Azoospermia is the complete absence of spermatozoa in the ejaculate in two or more semen analyses after centrifugation.Nonobstructive azoospermia(NOA)represents the most severe form of male factor infertility accounti...Azoospermia is the complete absence of spermatozoa in the ejaculate in two or more semen analyses after centrifugation.Nonobstructive azoospermia(NOA)represents the most severe form of male factor infertility accounting for 10%–15%of cases and stems from an impairment to spermatogenesis.Understanding of the hypothalamic–pituitary–testicular axis has allowed NOA to be subcategorized by anatomic and/or pathophysiologic level.The etiologies of NOA,and therefore,the differential diagnoses when considering NOA as a cause of male factor infertility,can be subcategorized and condensed into several distinct classifications.Etiologies of NOA include primary hypogonadism,secondary hypogonadism,defects in androgen synthesis and/or response,defective spermatogenesis and sperm maturation,or a mixed picture thereof.This review includes up-to-date clinical,diagnostic,cellular,and histologic features pertaining to the multitude of NOA etiologies.This in turn will provide a framework by which physicians practicing infertility can augment their clinical decision-making,patient counseling,thereby improving upon the management of men with NOA.展开更多
Premature Ovarian Failure (POF) is a heterogeneous syndrome characterized by Hypergonadotropic Hypogonadism that affects about 1% of women younger than 40 years old, while an incidence of 1/1000 is reported in women y...Premature Ovarian Failure (POF) is a heterogeneous syndrome characterized by Hypergonadotropic Hypogonadism that affects about 1% of women younger than 40 years old, while an incidence of 1/1000 is reported in women younger than 30 years old. [1] This hormonal disorder is caused by the loss of the ovarian response towards the pituitary gonadrotropins synthesis (FSH and LH) that are secreted according to the inhibitory feedback between hypothalamus, pituitary gland and gonads.展开更多
Topic: Kallmann syndrome (KS) is a congenital olfacto-genital disease. Affected persons show an absence of physical pubertal development, and their sense of smell is reduced or absent (anosmia). The prevalence is 1:40...Topic: Kallmann syndrome (KS) is a congenital olfacto-genital disease. Affected persons show an absence of physical pubertal development, and their sense of smell is reduced or absent (anosmia). The prevalence is 1:40,000 in women and 1:8000 to 1:10,000 in men. Development of gender identity corresponds to the assigned gender at birth. The cause of KS is a genetic defect. To date, only a few systematic investigations have delved into the psychological disstress and consequences of the somatic characteristics of KS. In order for affected persons to be appropriately informed, well-founded research results are necessary. The focus of the present study aims at examining the similarities and differences between the psychological disstress and consequences women and men experience through the development, on the one hand, and through its medical treatment on the other. The present text complements current findings on the psychological consequences of KS in men [1] and women, respectively [2]. Two questions lie at the center of the comparison: 1) Which similarities and which gender-specific differences are there concerning the perceived burdens? 2) Which coping strategies have been developed in dealing with the burdens and consequences caused by KS in the affected women and men? Which similarities and which gender-specific differences are there with respect to these coping strategies? Methodology: The survey has been carried out by means of topically focused narrative interviews of 16 men and 5 women. Based on the qualitative content analysis according to Mayring [3], categories have been generated and evaluated on the basis of the interview material. The results of the male and female samples have been contrasted and analyzed in gender-specific relevant key subjects [1,2]. Results: The comparison shows that the burdens women and men experience through KS go beyond the somato-medical problems, and that the psychosocial consequences are a heavy burden for the members of both groups. Men bear a heavier burden through insecurities and shame about the absence of virilization and subsequently suffer more from bullying and marginalization experiences. They also perceive mood changes more frequently and as more burdensome through the course of hormone treatment. Women also develop shame due to the absence of female body development;they do, however, perceive this as less burdensome than do men. They suffer particularly from a loss of libido before and also during hormone treatment. Differences occur concerning the gender-specific hormone treatment and its effects on mood and libido. Wellfounded statements relating to this do, however, require further-reaching studies. In women, KS is frequently misdiagnosed as simply estrogen deficiency, which could be an explanation for the differing degree of prevalence. The preferred coping strategies for both sexes include confidential talks with suitable people, such as parents, the partner, friends, or a psychotherapist. Using support from psychotherapists, sex education, and/or sexual therapists is recommended when necessary. Conclusion: Psychotherapeutic/psychological support is recommended for both women and men diagnosed with KS, taking into account the gender-specific differences in dealing with the burdens KS imposes. The focus for both sexes should be on developing and strengthening body image and self-esteem. In medical treatment for both women and men, normal or inconspicuous body development should be emphasized. Particularly in the case of women, sex therapy should be available for support due to loss of libido. For men, therapy should be recommended, so as to strengthen their social capabilities and self-confidence. Additional studies are necessary for examining the effects of hormonal treatment on mood and libido and phenotyp.展开更多
文摘Azoospermia is the complete absence of spermatozoa in the ejaculate in two or more semen analyses after centrifugation.Nonobstructive azoospermia(NOA)represents the most severe form of male factor infertility accounting for 10%–15%of cases and stems from an impairment to spermatogenesis.Understanding of the hypothalamic–pituitary–testicular axis has allowed NOA to be subcategorized by anatomic and/or pathophysiologic level.The etiologies of NOA,and therefore,the differential diagnoses when considering NOA as a cause of male factor infertility,can be subcategorized and condensed into several distinct classifications.Etiologies of NOA include primary hypogonadism,secondary hypogonadism,defects in androgen synthesis and/or response,defective spermatogenesis and sperm maturation,or a mixed picture thereof.This review includes up-to-date clinical,diagnostic,cellular,and histologic features pertaining to the multitude of NOA etiologies.This in turn will provide a framework by which physicians practicing infertility can augment their clinical decision-making,patient counseling,thereby improving upon the management of men with NOA.
文摘Premature Ovarian Failure (POF) is a heterogeneous syndrome characterized by Hypergonadotropic Hypogonadism that affects about 1% of women younger than 40 years old, while an incidence of 1/1000 is reported in women younger than 30 years old. [1] This hormonal disorder is caused by the loss of the ovarian response towards the pituitary gonadrotropins synthesis (FSH and LH) that are secreted according to the inhibitory feedback between hypothalamus, pituitary gland and gonads.
基金Funding for this work was received from the German Society of Sexual Research.
文摘Topic: Kallmann syndrome (KS) is a congenital olfacto-genital disease. Affected persons show an absence of physical pubertal development, and their sense of smell is reduced or absent (anosmia). The prevalence is 1:40,000 in women and 1:8000 to 1:10,000 in men. Development of gender identity corresponds to the assigned gender at birth. The cause of KS is a genetic defect. To date, only a few systematic investigations have delved into the psychological disstress and consequences of the somatic characteristics of KS. In order for affected persons to be appropriately informed, well-founded research results are necessary. The focus of the present study aims at examining the similarities and differences between the psychological disstress and consequences women and men experience through the development, on the one hand, and through its medical treatment on the other. The present text complements current findings on the psychological consequences of KS in men [1] and women, respectively [2]. Two questions lie at the center of the comparison: 1) Which similarities and which gender-specific differences are there concerning the perceived burdens? 2) Which coping strategies have been developed in dealing with the burdens and consequences caused by KS in the affected women and men? Which similarities and which gender-specific differences are there with respect to these coping strategies? Methodology: The survey has been carried out by means of topically focused narrative interviews of 16 men and 5 women. Based on the qualitative content analysis according to Mayring [3], categories have been generated and evaluated on the basis of the interview material. The results of the male and female samples have been contrasted and analyzed in gender-specific relevant key subjects [1,2]. Results: The comparison shows that the burdens women and men experience through KS go beyond the somato-medical problems, and that the psychosocial consequences are a heavy burden for the members of both groups. Men bear a heavier burden through insecurities and shame about the absence of virilization and subsequently suffer more from bullying and marginalization experiences. They also perceive mood changes more frequently and as more burdensome through the course of hormone treatment. Women also develop shame due to the absence of female body development;they do, however, perceive this as less burdensome than do men. They suffer particularly from a loss of libido before and also during hormone treatment. Differences occur concerning the gender-specific hormone treatment and its effects on mood and libido. Wellfounded statements relating to this do, however, require further-reaching studies. In women, KS is frequently misdiagnosed as simply estrogen deficiency, which could be an explanation for the differing degree of prevalence. The preferred coping strategies for both sexes include confidential talks with suitable people, such as parents, the partner, friends, or a psychotherapist. Using support from psychotherapists, sex education, and/or sexual therapists is recommended when necessary. Conclusion: Psychotherapeutic/psychological support is recommended for both women and men diagnosed with KS, taking into account the gender-specific differences in dealing with the burdens KS imposes. The focus for both sexes should be on developing and strengthening body image and self-esteem. In medical treatment for both women and men, normal or inconspicuous body development should be emphasized. Particularly in the case of women, sex therapy should be available for support due to loss of libido. For men, therapy should be recommended, so as to strengthen their social capabilities and self-confidence. Additional studies are necessary for examining the effects of hormonal treatment on mood and libido and phenotyp.
