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  • Infécondité Masculine
  • Infertilite Secondaires
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Etiologie des infertilités secondaires de l’homme

Aetiology of male secondary infertility

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. 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.

    CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  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.

    Google Scholar 

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

    PubMed  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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.

    CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    Google Scholar 

  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.

    Google Scholar 

  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.

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

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

    PubMed  CAS  Google Scholar 

  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.

    Google Scholar 

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

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

  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.

    Article  PubMed  CAS  Google Scholar 

  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.

    PubMed  CAS  Google Scholar 

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

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