Skip to main content

Advertisement

Etiologie des infertilités secondaires de l’homme

Aetiology of male secondary infertility

Article metrics

  • 1597 Accesses

  • 1 Citations

Résumé

Introduction

L’infertilité secondaire se définit comme l’impossibilité d’obtenir une nouvelle grossesse pour un couple ayant déjà procréer dans le passé.

Matériel et méthode

Sur une période de 16 ans, 49 patients sont venus consulter pour un problème d’infertilité secondaire d’origine masculine. Un bilan clinique et para-clinique a permis de conclure sur l’origine de l’infertilité.

Résultats

L’âge moyen de ces patients était de 33,6 ans (de 26 à 44 ans). Les enfants vivants obtenus auparavant dans ces couples étaient en moyenne de 1 par famille, représentés par une fille deux fois sur 3, et un garçon une fois sur 3. Les résultats obtenus chez ces patients montrent que l’infertilité est due à la présence d’une varicocèle pour 15 malades soit 31% des cas, la présence d’une infection pour 14 patients soit 29%, et la présence d’une varicocèle associée à une infection dans 11 cas soit 22%.

Conclusion

deux étiologies principales se dégagent dans le cadre de ce bilan. Cependant, certaines causes restent évidentes, comme les interventions chirurgicales avec ablation de la prostate ou des testicules, ou certains traitement cytotoxiques.

Abstract

Introduction

Secondary infertility is defined as the inability to achieve a new pregnancy for a couple that has been able to procreate in the past.

Material and methods

Over a 16-year period, 49 patients consulted for male secondary infertility. Clinical, laboratory or ultrasound assessment demonstrated the cause of infertility.

Results

These patients had a mean age of 33.6 years (range: 26 to 44 years). These couples had an average of 1 living child per family, corresponding to a girl in two-thirds of cases and a boy in one-third. In these patients, infertility was due to the presence of varicocele in 15 patients (31% of cases), infection in 14 patients (29%), and varicocele associated with infection in 11 cases (22%).

Conclusion

This assessment revealed two main aetiologies, but some causes remain obvious, such as surgery with resection of the prostate or testicles, or certain cytotoxic therapies.

References

  1. 1.

    ANDERSON J.B., WILLIAMSON R.C.N.: The fate of the human testes following unilateral torsion of the spermatic cord. Br. J. Urol., 1986, 73: 847–849.

  2. 2.

    ANDERSON J.B., WILLIAMSON R.C.N.: Fertility after torsion of the spermatic cord. Br. J. Urol., 1990, 65: 225–230.

  3. 3.

    BELKER A.M.: The varicoclele and male infertility. Urol. Clin. North Am., 1981, 8: 41–51.

  4. 4.

    BRAY G.A.: Obesity and reproduction. Hum. Reprod., 1997, 12: 26–32.

  5. 5.

    CHEVAL M.J., PURCELL M.H.: Deterioration of semen parameters over time in men with untreated varicocele: evidence of progressive testicular damage. Fertil. Steril., 1992, 57: 1289–1293.

  6. 6.

    CRITTENDEN J.A., HANDELSMAN D.J., STEWART G.J.: Semen tract inflammation and male virus infection. Fertil. Steril., 1992, 57: 1294–1299.

  7. 7.

    DONG Q., HAWER F., McWILLIAM D., BANGAH M., BURGER H., HANDELSMAN D.J.: Circulating inhibin and testosterone levels in men with critical illness. Clin. Endocrinol., 1992, 36: 399–404.

  8. 8.

    FUJISAWA M., YOSHIDA S., KOJIMA K., KAMIDONO S.: Biochemical changes in testicular varicocele. Arch. Androl., 1989, 22: 149–159.

  9. 9.

    GETZOFF P.L.: Psychotropic drug induced male infertility: a case report. Infertility, 1978, 1: 53–58.

  10. 10.

    GORELICK J.L., GOLDSTEIN M.: Loss of fertility in men with varicocele. Fertil. Steril., 1993, 59: 613–161.

  11. 11.

    HAFEZ B.: Recent davances in clincal/molecular andrology. Arch. Androl., 1998, 40: 187–210.

  12. 12.

    HANDELSMAN D.J.: Hypothalamic-pituitary gonadal dysfunction in chronic renal failure, dialysis, and renal transplantation. Endocr. Rev., 1985, 6: 151–182.

  13. 13.

    HANDSFIELD H.H., LIPMAN T.O., HARNISH J.B., TRONCA E., HOLMES K.K.: Asymptomatic gonorrhea in men: diagnosis natural course, prevalence and significance. N. Eng. J. Med., 1974, 290: 117–122.

  14. 14.

    HIROKAWA M., IWAMOTO T., IWASAKI A., YAMAZAKI A., ASAKURA S., MATSUSSHITA K.: Clinical observations on fertile males with varicocele. Eur. Urol., 1989, 16: 23–27.

  15. 15.

    JAROW J.P., COBURN M., SIGMAN M.: Incidence of varicoceles in men with primary and secondary infertility. Urology, 1996, 47: 73–76.

  16. 16.

    KASS E.J., BELMAN A.B.: reversal of testicular growth failure by varicocele ligation. J. Urol., 1987, 137: 475–476.

  17. 17.

    KECK C., GERBER-SCHAFER C., CLAD A., WILHLEM C., BRECKWOLDT M.: Seminal tract infections: impact on male fertility and treatment options. Hum. Reprod. Update, 1998, 4: 891–903.

  18. 18.

    KIBAR Y., SECKIN B., ERDURAN D.: The effects of subinguinal varicocelectomy on Kruger morphology and semen parameters. J. Urol., 2002, 168: 1071–1074.

  19. 19.

    LUBBE J., RUEF C., SPIRIG W., DUBS M., SIGG C.: Infertility as the first symptom of male genitourinary tuberculosis. Urol. Int., 1996, 56: 204–206.

  20. 20.

    LUTON J.P., THIEBLOT P., VALCKE J.C., MAHOUDEAU J.A., BRICAIRE H.: Reversible gonadotrophin deficiency in male Cushing’s disease. J. Clin. endoncrinol. Metab., 1977, 45: 488–495.

  21. 21.

    MARTIN P.M.V., GRESSENHUET G., HERVE V.M., RENOM G., STENMAN G., GEORGES A.J.: Decreased number of spermatozoa in HIV infected individuals. AIDS, 1991, 6, 130.

  22. 22.

    MARTIN DU PAN R.C., CAMPANA A.: Etiologie de 350 cas de stérilité masculine. Effet de divers traitements sur la qualité du sperme et analyse de leur rôle dans la survenue de 100 grossesses. Andrologie, 1997, 7: 199–211.

  23. 23.

    MARTIN DU PAN R.C., BISCHOF P., CAMPANA A.: Relationship between etiological factors and total motile sperm count in 350 infertile patients. Arch. Androl., 1997, 33: 197–210.

  24. 24.

    MARTINEZ-GARCIA F., REGADERA J., MAYER R., SANCHEZ S., NISTAL M.: Protozoan infections in the male genital tract. J. Urol., 1996, 156: 339–349.

  25. 25.

    NAUGHTON C.K., NANGIA A.K., AGARWALA.: Patholphysiology of varicocele in male infertility. Hum. Reprod. Update, 2001, 7: 473–481.

  26. 26.

    O’BRIEN I.A.D., LEWIN I.G., O’HARE J.P., CORRALL R.J.M.: Reversible male subfertility due to hyperthyroidism. Br. Med. J., 1982, 285: 691.

  27. 27.

    OLIVA A., SIRA A., MULTIGNER L.: Contribution of environmental factors to the risk of male infertility. Hum. Reprod., 2001, 16: 1768–1776.

  28. 28.

    PAJRINEN J.T., KARHUNEN P.J.: Spermatogenic arrest and ‘Sertoli cell-colony” syndrome-common alcohol-induced disorders of the human testis. Int. J. Androl., 1994, 17: 292–299.

  29. 29.

    PAKENDORF U.W., BORNMAN M.S., DU PLESSIS D.J.: Prevalence of human papilloma virus in men attending the infertility clinic. Andrologia, 1998, 30: 11–14.

  30. 30.

    ROWLEY M.J., LEACH D.R., WARNER G.A., HELLER C.G.: Effects of graded doses of ionizing radiation on the human testis. Radiat. Res., 1974, 59: 665–678.

  31. 31.

    SALEH R.A., AGARWAL A., SHARMA R.K., NELSON D.R., THOMAS A.J.: Effects of cigarette smoking on levels of seminal oxidative stress in infertile men: a prospective study. Fertil. Steril., 2002, 78: 491–499.

  32. 32.

    SCHOOR R.A., ELHANBLY S.M., NIEDERBERGER C.: The pathophysiology of varicocele-associated male infertility. Curr. Urol. Rep., 2001, 2, 432–436.

  33. 33.

    SHARPE R.M.: Declining sperm counts in men—is there an endocrine cause?: J. Endocrinol., 1993, 136: 357–360.

  34. 34.

    THONNEAU P., BUJAN L.: Epidémiologie des infertilités masculines. Rev. Prat., 1993, 43: 936–940.

  35. 35.

    THONNEAU P.: Fertility and environment: a new challenge. Contracept Fertil. Sex., 1993, 21: 639–641.

  36. 36.

    VILLANOVA-DIAZ C.A., FLORES-REYES G.A., BELTRANZUNIGA M., ECHAVARRIA-SANCHEZ M., ORTIZ-IBARRA F.J., ARREDONDO-GARCIA J.L.: Bacteriospermia and male infertility: a method for increasing the sensitivity of semen culture. Int. J. Fertil. Womens Med., 1999, 44: 198–203.

  37. 37.

    WHORTON D., KRAUSS R.M., MARSHALL S., MILBY T.H.: Infertility in male pesticide workers. Lancet, 1977, 2: 1259–1261.

  38. 38.

    WOOLF P.D., HAMIL R.W., McDONALD J.V., LEE L.A., KELLY M.: Transient hypogonadotrphic hypogonadism caused by critical illness. J. Clin. Endocrinol. Metab., 60: 444–450, 1985.

  39. 39.

    XU C., SUN G.F., ZHU Y.F., WANG Y.F.: The correlation of ureaplasma urealyticum infection with infertility. Andrologia, 1997, 29: 219–226.

  40. 40.

    XUEZHI J., YOUXIN L., YILAN W.: Studies of lead exposure on reproductive system: A review of work in China. Biomed. Environ. Sci., 1992, 5: 266–275.

Download references

Author information

Correspondence to Jean Hermabessiere.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Darcq, C., Hermabessiere, J. Etiologie des infertilités secondaires de l’homme. Androl. 16, 155–159 (2006) doi:10.1007/BF03034847

Download citation

Mots clefs

  • infertilité secondaire
  • homme
  • varicocèle
  • infection

Key-words

  • secondary infertility
  • men
  • varicocele
  • infection