Andrology pp 89-124 | Cite as

Diagnosis of Male Infertility and Hypogonadism

  • H. M. Behre
  • C. H. Yeung
  • A. F. Holstein
  • G. F. Weinbauer
  • P. Gassner
  • E. Nieschlag


In this chapter the diagnostic methods of andrology are presented with particular emphasis on the two main topics, male infertility and male hypogonadism. Regarding special diagnostic procedures, reference is made to separate chapters of this book, e. g. erectile dysfunction (Chap. 10) or special gynecological diagnostics (Chap. 14).


Sertoli Cell Leydig Cell Male Infertility Acrosome Reaction Testicular Tumor 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Abshagen K, Behre HM, Cooper TG, Nieschlag E (1998) Influence of sperm surface antibodies on spontaneous pregnancy rates. Fertil Steril 70:355–356PubMedGoogle Scholar
  2. Aitken RJ, Brindle JP (1993) Analysis of the ability of three probes targetting the outer acrosomal membrane or acrosomal contents to detect the acrosome reaction in humareaction in human spermatozoa. Hum Reprod 8:1663–1669PubMedGoogle Scholar
  3. Aitken J (1994) On the future of the hamster oocyte penetration assay. Fertil Steril 62:17–19PubMedGoogle Scholar
  4. Aitken RJ (1995) Free radicals, lipid peroxidation and sperm function. Reprod Fertil Dev 7:659–668PubMedGoogle Scholar
  5. Baker RR, Bellis MA (1995) Human sperm competition. Copulation, masturbation and infidelity. Chapman and Hall, LondonGoogle Scholar
  6. Barratt CLR, Tomlinson MJ, Cooke ID (1993) Prognostic significance of computerized motility analysis for in vivo fertility. Fertil Steril 60:520–525PubMedGoogle Scholar
  7. Behre HM, Nashan D, Nieschlag E (1989) Objective measurement of testicular volume by ultrasonography: evaluation of the technique and comparison with orchidometer estimates. Int J Androl 12:395–403PubMedGoogle Scholar
  8. Behre HM, Klein B, Steinmeyer E, McGregor GP, Voigt K, Nieschlag E (1992) Effective suppression of luteinizing hormone and testosterone by single doses of the new gonado-tropin-releasing hormone antagonist cetrorelix (SB-75) in normal men. J Clin Endocrinol Metab 75:393–398PubMedGoogle Scholar
  9. Behre HM, Bohmeyer J, Nieschlag E (1994) Prostate volume in testosterone-treated and untreated hypogonadal men in comparison to age-matched controls. Clin Endocrinol 40:341–349Google Scholar
  10. Behre HM, Kliesch S, Schädel F, Nieschlag E (1995) Clinical relevance of scrotal and transrectal ultrasonography in andrological patients. Int J Androl 18 [Suppl]:227–31Google Scholar
  11. Behre HM, Kliesch S, Leifke E, Link TM, Nieschlag E (1997) Long-term effect of testosterone therapy on bone mineral density in hypogonadal men. J Clin Endocrinol Metab 82:2386–2390PubMedGoogle Scholar
  12. Benson DM, Busch R (1996) Fixation of testicular tissue for immunohistochemical and ultrastructural examination. Andrologia 28:27–33PubMedGoogle Scholar
  13. Bergmann M, Behre HM, Nieschlag E (1994) Serum FSH and testicular morphology in male infertility. Clin Endocrinol 40:133–136Google Scholar
  14. Böck P (1989) Romeis Mikroskopische Technik. Urban and Schwarzenberg, MunichGoogle Scholar
  15. Braunstein GD (1993) Current concept: gynecomastia. N Engl J Med 328:490–495PubMedGoogle Scholar
  16. Büchter D, Behre HM, Kliesch S, Nieschlag E (1998) Pulsatile GnRH or human chorionic gonadotropin/human menopausal gonadotropin as effective treatment for men with hypogonadotropic hypogonadism: a review of 42 cases. Eur J Endocrinol 139:298–303PubMedGoogle Scholar
  17. Bundesärztekammer (1998) Richtlinien zur Durchführung der Assistierten Reproduktion. Dtsch Ärztebl 95:A3166-A317iGoogle Scholar
  18. Carlsen E, Olsson C, Petersen JH, Andersson AM, Skakkebaek NE (1999) Diurnal rhythm in serum levels of inhibin B in normal men: relation to testicular steroids and gonadotropins. J Clin Endocrinol Metab 84:1664–1669PubMedGoogle Scholar
  19. Chemes HE, Olmedo SB, Carrere C, Oses R, Carizza C, Leisner M, Blaquier J (1998) Ultrastructural pathology of the sperm flagellum: association between flagellar pathology and fertility prognosis in severely asthenozoospermic men. Hum Reprod 13:2521–2526PubMedGoogle Scholar
  20. Chiou RK, Anderson JC, Wobig RK, Rosinsky DE, Matamoros A Jr, Chen WS, Taylor RJ (1997) Color Doppler ultrasound criteria to diagnose varicoceles: correlation of a new scoring system with physical examination. Urology 50:953–956PubMedGoogle Scholar
  21. Clements S, Cooke ID, Barratt CLR (1995) Implementing comprehensive quality control in the andrology laboratory. Hum Reprod 10:2096–2106PubMedGoogle Scholar
  22. Colombero LT, Hariprashad JJ, Tsai MC, Rosenwaks Z, Palermo GD (1999) Incidence of sperm aneuploidy in relation to semen characteristics and assisted reproductive outcome. Fertil Steril 72:90–96PubMedGoogle Scholar
  23. Cooper TG (1990) Secretory proteins from the epididymis and their clinical relevance. Andrologia 22 [Suppl 1]:155–165PubMedGoogle Scholar
  24. Cooper TG, Yeung CH (1998) A flow cytometric technique using peanut agglutinin for evaluating acrosomal loss from human spermatozoa. J Androl 19:542–550PubMedGoogle Scholar
  25. Cooper TG, Neuwinger J, Bahrs S, Nieschlag E (1992) Internal quality control of semen analysis. Fertil Steril 58:172–178PubMedGoogle Scholar
  26. Cooper TG, Atkinson AD, Nieschlag E (1999) Experience with external quality control in spermatology. Hum Reprod 14:765–769PubMedGoogle Scholar
  27. Corund F, Belin X, Amar E, Delafontaine D, Helenon O, Moreau JF (1999) Varicocele: strategies in diagnosis and treatment. Eur Radiol 9:536–545Google Scholar
  28. De Braekeleer M, Dao TN (1991) Cytogenetic studies in male infertility: a review. Hum Reprod 6:245–250PubMedGoogle Scholar
  29. De Geyter Ch, De Geyter M, Schneider HPG, Nieschlag E (1992) Interdependent influence of follicular fluid oestradiol concentration and motility characteristics of spermatozoa on in-vitro fertilization results. Hum Reprod 7:664–670Google Scholar
  30. De Geyter C, De Geyter M, Koppers B, Nieschlag E (1998) Diagnostic accuracy of computer-assisted sperm motion analysis. Hum Reprod 13:2512–2520PubMedGoogle Scholar
  31. De Kretser DM, Holstein AF (1976) Testicular biopsy and abnormal germ cells. In: Hafez ESE (ed) Human semen and fertility regulation in men, Mosby, St. Louis, pp 332–343Google Scholar
  32. deLarmirande E, Gagnon C (1999) The dark and bright sides of reactive oxygen species on sperm function. In: Gagnon C (ed) The male gamete: from basic science to clinical application. Cache River Press, Vienna, pp 455–467Google Scholar
  33. Dieckmann KP (1993) Carcinoma in situ (testikuläre intraepitheliale Neoplasie) des Hodens. In: Hertle L, Pohl J (eds) Urologische Therapie. Urban and Schwarzenberg, Munich, pp 456–458Google Scholar
  34. Downie SE, Flaherty SP, Matthews C (1997) Detection of chromosomes and estimation of aneuploidy in human spermatozoa using fluorescence in-situ hybridization. Mol Hum Reprod 3:585–598PubMedGoogle Scholar
  35. Eckardstein S v, Simoni M, Bergmann M, Weinbauer GF, Gassner P, Schepers AG, Nieschlag E (1999) Serum inhibin B in combination with serum follicle-stimulating hormone (FSH) is a more sensitive marker than serum FSH alone for impaired spermatogenesis in men, but cannot predict the presence of sperm in testicular tissue samples. J Clin Endocrinol Metab 84:2496–2501Google Scholar
  36. Eckardstein S v, Cooper TG, Rutsch K, Meschede D, Horst J, Nieschlag E (2000) Seminal plasma characteristics as indicators of cystic fibrosis transmembrane conductance regulator (CFTR) gene mutations in men with obstructive azoospermia. Fertil Steril 73:1226–1231Google Scholar
  37. Ekbom A, Akre O (1998) Increasing incidence of testicular cancer — birth cohort effect. Acta Pathol Microbiol Immunol Scand 106:225–229Google Scholar
  38. Fénichel P, Hsi BL, Farahifar D, Donzeau M, Barrier-Delpech D, Yeh CJG (1989) Evaluation of the human sperm acrosome reaction using a monocloncal antibody, GB24, and fluorescence-activated cell sorter. J Reprod Fertil 87:699–706PubMedGoogle Scholar
  39. Fénichel P, Donzeau M, Farahifar D, Basteris B, Ayraud N, Hsi L (1991) Dynamics of human acrosome reaction: relation with in vitro fertilization. Fertil Steril 55:699–706Google Scholar
  40. Fischer M, Felsenberg D, Kempers B (1993) Methoden der Knochendichtemessung — heutiger Stand. Klinikarzt 22:15–23Google Scholar
  41. Foresta C, Galeazzi C, Bettella A, Stella M, Scandellari C (1998) High incidence of sperm sex chromosome aneuploidies in two patients with Klinefelter’s syndrome. J Clin Endocrinol Metab 83:203–205PubMedGoogle Scholar
  42. Ghadessy FJ, Lim J, Abdullah AA, Panet-Raymond V, Choo CK, Lumbroso R, Tut TG, Gottlieb B, Pinsky L, Trifiro MA, Yong EL (1999) Oligospermic infertility associated with an androgen receptor mutation that disrupts interdomain and coactivator (TIF2) interactions. J Clin Invest 103:1517–1525PubMedGoogle Scholar
  43. Gray A, Feldman HA, McKinlay JB, Longcope C (1991) Age, disease, and changing sex hormone levels in middle-aged men: results of the Massachusetts Male Aging Study. J Clin Endocrinol Metab 73:1016–1025PubMedGoogle Scholar
  44. Greulich WW, Pyle SI (1959) Radiographic atlas of skeletal development of the hand and wrist, 2nd edn. Stanford University Press, StanfordGoogle Scholar
  45. Grunert JH, De Geyter Ch, Nieschlag E (1990) Objective identification of hyperactivated human spermatozoa by computerized sperm motion analysis with the Hamilton-Thorn sperm motility analyser. Hum Reprod 5:593–599PubMedGoogle Scholar
  46. Gsponer J, De Tribolet N, Deruaz JP, Janzer R, Uske A, Mirimanoff RO, Reymond MJ, Rey F, Temler E, Gaillard RC, Gomez F (1999) Diagnosis, treatment, and outcome of pituitary tumors and other abnormal intrasellar masses. Retrospective analysis of 353 patients. Medicine 78:236–269PubMedGoogle Scholar
  47. Guttenbach M, Engel W, Schmid M (1997) Analysis of structural and numerical chromosome abnormalities in sperm of normal men and carriers of constitutional chromosome aberrations. A review. Hum Genet 100:1–21PubMedGoogle Scholar
  48. Hacker-Klom UB, Göhde W, Nieschlag E, Behre HM (1999) DNA flow cytometry of human semen. Hum Reprod 14:2506–2512PubMedGoogle Scholar
  49. Hayes FJ, Hall JE, Boepple PA, Crowley WF (1998) Differential control of gonadotropin secretion in the human: endocrine role of inhibin. J Clin Endocrinol Metab 83:1835–1841PubMedGoogle Scholar
  50. Heidenreich A, Sesterhenn IA, Mostofi FK, Moul JW (1998) Immunohistochemical expression of monoclonal antibody 43–9F in testicular germ cell tumours. Int J Androl 21:283–288PubMedGoogle Scholar
  51. Holstein AF, Roosen-Runge EC (1981) Atlas of human spermatogenesis. Grosse, BerlinGoogle Scholar
  52. Holstein AF, Wulfhekel U (1971) Die Semidünnschnitt-Technik als Grundlage für eine cytologische Beurteilung der Spermatogenese des Menschen. Andrologie 3:65–69Google Scholar
  53. Holstein AF, Davidoff M (1997) Compartmentalization of the intertubular space in the human testis. Adv Exp Med Biol 424:161–162PubMedGoogle Scholar
  54. Holstein AF, Roosen-Runge EC, Schirren C (1988) Illustrated pathology of human spermatogenesis. Grosse, BerlinGoogle Scholar
  55. Huhtaniemi I, Jiang M, Nilsson C, Pettersson K (1999) Mutations and polymorphisms in gonadotropin genes. Mol Cell Endocrinol 151:89–94PubMedGoogle Scholar
  56. Irvine DS, Macleod IC, Templeton AA, Masterton A, Taylor A (1994) A prospective clinical study of the relationship between the computer-assisted assessment of human semen quality and the achievement of pregnancy in vivo. Hum Reprod 9:2324–2334PubMedGoogle Scholar
  57. Imperato-McGinley J, Gautier T, Cai LQ, Yee B, Epstein J, Pochi P (1993) The androgen control of sebum production. Studies of subjects with dihydrotestosterone deficiency and complete androgen insensitivity. J Clin Endocrinol Metab 76:524–528PubMedGoogle Scholar
  58. Jackson JA, Riggs MW, Spiekerman AM (1992) Testosterone deficiency as a risk factor for hip fractures in men: a case-control study. Am J Med Sci 304:4–8PubMedGoogle Scholar
  59. Jensen TK, Andersson AM, Hjollund NH, Scheike T, Kolstad H, Giwercman A, Henriksen TB, Ernst E, Bonde JP, Olsen J, McNeilly A, Groome NP, Skakkebaek NE (1997) Inhibin B as a serum marker of spermatogenesis: correlation to differences in sperm concentration and follicle-stimulating hormone levels. A study of 349 Danish men. J Clin Endocrinol Metab 82:4059–4063PubMedGoogle Scholar
  60. Jeyendran RS, Van der Ven HK, Perez-Palaez M, Crabo BG, Zaneveld LJD (1984) Development of an assay to assess the functional integrity of the human sperm membrane and its relationship to other semen characteristics. J Reprod Fertil 70:219–228PubMedGoogle Scholar
  61. Jockenhövel F, Grawe A, Nieschlag E (1990) A portable digital data recorder for long-term monitoring of scrotal temperatures. Fertil Steril 54:694–700PubMedGoogle Scholar
  62. Johnston RC, Mbizvo MT, Summerbell D, Kovacs GT, Baker HWG (1994) Relationship between stimulated hyperactivated motility of human spermatozoa and pregnancy rate in donor insemination: A preliminary report. Hum Reprod 9:1684–1687PubMedGoogle Scholar
  63. Kruger TF, Dutoit TC, Franken DR, Menkveld R, Lombard CJ (1995) Sperm morphology: assessing the agreement between the manual method (strict criteria) and the sperm morphology analyzer IVOS. Fertil Steril 63:134–141PubMedGoogle Scholar
  64. Lacey HA, Pinarbasi E, Hornby DPH (1995) Subcloning of human ZP2 cDNA for in vitro prokaryotic and eukaryotic expression. Annual Conference of the Society for the Study of Fertility, DublinGoogle Scholar
  65. Laczkó J, Lévai G (1975) A simple differential staining method for semi-thin sections of ossifying cartilage and bone tissues embedded in Epoxy resin. Mikroskopie 31:1–4Google Scholar
  66. Lee MA, Trucco GS, Bechtol KB, Wummer N, Kopf GS, Blasco L, Storey BT (1987) Capacitation and acrosome reactions in human spermatozoa monitored by a Chlortetracycline fluorescence assay. Fertil Steril 48:649–658PubMedGoogle Scholar
  67. Lee MM, Donahoe PK, Silverman B, Hasegawa T, Hasegawa Y, Gustafson ML, Chan Y, MacLaughlin DT (1997) Measurements of serum müllerian inhibiting substance in the evaluation of children with nonpalpable gonads. N Engl J Med 336:1480–1486PubMedGoogle Scholar
  68. Le Moli R, Endert E, Fliers E, Mulder T, Prummel MF, Romijn JA, Wiersinga WM (1999) Establishment of reference values for endocrine tests. II: Hyperprolactinemia. Nether J Med 55:71–75Google Scholar
  69. Lerchl A, Keck C, Spiteri-Grech J, Nieschlag E (1993) Diurnal variations of scrotal temperature in normal men and patients with varicocele before and after treatment. Int J An-drol 16:195–200Google Scholar
  70. Liu DY, Baker HWG. (1996) A simple method for assessment of the human acrosome reaction of spermatozoa bound to the zona pellucida: a lack of relationship with ionophore A23187 induced acrosome reaction. Hum Reprod 11:551–557PubMedGoogle Scholar
  71. Marin P, Oden B, Björntorp P (1995) Assimilation and mobilization of triglycerides in subcutaneous abdominal and femoral adipose tissue in vivo in men: effects of androgens. J Clin Endocrinol Metab 80:239–243PubMedGoogle Scholar
  72. Martin RH (1998) Genetics of human sperm. J Ass Reprod Genet 15:240–245Google Scholar
  73. Martin RH, Ernst S, Rademaker A, Barclay L, Ko E, Summers N (1997) Analysis of human sperm karyotypes in testicular cancer patients before and after chemotherapy. Cytogenet Cell Genet 78:120–123PubMedGoogle Scholar
  74. Martin RH, Ernst S, Rademaker A, Barclay L, Ko E, Summers N (1999) Analysis of sperm chromosome complements before, during and after chemotherapy. Cancer Genet Cytogenet 108:133–136PubMedGoogle Scholar
  75. Mclnness B, Rademaker A, Greene CA, Ko E, Barclay L, Martin R (1998) Abnormalities for chromosomes 13 and 21 detected in spermatozoa from infertile men. Hum Reprod 13:2787–2790Google Scholar
  76. Mennicke K, Diercks P, Schlieker H, Bals-Pratsch M, Al Hasani S, Diedrich K, Schwinger E (1997) Molecular cytogenetic diagnostics in sperm. Int J Androl 20 [Suppl 3]:11–19PubMedGoogle Scholar
  77. Meschede D, Horst J (1997) Genetic counselling for infertile male patients. Int J Androl 20 [Suppl 3:20–30PubMedGoogle Scholar
  78. Meschede D, Behre HM, Nieschlag E (1995) Endocrine and spermatological characteristics of 135 patients with bilateral megalotestis. Andrologia 27:207–212PubMedGoogle Scholar
  79. Meschede D, Dworniczak B, Behre HM, Kliesch S, Claustres M, Nieschlag E, Horst J (1997) CFTR gene mutations in men with bilateral ejaculatory-duct obstruction and anomalies of the seminal vesicles. Am J Hum Genet 61:1200–1202PubMedGoogle Scholar
  80. Meschede D, Lemcke B, Exeler JR, De Geyter C, Behre HM, Nieschlag E, Horst J (1998) Chromosome abnormalities in 447 couples undergoing intracytoplasmic sperm injection — prevalence, types, sex distribution and reproductive relevance. Hum Reprod 13:576–582PubMedGoogle Scholar
  81. Moelier H (1993) Clues to the aetiology of testicular germ cell tumours from descriptive epidemiology. Eur Urol 23:8–15Google Scholar
  82. Nashan D, Behre HM, Grunert JH, Nieschlag E (1990) Diagnostic value of scrotal sonography in infertile men: report on 658 cases. Andrologia 22:387–385PubMedGoogle Scholar
  83. Neugebauer DC, Neuwinger J, Jockenhövel F, Nieschlag E (1990) 9+0 axoneme in spermatozoa and some nasal cilia of a patient with totally immotile spermatozoa associated with thickened sheath and short midpiece. Hum Reprod 5:981–986PubMedGoogle Scholar
  84. Neuwinger J, Behre HM, Nieschlag E (1990) External quality control in the andrology laboratory: an experimental multicenter trial. Fertil Steril 54:308–314PubMedGoogle Scholar
  85. Neuwinger J, Cooper TG, Knuth UA, Nieschlag E (1991) Hyaluronic acid as a medium for human sperm migration tests. Hum Reprod 6:396–400PubMedGoogle Scholar
  86. Nieschlag E (1998) Hodenfunktionen. In: Thomas L (ed) Labor und Diagnose, 5th edn. TH-Books Verlagsgesellschaft, Frankfurt, pp 1124–1133Google Scholar
  87. Nieschlag E, von zur Mühlen A, Sippell W (1993) Männliche Gonaden. In: Deutsche Gesellschaft für Endokrinologie (ed) Rationelle Diagnostik in der Endokrinologie einschließlich Diabetologie und Stoffwechsel. Thieme, Stuttgart, pp 186–212Google Scholar
  88. Ochsendorf FR (1998) Infection and reactive oxygen species. Andrologia 30 [Suppl 1]:81–86PubMedGoogle Scholar
  89. Oei SG, Helmerhorst FM, Keirse MJNC (1995) When is the postcoital test normal? A critical appraisal. Hum Reprod 10:1711–1714PubMedGoogle Scholar
  90. Pang MG, Hoegerman SF, Cuticchia AJ, Moon SY, Doncel GF, Acosta AA, Kearns WG (1999) Detection of aneuploidy for chromosomes 4,6,7,8,9,10,11,12,13,17,18,21, X and Y by fluorescence in-situ hybridization in spermatozoa from nine patients with oligoasthenoteratozoospermia undergoing intracytoplasmic sperm injection. Hum Reprod 14:1266–1273PubMedGoogle Scholar
  91. Paschke R, Schulze Bertelsbeck D, Bahrs S, Heinecke A, Behre HM (1994) Seminal sperm antibodies exhibit an unstable spontaneous course and an increased incidence of leucocytospermia. Int J Androl 17:135–139PubMedGoogle Scholar
  92. Pfeffer J, Pang M-G, Hoegerman SF, Osgood Ch J, Stacey MW, Mayer J, Oehninger S, Kearns WG (1999) Aneuploidy frequencies in semen fractions from ten oligoasthenoteratozoospermic patients donating sperm for intracytoplasmic sperm injection. Fertil Steril 72:472–478PubMedGoogle Scholar
  93. Pierik FH, Vreeburg JT, Stijnen T, De Jong FH, Weber RF (1998) Serum inhibin B as a marker of spermatogenesis. J Clin Endocrinol Metab 83:3110–3114PubMedGoogle Scholar
  94. Pierik FH, Dohle GR, van Muiswinkel JM, Vreeburg JT, Weber RF (1999) Is routine scrotal ultrasound advantageous in infertile men? J Urol 162:1618–1620PubMedGoogle Scholar
  95. Pralong FP, Gomez F, Castillo E, Cotecchia S, Abuin L, Aubert ML, Portmann L, Gaillard RC (1999) Complete hypogonadotropic hypogonadism associated with a novel inactivating mutation of the gonadotropin-releasing hormone receptor. J Clin Endocrinol Metab 84:3811–3816PubMedGoogle Scholar
  96. Purvis K, Christiansen E (1993) Infection in the male reproductive tract. Impact, diagnosis and treatment in relation to male infertility. Int J Androl 16:1–13PubMedGoogle Scholar
  97. Quigley CA (1998) The androgen receptor: physiology and pathophysiology. In: Nieschlag E, Behre HM (eds) Testosterone — action, deficiency, substitution, 2nd edn. Springer, Berlin Heidelberg New York, pp 33–106Google Scholar
  98. Randall VA (1998) Androgens and hair. In: Nieschlag E, Behre HM (eds) Testosterone — action, deficiency, substitution, 2nd edn. Springer, Berlin Heidelberg New York, pp 169–186Google Scholar
  99. Rolf C, Cooper TG, Yeung CH, Nieschlag E (1999) Antioxidant treatment of patients with asthenozoospermia or moderate oligoasthenozoospermia with high-dose vitamin C and vitamin E: a randomized, placebo-controlled, double-blind study. Hum Reprod 14:1028–1033PubMedGoogle Scholar
  100. Ron-El R, Strauss S, Friedler S, Strassburger D, Komarovsky D, Raziel A (1998) Serial sonography and colour flow Doppler imaging following testicular and epididymal sperm extraction. Hum Reprod 13:3390–3393PubMedGoogle Scholar
  101. Santner SJ, Albertson B, Zhang GY, Zhang GH, Santulli M, Wang C, Demers LM, Shackleton C, Santen RJ (1998) Comparative rates of androgen production and metabolism in Caucasian and Chinese subjects. J Clin Endocrinol Metab 83:2104–2109PubMedGoogle Scholar
  102. Schulze W, Knuth UA (2000) Diagnostics of testicular dysfunction: Testicular biopsy. In: Shalet SM, Wass JAH (eds) Oxford textbook of endocrinology. Oxford University Press, Oxford (in press)Google Scholar
  103. Schulze W, Thorns F, Knuth UA (1999) Testicular sperm extraction: comprehensive analysis with simultaneously performed histology in 1418 biopsies from 766 subfertile men. Hum Reprod 14 [Suppl 1]:82–96PubMedGoogle Scholar
  104. Simoni M, Nieschlag E (1991) In vitro bioassays of follicle-stimulating hormone: methods and clinical applications (review). J Endocrinol Invest 14:983–997PubMedGoogle Scholar
  105. Simoni M, Gromoll J, Nieschlag E (1997) The follicle-stimulating hormone receptor: biochemistry, molecular biology, physiology, and pathophysiology. Endocr Rev 18:739–773PubMedGoogle Scholar
  106. Simoni M, Bakker E, Eurlings MC, Matthijs G, Moro E, Muller CR, Vogt PH (1999) Laboratory guidelines for molecular diagnosis of Y-chromosomal microdeletions. Int J Androl 22:292–299PubMedGoogle Scholar
  107. Tschöp M, Behre HM, Nieschlag E, Dressendorfer RA, Strasburger CJ (1998) A time-resolved fluorescence immunoassay for the measurement of testosterone in saliva: monitoring of testosterone replacement therapy with testosterone buciclate. J Clin Chem Lab Med 36:223–230Google Scholar
  108. Tong S, Cardinal HN, McLoughlin RF, Downey DB, Fenster A (1998) Intra- and inter-observer variability and reliability of prostate volume measurement via two-dimensional and three-dimensional ultrasound imaging. Ultrasound Med Biol 24:673–681PubMedGoogle Scholar
  109. Tournaye H, Verheyen G, Nagy P, Ubaldi F, Goossens A, Silber S, Van Steirteghem AC, Devroey P (1997) Are there any predictive factors for successful testicular sperm recovery in azoospermic patients? Hum Reprod 12:80–86PubMedGoogle Scholar
  110. van Duin M, Polman JEM, de Breet ITM, van Ginneken K, Bunschoten H, Grootenhuis A, Brindle J, Aitken RJ (1994) Recombinant human zona pellucida protein ZP3 produced by Chinese hamster ovary cells induces the human sperm acrosome reaction and promotes sperm-egg fusion. Biol Reprod 51:607–617PubMedGoogle Scholar
  111. Vermeulen A, Verdonck G (1992) Representativeness of a single point plasma testosterone level for the long term hormonal milieu. J Clin Endocrinol Metab 74:939–942PubMedGoogle Scholar
  112. Vermeulen A, Verdonck L, Kaufman JM (1999) A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab 84:3666–3672PubMedGoogle Scholar
  113. Wang C, Lee GS, Leung A, Surrey ES, Chan SYW (1993) Human sperm hyperactivation and acrosome reaction and their relationships to human in vitro fertilization. Fertil Steril 59:1221–1227PubMedGoogle Scholar
  114. Weidner W, Schroeder-Printzen I, Weiske WH, Haidl G (1995) Microsurgical aspects of the treatment of azoospermia. The BMFT Study Group for Microsurgery. Int J Androl 18 [Suppl 2]:63–66PubMedGoogle Scholar
  115. WHO Laborhandbuch zur Untersuchung des menschlichen Ejakulats und der Spermien-Zervikalschleim-Interaktion (1999) Übersetzung von: Nieschlag E, Nieschlag S, Bals-Pratsch M, Behre HM, Knuth UA, Meschede D,Niemeier M, Schick A, 4th edn. Springer, Berlin Heidelberg New YorkGoogle Scholar
  116. WHO Manual for the standardized investigation and diagnosis of the infertile couple (1993) Rowe PJ, Comhaire FH, Hargreave TB, Mellows H J (eds). Cambridge University Press, CambridgeGoogle Scholar
  117. Wüster C, Heilmann P, Pereira-Lima J, Schlegel J, Anstatt K, Soballa T (1998) Quantitative ultrasonometry (QUS) for the evaluation of osteoporosis risk: reference data for various measurement sites, limitations and application possibilities. Exp Clin Endocrinol Diabetes 106:277–288PubMedGoogle Scholar
  118. Yeung CH, Cooper TG, DeGeyter M, DeGeyter C, Rolf C, Kamischke A, Nieschlag E (1998) Studies on the origin of redox enzymes in seminal plasma and their relationship with results of invitro fertilization. Mol Human Reprod 4:835–839Google Scholar
  119. Young J, Rey R, Couzinet B, Chanson P, Josso N, Schaison G (1999) Antimüllerian hormone in patients with hypogonadotropic hypogonadism. J Clin Endocrinol Metab 84:2696–2699PubMedGoogle Scholar
  120. Zamboni L (1992) Sperm structure and its relevance to infertility. An electron microscopic study. Arch Pathol Lab Med 116: 325–344PubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2001

Authors and Affiliations

  • H. M. Behre
  • C. H. Yeung
  • A. F. Holstein
  • G. F. Weinbauer
  • P. Gassner
  • E. Nieschlag

There are no affiliations available

Personalised recommendations