Discovery of spermatozoa during the 17 th century led to developing technologies for semen analysis in the early 1900s, and then, standard techniques were implemented during the 20 th century. Semen analysis has a pivotal role in the male infertility evaluation, and azoospermia is an important finding. Azoospermia is identified in 15% of infertile men. However, the accurate laboratory assessment of azoospermia poses certain technical challenges. Laboratories currently perform semen assessment with great variability; thus, a standard method should be used. Planning suitable management and determining the cause of infertility require a precise evaluation of azoospermia. This review aims to address the definition of azoospermia and highlight laboratory methods in the assessments of azoospermia. Basic methods such as centrifugation, repeat pellet analysis, and staining and advanced methods such as genetic testing and biomarkers have been discussed. These methods have helped in standardizing the protocol for accurate azoospermia assessments with less variability.
Humans ; Azoospermia/genetics* ; Male ; Semen Analysis/methods* ; Andrology/methods*

Since the early days of assisted reproductive technology (ART), the importance of sperm processing, employed to separate the motile, morphologically normal sperm from the semen, has been shown to be beneficial. The aim of the semen processing technique has been to remove seminal plasma and facilitate capacitation. Additionally, the presence of leukocytes, bacteria, and dead spermatozoa has been shown to be detrimental as it may cause oxidative stress that has an adverse effect on oocyte fertilization and embryo development. Hence, removal of leukocytes, bacteria, and dead spermatozoa is an important step of sperm processing for assisted reproduction. Currently, several sperm processing techniques have been evolved and optimized in the field of assisted reproduction. The requirements for in vitro fertilization (IVF), intracytoplasmic sperm injection (ICSI), and testicular sperm extraction (TESE) are different than those of intrauterine insemination (IUI). The yield of as many motile, morphologically normal sperm as possible is a prerequisite for the success of IVF insemination procedure. In ICSI, where injection of a single spermatozoon into the oocyte is performed by the embryologist, sperm selection techniques play a crucial role in the ICSI procedure. Finally, sperm retrieval in TESE samples with very low number of sperm may be challenging and requires extra care during sample processing. Additionally, sperm cryopreservation is necessary in TESE cases in order to avoid multiple biopsies.
Humans ; Sperm Injections, Intracytoplasmic/methods* ; Male ; Fertilization in Vitro/methods* ; Sperm Retrieval ; Andrology/methods* ; Cryopreservation ; Female ; Spermatozoa

Artificial intelligence (AI) is revolutionizing the current approach to medicine. AI uses machine learning algorithms to predict the success of therapeutic procedures or assist the clinician in the decision-making process. To date, machine learning studies in the andrological field have mainly focused on prostate cancer imaging and management. However, an increasing number of studies are documenting the use of AI to assist clinicians in decision-making and patient management in andrological diseases such as varicocele or sexual dysfunction. Additionally, machine learning applications are being employed to enhance success rates in assisted reproductive techniques (ARTs). This article offers the clinicians as well as the researchers with a brief overview of the current use of AI in andrology, highlighting the current state-of-the-art scientific evidence, the direction in which the research is going, and the strengths and limitations of this approach.
Humans ; Artificial Intelligence ; Andrology ; Machine Learning ; Male ; Clinical Decision-Making ; Reproductive Techniques, Assisted

The development of Chinese medicine and Western medicine andrology is based on different social background and academic systems, either Chinese medicine or Western medicine andrology has their limitations, therefore, integration of Chinese and Western medicine (ICWM) andrology is in a great need. After more than 30 years of development, andrology has made great achievements in the construction of specialized academic association, holding academic conferences and publication of academic monographs, and the research progress on this field is mainly in the combination of disease and syndrome, microdifferentiation of symptoms and signs and basic research development. However, the comprehensive theoretic system of ICWM andrology has not yet established, and the related studies are still on the primary stage. In the future studies, great efforts still need to be made to expand the methods for the investigation of ICWM, and make innovations in the field of andrology.
Andrology ; trends ; Humans ; Male ; Medicine, Chinese Traditional ; trends ; Periodicals as Topic ; Research Design

With the continuous improvement of living conditions, increasing attention is being drawn to the genitourinary health of males, which has boomed the development of uroandrology in recent years. Refractory hemospermia, infertility, and perineal pain are commonly seen in some male patients, and mainly relied on medical imaging for diagnosis in the past, which, however, has a high pseudopositive rate and cannot give an etiological explanation. Patients with these diseases often adopt conservative treatments such as medication and physiotherapy, often with poor prognosis, and those suffering frequent recurrence used to be treated by transurethral resection, laparoscopic surgery or open surgery, which are now rarely employed due to their high rate of postoperative complications, slow recovery, and easy recurrence. In recent years, transurethral seminal vesiculoscopy has gained a wide application in the diagnosis and treatment of the above-mentioned uroandrological diseases and shown its advantages of high clinical effectiveness and low incidence of complications. The review updates on the indications, methods, skills and clinical application of transurethral seminal vesiculoscopy.
Andrology/trends* ; Hemospermia ; Humans ; Male ; Postoperative Complications ; Recurrence ; Seminal Vesicles/surgery* ; Treatment Outcome

Leukocytospermia is an ill-defined and poorly understood condition affecting up to 30% of male factor infertility. Current guidelines on leukocytospermia vary significantly, although it has been linked to increased rates of infertility, uncertainty about its clinical significance, diagnosis, and treatment remains. The guidelines are conflicting with sparse data scattered across different specialties and continents. This study aims to compare and contrast available international guidelines and recommendations. In addition to these guidelines, we sought to consolidate the findings of trials over the last several decades. English language articles on human observational studies, retrospective, prospective, clinical trials and randomized control trials were searched for using the following terms: “leukocytospermia, pyospermia, and male infertility.” Articles about treatment and management of leukocytospermia that were published between January 2010 and April 2018 were included, as well as four articles referenced in best practice and guideline statements from urological and andrological associations. Disagreements on this topic are highlighted as some guidelines describe no correlation between leukocytospermia and infertility while others show that treatment leads to improvement of sperm quality by many measures including improved pregnancy rate. Various treatments have been suggested including antibiotics, anti-inflammatory medications, and frequent ejaculation. There is a need for definitive characterization of Leukocytospermia as an infectious or inflammatory marker and a re-evaluation of the leukocyte concentration threshold. Additional studies investigating rates of conception as a measure of outcome are needed, to provide greater level of evidence and generalizability of leukocytopsermia management.
Andrology ; Anti-Bacterial Agents ; Diagnosis ; Ejaculation ; Fertilization ; Humans ; Infertility ; Infertility, Male ; Leukocytes ; Male ; Male ; Practice Guidelines as Topic ; Pregnancy Rate ; Prospective Studies ; Retrospective Studies ; Semen ; Spermatozoa ; Uncertainty

ObjectiveTo know the basic status of researches on the mental health of prostatitis patients in China by statistical analysis of the literature published in the past two decades and provide some reference for such studies.

METHODSUsing the bibliometrics method, we performed statistical analyses on the publication years, journals, and authors of the articles published in the core journals concerning the mental health of prostatitis patients in China as well as on the topics of the identified studies using their titles, key words and abstracts.

RESULTSTotally, 226 related studies were identified, of which 31 (by 29 authors) were published in the Chinese core journals. As for the topics of the included studies, 102 (45.13%) focused on the role and significance of psychotherapy in the treatment of prostatitis, 52 (23.01%) on the correlation of psychological factors with prostatitis, and 23 (10.18%) on the correlation of psychopathic factors with prostatitis complicated by sexual dysfunction. Most of the articles on the mental health of prostatitis patients were published in National Journal of Andrology.

CONCLUSIONSStudies on the mental health of prostatitis patients in China are carried out in varied institutions and different directions but, however, need to be furthered and deepened. For this condition, a comprehensive therapeutic mode of "prevention-communication-treatment" is coming into being, and the methodology for related researches is gradually turning from linear to stereoscopic.

Andrology ; statistics & numerical data ; Bibliometrics ; China ; Humans ; Male ; Mental Health ; Prostatitis ; psychology ; therapy ; Psychotherapy

Objective: To investigate the value of real-time RNA simultaneous amplification and testing (SAT) in the detection of Ureaplasma urealyticum (UU) in the semen of infertile males and its clinical significance. METHODS: We collected semen samples from 542 infertility patients and 120 normal fertile men as controls in the Andrology Clinic of Nanjing General Hospital from March to September 2015. We detected UU infection in the samples using the culture method and SAT technology, respectively. RESULTS: All the UU positive cases (except 4 false positive cases) detected by the culture method were also shown to be positive in SAT. The UU detection rate of SAT was significantly higher than that of the culture method both in the infertility patients (54.1 vs 19.7%, P<0.05) and in the normal controls (42.5 vs 12.5%, P<0.05). CONCLUSIONS SAT is a rapid and accurate method for detecting UU infection in semen samples, with a higher sensitivity and accuracy than the culture method, and it can also be used to evaluate the therapeutic effects. However, the culture method has its own advantages, such as low requirement of technical equipment, easy operation, and possibility of drug sensitivity test at the same time. Therefore, SAT and the culture method can be used alternatively according to the clinical need.
Andrology ; Humans ; Infertility, Male ; microbiology ; Male ; Nucleic Acid Amplification Techniques ; RNA, Bacterial ; analysis ; Semen ; chemistry ; microbiology ; Semen Analysis ; Ureaplasma Infections ; diagnosis ; Ureaplasma urealyticum ; genetics ; isolation & purification

Researches on the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine are becoming a hot spot in andrology, but many recent studies of this kind have failed to explain the connotation of integrated traditional Chinese and Western medicine in andrology. Related existing problems include repeated researches into the same indexes of action mechanisms of different therapeutic principles of traditional Chinese medicine (TCM), Chinese herbal compound and special prescriptions, studies focusing on individual diseases but ignoring symptoms, immature syndrome models for studies of mechanisms, and too much attention to uncertain or immature target mechanisms. The stress should be placed on the action mechanisms of Chinese herbal compound and special prescriptions on male diseases and, what is more important, on the clarification of the essential principles of differentiation and treatment of TCM syndromes. In the recent years, proteomics, genomics, transcriptomics and metabolomics have shed some light upon researches into the mechanisms underlying the therapeutic effects of the disease-syndrome combination approach in integrated traditional Chinese and Western medicine in andrology. An insight into the TCM syndrome, a macroscopic inductive analysis, and a comprehension of such microcosmic aspects as the gene, protein, metabolism and metagenome may contribute to some breakthroughs and new ideas in the studies of disease-syndrome combination in integrated traditional Chinese and Western medicine in andrology.
Andrology ; methods ; organization & administration ; Biomedical Research ; Combined Modality Therapy ; methods ; Drugs, Chinese Herbal ; therapeutic use ; Genomics ; Humans ; Male ; Medicine, Chinese Traditional ; methods ; Metabolomics ; Proteomics ; Syndrome ; Transcriptome

ObjectiveTo investigate the correlation between the premature ejaculation diagnostic tool (PEDT) and International Index of Erectile Function-15 (IIEF-15) in different types of premature ejaculation (PE).

METHODSWe performed a cross-section survey among 352 PE patients received in the andrology clinic from December 2014 to December 2015 and 104 healthy men from the health examination center using basic demographic information (as on age, height, weight, education status, occupation, income, etc.), PEDT results, and IIEF-15 scores of the subjects.

RESULTSThe PE patients had remarkably higher PEDT and lower IIEF-15 scores than the healthy men (P<0.01). The PEDT score of the PE patients was negatively correlated with their total IIEF-15 score as well as with the scores in the domains of erectile function, sexual intercourse satisfaction, and overall satisfaction after adjusted for age (P<0.01). The patients with acquired PE (APE) showed a lower IIEF-15 score than those with lifelong PE (LPE) (P<0.01). The PEDT score of the APE patients was correlated negatively with the total IIEF-15 score (r=－0.391, P<0.01) and the scores in the domains of erectile function (r=－0.362, P<0.01) and overall satisfaction (r=－0.621, P<0.01), but not correlated with intercourse satisfaction, sexual orgasm, or sexual desire. The PEDT score of the LPE group was correlated negatively with intercourse satisfaction (r=－0.286, P<0.05) but not correlated with either the total IIEF-15 score or the scores in the domains of erectile function, overall satisfaction, sexual orgasm, or sexual desire.

CONCLUSIONSPE patients have a higher PEDT score and a lower IIEF-15 score than normal males. The PEDT score of APE patients is significantly correlated with the total IIEF-15 score, while that of LPE patients is correlated not with the total IIEF-15 score but with intercourse satisfaction.

Adult ; Andrology ; Case-Control Studies ; Coitus ; psychology ; Cross-Sectional Studies ; Erectile Dysfunction ; physiopathology ; Humans ; Libido ; Male ; Middle Aged ; Penile Erection ; physiology ; Personal Satisfaction ; Premature Ejaculation ; diagnosis ; physiopathology ; Surveys and Questionnaires