscopic cytological study in the case of total asthenospermia or major monomorphous teratospermia, reflecting an irreversible constitutional abnormality of the ultrastructure of the spermatozoon, is emphasised. - From a therapeutic viewpoint, recent progress has involved the technique of surgical treatment for varicocoele as well as hormone therapy. It is essential not to neglect empirical "minor aids" indicated in the case of unexplained abnormalities (homologous artifical insemination in the case of abnormalities in the volume of the ejaculate, retard androgen therapy in the case of polyzoospermia). - From a prognostic viewpoint. The distinction must be drawn between aetiologies of good prognosis (80% of our success) responsible for transient abnormalities in spermatogenesis (infections, metabolic disturbances, varicocoele) and aetiologies with an unfavourable prognosis since they cause tubulopathies of greater or lesser severity with a lesional impairment of spermatogenesis.