How to Reverse Testicular Atrophy

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Environmental And Occupational Factors

Warmer temperatures tend to hinder sperm production. That's because the temperature in the scrotum must be below the rest of the body for the testicles to produce healthy sperm. Exposing the male genitals to heat, such as the frequent use of saunas, steam rooms, hot tubs, whirlpools, and hot baths, can temporarily lower sperm count. Men who wear tight clothing may be lowering their sperm count as well. That's because the testicles are pressed closely to the body and become warmer than if they were able to hang freely within the scrotal sac. Males with infertility difficulties are often advised not to wear tight-fitting pants or underwear.

Pituitary Gland Abnormalities

Pituitary gland abnormalities are a rare cause for male infertility. In such circumstances, the pituitary gland fails to release hormones necessary to promote sperm production. The pituitary gland in the man produces two important hormones for sexual reproduction luteinizing hormone (LH) and follicle-stimulating hormone (FSH). The primary function of LH is to act on specialized cells within the testicles to manufacture the male hormone testosterone. FSH has the main purpose of stimulating the production of sperm. In most cases of pituitary gland abnormalities, either LH or FSH or both are greatly reduced. This drop in hormones results in lowered testosterone levels and also reduced sperm production.

Fertility Testing for

During your first appointment, the fertility specialist will ask you and your partner about your medical conditions, medications, lifestyle choices, and family history. Focus may be placed on identifying certain fertility risk factors, such as a history of mumps, undescended testicles, STD infections, urological surgery, or exposure to toxins.

Primary Nursing Diagnosis

Or peripheral blood progenitor cell transplant. Multiple pheresis, or removal of cells from the blood, provides the stem cells from the patient for transplantation. SCT permits the use of doses of chemotherapy and radiation therapy high enough to destroy the patient's bone marrow after the treatment is completed SCT restores blood-producing bone marrow stem cells. Radiation treatment is sometimes used to treat leukemic cells in the brain, spinal cord, or testicles.

Regulation Of Testicular Function

Testicular function, as we have seen, depends on stimulation by two pituitary hormones, FSH and LH. Without them, the testes lose spermatogenic and steroi-dogenic capacities and either atrophy or fail to develop. Secretion of these hormones by the pituitary gland is driven by the central nervous system through its secretion of the gonadotropin-releasing hormone (GnRH), which reaches the pituitary by way of the hypophysial portal blood vessels (see Chapter 38). Separation of the pituitary gland from its vascular linkage to the hypothalamus results in total cessation of gonadotropin secretion and testicular atrophy. The central nervous system and the pituitary gland are kept apprised of testicular activity by signals related to each of the testicular functions steroidogenesis and gametogenesis. Characteristic of a negative feedback, signals from the testis are inhibitory. Castration results in a prompt increase in secretion of both FSH and LH. The central nervous system also receives...

Fragile X Syndrome FraX

The protein encoded by the FRM1 gene is known as FRMP. It is expressed not only in the brain but also in other parts of the body and especially in the testicles. FraX males exhibit macro-orchidism enlarged testicles. Both males and females also present with connective tissue problems including ear infections, and skeletal problems such as flat feet and double-jointed fingers. Whilst the precise role of FRMP remains unknown there is evidence that it is involved in the regulation of protein synthesis. This is likely to account for the male macro-orchidism mentioned above. High levels of FMR1 mRNA are also found in cerebellar granule

In vitro Fertilization

Viable sperm are collected from the man and washed in a special solution that activates them so they can fertilize the egg. The process of sperm activation is called capacitation and normally occurs when sperm are ejaculated and enter the female reproductive tract. Capacitation involves activating enzymes in the sperm's acrosomal cap, allowing the sperm head, which contains the sperm's genetic material, to penetrate the outer and inner membranes of the egg (zona pellucida and vitelline membrane). For males with azoospermia, microsurgical or aspiration techniques can directly extract sperm from either the epididymis or the testicles. Azoospermia is the most severe form of male infertility, caused by obstructions in the genital tract or by testicular failure.

Pathology and Transmission

The agonadal condition caused by Hz-2V results in female moths having enlarged common and lateral oviducts, a deformed bursa copulatrix and malformed or missing ovaries, accessory glands and or sper-matheca. Affected males have very small testes and are lacking seminal vesicles, vasa deferentia and or accessory glands. These individuals are sterile and most infected females have a white, 'waxy plug' protruding from the vulva. This plug contains a high concentration of virus particles located inside vesicles which resemble baculovirus occlusion bodies but which lack the dense protein matrix characteristic of occlusion bodies. The replication of Hz-2V appears to be confined to reproductive tissues since the virus is readily observed in the nucleus of cells in these tissues and has not been found in any other tissues of infected animals.

Clinical Description Dm1

Ninety percent of DM1 patients present at adulthood with delayed muscle maturation, distal muscle weakness, wasting, myotonia, cataracts, cardiac abnormalities, smooth muscle dysfunction, insulin resistance, daytime sleepiness, testicular atrophy (low reproductive fitness), ''difficult'' personality, neuropsychiatric disturbances, and frontal balding. 1 Ten percent of the patients present at infancy with hypotonia (floppy infant), oromotor dysfunction, tent-shaped mouth, feeding and respiratory insufficiency (diaphragmatic hypoplasia), arthrogryposis, and mental retardation in those who survive until adulthood (congenital DM). 1 All manifestations show a progressive course. Usually, creatine kinase is elevated. Muscle biopsy shows type 1 predominance, centrally located nuclei, severe fiber atrophy with nuclear clumps, hypertrophic and angulated fibers, and occasionally, necrotic fibers, fibrosis, or fat deposits. Cardiac involvement comprises conduction defects (mostly HV...

Clinical manifestation

Borderline leprosy numerous, asymmetric, moderately anesthetic, red, irregularly shaped plaques less well defined than those in the tuberculoid type regional adenopa-thy sometimes present Lepromatous leprosy only infectious stage early cutaneous lesions consisting mainly of pale, small, diffuse, symmetric macules, which become infiltrated later, with little loss of sensation nerves not thickened and sweating normal alopecia of lateral eyebrows, eyelashes, and trunk, but scalp hair intact lepromatous infiltrations either diffuse nodules (lepromas) or plaques, which result in appearance of leonine facies brawny lower extremity edema neuritic lesions symmetric and slow to develop eye involvement causes pain photophobia, decreased visual acuity, glaucoma, and blindness testicular atrophy produces sterility and gynecomastia lymphadenopathy and hepatomegaly result from organ infiltration stridor and hoarseness from laryn-geal involvement nasal infiltration sometimes produces a saddle-nose...

External Male Reproductive Organs

The external male reproductive organs consist of the penis and two testicles. The two testicles are located in a sac called the scrotum. When a male baby is born, his penis is fully formed and his testicles have usually descended from his pelvis and into the scrotum. Testicles The two testicles are egg-shaped glands held within the scrotum. The scrotum is located underneath the penis and hangs outside of the body cavity. The testicles should hang outside of the body cavity to optimize sperm production because sperm production is most effective when performed at slightly below body temperature. Unfortunately, placement of the scrotum outside of the body cavity puts the testicles at greater risk for injury. Therefore, the testicles should be protected with a jockstrap or protective cup during sports or other strenuous activities. The testicles serve two primary functions the production of the hormone testosterone and the production of sperm. The testicles are sometimes referred to as...

Almond

Greek mythology has the Phrygian tale of Attis. In one version he is castrated by the gods, and dies. His testicles fall to the ground and sprout new life in the form of an almond tree (Edwards). Not that this symbolism is entirely Greek, for at gypsy weddings in parts of Spain everyone heaps pink almond blossoms over the bride's head as she dances. Such throwing over the bride's head is known in Greece as, significantly, pouring , as if the almond blossom were life-giving water. An almond tree will always fruit well near the home of a bride, it is said. Almond paste, called 'matrimony', since it blends sweet and bitter flavours, usually appears on wedding cakes. In Italy, pink and white sugared almonds are distributed in ornamental boxes at weddings, like bread cake elsewhere. So universal are almonds at Greek weddings that the question when will we eat sugared almonds is asked instead of when will the wedding be (Edwards). They are equally prominent...

Alcohol

Consuming alcohol of more than one or two drinks per day can affect the quality and quantity of sperm, lower testosterone levels, and contribute to impotence. A 1996 research study from Finland showed that moderate alcohol consumption can kill off some sperm-producing cells within the testicles and also may cause abnormal sperm shapes. A normally shaped sperm should resemble a streamlined tadpole with an oval head and long tail. Abnormally shaped sperm vary in appearance and may have two tails, a tapered head, a crooked kinky shape, or an unusually large or small head. Any of these abnormalities make it so that the sperm is unable to penetrate the surface of the egg and therefore unable to successfully fertilize the egg. Men who partake in heavy alcohol consumption that is, more than six drinks per day are more likely to suffer from low sperm count, poor sperm motility, and abnormal sperm shape.

An Expanding Gene

Although there is currently no cure for fragile X syndrome, scientists are making great progress in understanding the biology of the disorder. In the mid- to late 1990s, Stephen Warren and colleagues determined that the FMR1 gene product, named FMRP, is an RNA-binding protein that shuttles in and out of the nucleus and is involved in binding various messenger RNAs. Moreover, scientists successfully developed mice that lack the FMR1 gene, which will greatly aid research. Symptoms of fragile X mice include learning disabilities, hyperactivity, and, in males, enlarged testicles. Prevailing hypotheses about FMRP suggest that this protein is involved in forming neural connections in the developing brain.

Pediatric Torsion

Pediatric torsion is usually secondary to the bell-clapper deformity and occurs intravaginally. Prompt recognition and surgical detorsion will prevent atrophy and testicular nonfunction. Orchidopexy within 4 h will result in almost certain complete testicular viability however, some germ and Leydig cell function can still be preserved after 12 h of untreated torsion. Beyond 24 h, nearly complete testicular atrophy occurs despite detorsion and orchidopexy (Rampaul and Hos-

Mammalian Mechanisms

Early in an embryo's development (four weeks after fertilization, in humans), two groups of cells become organized into the gonad rudiment that will eventually develop into either the ovaries or testicles. These gonads will eventually be the source of gametes in the adult. However, at this early stage they are unstructured organs that lack sex-specific features but have the potential to develop into gonads. Testicles produce Mullerian inhibiting substance, a hormone that causes the Mullerian duct to degenerate. They also produce testosterone, which causes the Wolffian duct to develop into the internal male genitalia, such as the seminal vesicles and the vas deferens. Testosterone also promotes the development of the external male genitalia, including the penis, and it reduces the development of the breasts. In females, where there are no testicles and where there is therefore no Mullerian inhibiting substance, the Mullerian duct differentiates into internal...

Keep The Boys Cool

You've probably already heard that boxers are better than briefs when it comes to fertility concerns regarding men's underwear. That's because the testicles need to be at a slightly lower temperature than the rest of the body to maximize sperm production. It stands to reason that testicles will enjoy slightly cooler temperature conditions when positioned in boxers as compared to the tight confines of briefs.

Fourniers Gangrene

Management is emergent (Baskin et al. 1990). Rapid recognition, speedy resuscitation with fluids and oxygen, administration of broad-spectrum antibiotics, and wide debridement of all necrotic tissue are the cornerstones of treatment, along with the recognized need for a second trip to the operating room for a second look within 24 h. Many times additional surgery is required beyond the second surgery. Support in an intensive care unit may be required, including a large amount of fluid resuscitation, ventilatory support, and vasopres-sor support. Antibiotic coverage should include metro-nidazole or clindamycin for anaerobes, a third-generation cephalosporin or aminoglycoside for Gram-negative infections and penicillin for Gram-positive bacteria. Debridement should extend to fresh, vital tissue at every surgical margin. The glans, corpus spongiosum, corpora cavernosa and testes are almost always unin-fected and preserved because of their deep blood supply. However, if the tunica...

Weddings

ALMONDS, in the Mediterranean area, have always been important at weddings, and there is a lot of sexual symbolism associated with them. Greek mythology has the Phrygian tale of Attis. In one version he is castrated by the gods and dies. His testicles fell to the ground and sprouted new life in the form of an almond tree (Edwards). At Spanish gypsy weddings everyone heaps pink almond blossom on the bride's head as she dances. Such throwing is known in Greece as pouring , as if the blossom were life-giving water. Almond paste, known as 'matrimony' because it blends bitter and sweet flavours, usually appears on wedding cakes. Sugared almonds are used these days at Greek weddings, the sugar adding another dimension - white for purity. So universal are they in Greece that the question when will we eat sugared almonds is asked instead of when will the wedding be They are equally prominent at Indian weddings, and some are put at every table-setting at a reception. They may indicate both...

Fennel

The Greeks believed that snakes had recourse to fennel to cure blindness (Grieve. 1933), and it was popularly believed in the Middle Ages that dragons could cure their blindness, apparently a common affliction of dragons , by rubbing their eyes with fennel, or eating it (Hogarth). The other point about snakes and fennel is that so soone as they taste of it they become young again. (Hulme). Macer reckoned fennel to be a restorer of youth, quoting the snake belief (Hulme). Perhaps this is relevant to an odd reference in Shakespeare Falstaff, in Henry IV pt 2, says of Poins, he plays quoits well, and eats conger and fennel , as if this were a sign of manliness.

Mandrake

This was the reason it was dedicated to the goddess. So also, it should be gathered on a Friday, the day of the goddess (Bonser). Theo-phrastus, in the 4th century BC, recommended the root, scraped and soaked in vinegar, as an aphrodisiac (Dyer. 1889). One of the Egyptian names means phallus of the field, and an Arabic name was devil's testicles (Ellis). It was the fruit that was to be used it had the power, so it was said, to put an end to barrenness, quite independently of sexual intercourse. See Genesis 30 14-16. Rachel bargained for the mandrake with her sister Leah (by giving up her husband to her). She afterwards bore, though she had previously been barren, her first-born, Joseph (Hartland. 1909). The plant had been found in the fields by Reuben, and given by him to his mother Leah on the night of the conception of Issachar (Bonser). Palestinian women quite often used to bind a piece of the root to their arm (for it could only exert its magical influence if...

Presentation

Patients generally present with acute testicular pain, often being awoken from sleep with pain. If the patient has mild pain, which has increased over a few days, a torsion of a testicular appendage should be suspected, rather than testicular torsion. If the patient complains of intermittent acute pain, which completely resolves, a diagnosis of intermittent testicular torsion should be suspected (Eaton et al. 2005). In classic testicular torsion, there tends to be nausea and vomiting, along with referred abdominal pain. On inspection, the typical torsion patient is lying quite still on the exam table. A patient who is ambulating easily without pain is unlikely to have torsion. Close inspection of the scrotum may show asymmetric positioning of the testicles with the torsed testicle occupying a high position in the scrotum, which is termed a high-riding testicle. A cremasteric reflex should be elicited next, before palpation, as absence of a cremasteric reflex is associated with...

Conception aids to

Women who wanted children were told to eat LEEKS, and not only in Wales, though Evelyn noted that the Welch, who eat them much, are observed to be very fruitful , and the Welsh medical text known as the Physicians of Myddfai lists among the virtues of leeks that it is good for women who desire children to eat (them) . Perhaps the reason for such claims lies in the Germanic peoples' belief that leeks contribute to manly vigour (Wimberley), clearly derived from their upstanding growth. CARAWAY, at least according to Gerard, helpeth conception , but he did not go into details. BIRTHWORT must obviously be included here. The doctrine of signatures, from the shape of the flowers which constrict into a tube that opens into a globular swelling at the base, interpreted as the womb and the birth passage, ensured its use to help delivery, etc., The generic name is Aristolochia, which comes from two Greek words meaning 'best birth'. As well as helping delivery, it was said to encourage conception...

Varicocele

A varicocele is a collection of dilated veins within the scrotum that look like varicose veins. It lessens a man's fertility by producing a slightly higher temperature in the testicles. A varicocele occurs in about 15 percent of all men and accounts for as much as 40 percent of male infertility problems.

Previous Vasectomy

Unfortunately, it is not just DES daughters who are affected if the woman who took the DES was pregnant with a male child, her son may experience fertility difficulties as well. According to the Centers for Disease Control and Prevention (CDC), the most common research finding for DES sons is that they have an increased risk for benign (noncancerous) growths on their testicles. Sons of women who took this drug have been found to have abnormal sperm type and motility. They also occasionally have testicular abnormalities. If you suspect that your partner has been exposed to DES, please alert your fertility specialist. In rare cases, male infertility may be inherited. This is usually diagnosed through blood samples and by performing chromosomal analysis. For example, a man with cystic fibrosis may have missing or obstructed vas deferens, the tubes that carry sperm. Another example is Klinefelter's syndrome, where the man is born with two X and one Y chromosomes (the normal is one X and...

Hormones

The hypothalamus monitors the hormone levels in the bloodstream. Just like all of the hormones within the body, the reproductive hormones are constantly being monitored and adjusted depending on your physical and emotional demands. The hypothalamus sort of acts like the CEO of a corporation, just sitting by and monitoring what's going on and barking orders from time to time. The hypothalamus will send a message in the form of gonadotropin-releasing hormone (GnRH) to the pituitary gland. In this example, the pituitary gland is the worker. It must calculate which hormones are needed and the required amounts of each and release this message in the form of gonadotropins. The specific names of these gonadotropins are follicle-stimulating hormone (FSH) and luteinizing hormone (LH). As discussed in Chapter 1, in men, FSH stimulates sperm production and LH stimulates the testicles to release testosterone.

Fertility

Given the difficulties of evaluating spermatogenesis by studies requiring semen analysis, valid surrogate variables would be useful. Indeed, semen analysis itself is an imperfect surrogate marker for male fertility for which questionnaire instruments have been developed (Levine 1988, Joffe 1997). Testicular volume provides an excellent surrogate marker of spermatogenesis because seminiferous tubules comprise the bulk of testis volume as noted in the clinical observation that testicular atrophy reliably connotes impaired spermatogenesis in infertile men. Lacking any longitudinal studies of testis size, the largest cross-sectional study indicates that testis volume is little affected by age until the eighth decade, if the

Chromosome Disorders

Klinefelter's syndrome is a sex chromosome abnormality that occurs in 1 of 600 males, with a karyotype of 47. Individuals with Klinefelter's syndrome possess an extra X chromosome XXY. Clinical characteristics are variable and include some learning and developmental disabilities, hypogonadism, small testes, and gynecomastia occuring in puberty. The condition can be managed by administering testosterone supplements beginning in adolescence. As with some other sex chromosome abnormalities, adults with Klinefelter's syndrome are usually infertile.

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