Editors: Marc Goldstein, MD and Peter N. Schlegel, MD
Publisher: Cambridge University Press – 351 pages, with DVD
Book Review by: Sonu Chandiram

Hope has been increasing in recent years for infertile males, write the editors of this book – Drs. Marc Goldstein and Peter Schlagel – in the Preface.

The write: “Dramatic advances in the diagnosis and treatment of male infertility allow conception for couples previously considered untreatable,” pointing out to gains from tests of sperm function, contributing to better understanding of the causes.

The editors also write that in vitro fertilization combined with intracytoplasmic sperm injection (IVF/ICSI) of a human oocyte, as discussed and illustrated in chapter 28, has ‘revolutionized’ the treatment of male factor infertility.

Sixty-seven urologists, many of whom are professors of urology and reproductive medicine, or surgeons with specialist knowledge and surgical experience on male infertility, are among the contributors to the content of this unique book.

Among others who authored the chapters of this book are those whose specialty back ground is in other fields such as andrology, embryology, gynecology, obstetrics, pathology, psychology, and radiology. They hail from all over the United States and three other countries – Canada, Denmark, and Switzerland.

The 37 chapters of this book are organized around nine sections that we name below to provide you an overview of the topics covered in this book.

  1. Section I – Anatomy and Physiology of the Male Reproductive System
    1. Anatomy and physiology of the male reproductive system
  2. Section II – Evaluation
    1. History and physical examination of the infertile male
    2. Basic laboratory evaluation of the infertile male
    3. Genetic evaluation of male infertility
    4. Auto-immunity to spermatozoa: its effect on male fertility, diagnosis and treatment
    5. Imaging of the male reproductive system
    6. Testis biopsy
    7. Vasography
    8. Evaluation for ejaculatory duct obstruction
  3. Section III – Treatment of Obstructive Azoospermia
    1. Vasovasostomy
    2. Vasoepididymostomy
    3. Ejaculatory duct obstruction
    4. Epididymal sperm aspiration
  4. Section IV – Ejaculatory Disorders
    1. Anejaculation
    2. Penile vibratory stimulation
    3. Treatment of ejaculatory dysfunction
  5. Section V – Varicocele, Hydrocele, and Retractile Testes
    1. Varicocele
    2. Hydrocele
    3. Scrotal orchiopexy for adult retractile testis
  6. Section VI – Non-Obstructive Azoospermia
    1. Non-obstructive azoospermia: evolution of clinical concepts and treatment
  7. Section VII – Non-Surgical Treatments
    1. Specific medical therapy
    2. Klinefelter syndrome
    3. Empirical and complementary treatment of male infertility
  8. Sexual Disorders
    1. Male sexual dysfunction and infertility
    2. The role of sex therapy for male infertility
  9. Section IX – Assisted Reproduction for Male Infertility
    1. In vitro fertilization
    2. Intrauterine insemination
    3. Intracytoplasmic sperm injection (ICSI)
  10. Section X – Other
    1. Male infertility and the environment: a plethora of associations based on a paucity of meaningful data
    2. Fertility issues in pediatric urology
    3. Preservation of male infertility
    4. Testis-preserving surgery for testis tumor
    5. Sperm cryopreservation
    6. Microsurgical models, animal models, and training
    7. Nursing considerations for the treatment of male infertility
    8. Cost-effectiveness of male infertility treatments
    9. Future of male infertility research and treatments

This book is valuable to established as well aspiring urologists, and especially to male infertility specialists for the many nuggets of information provided in it. Among the nuggets provided at the outset of this book in the Preface itself, are these (we quote the editors):

  • Recent studies have shown that the incidence of testicular cancer and of genetic abnormalities is higher in infertile men, emphasizing the importance of evaluating the male, even though enough sperm are present for IVF/ICSI
  • Treatment by urologists trained in male infertility can induce sperm production in men and / or extract sperm for men who have zero sperm counts
  • Urologists trained in male infertility can often provide treatments that:
    • Upgrade the fertility of infertile men from nothing to candidates for IVF/ICSI
    • Upgrade from only IVF/ICSI to intrauterine insemination
    • Upgrade to often enable naturally conceived pregnancies
  • Advances in sperm retrieval techniques as well as refinements in the management of obstructive azoospermia and varicocele have made pregnancies possible that were unimaginable only a decade ago.
  • Many conditions associated with infertility, in particular varicoele, have now been shown to be associated with a more rapid decline in testosterone levels compared with age matched men without varicocele
  • Thus, treatment of conditions that are risk factors for infertility not only can help treat infertility, but also treat and prevent androgen deficiency in the aging male.

For the above new points of information and others you will find in the DVD that comes in it when you obtain and use this book, we congratulate the editors Marc Goldstein and Peter N. Schlegel and all others who contributed content to this highly important work that is full of pioneering discoveries provided with clear and concise elucidation.



Marc Goldstein, MD, DSc (Hon), FACS is Professor of Reproductive Medicine and Urology at Weill Cornell Medical College of Cornell University in New York, Director of the Center for Male Reproductive Medicine and Microsurgery at New York Presbyterian Hospital, Senior Scientist at the Center for Biomedical Research at the Population Council in New York, New York.

Peter N. Schlegel, MD, FACS is Professor and Chairman of Urology, and Professor of Reproductive Medicine at Weill Cornell Medical College of Cornell University in New York and Senior Scientist at the Center for Biomedical Research at the Population Council in New York, New York.