Cover -- Half-title -- Title -- Copyright -- Contents -- Contributors -- Foreword -- Preface -- Acknowledgements -- Part 1 Biological perspectives -- 1 The evolution of the sexual arena -- Introduction: the Scala Naturae of reproduction -- A better history of reproduction -- 'Primitive' organisms -- Provision for propagules -- Sex is not simply a recombination of mutations -- Spermatozoa and eggs are not the 'ultimate development' -- Mammals have not got the best method of reproduction -- Revolutions in reproductive theory -- Reproduction and redundancy -- Sperm competition -- Female management of males and sperm competition -- Conclusions: simplexities and complicities in the evolution of sexuality -- References -- 2 The role of sperm competition in reproduction -- Introduction -- The male reproductive system in mammals -- The testis -- Epididymis -- Penis -- Ejaculate -- Spermatozoa -- Sperm competition in humans -- Conclusions -- Acknowledgements -- References -- 3 Sperm production and delivery in mammals, including man -- Introduction -- Mating and social structure -- Anatomy of the female tract -- The need for induced ovulation -- Vulnerability to predators -- Production of spermatozoa in mammals (incorporating epididymal function) -- Genetic composition of spermatozoa -- Sperm transport in the male tract -- Maturation of spermatozoa in the epididymis -- Sperm storage in the epididymis -- Temperature and sperm storage -- Special features of the human testicle and what they might mean -- Delivery of spermatozoa -- Transfer to the female tract -- Structure of the penis -- Changes in the female tract -- Seminal plasma and its constituents -- 'Gel' in semen -- Semen characteristics -- Semen volume -- Sperm numbers -- Sperm motility -- Sperm morphology -- Conclusion -- References -- 4 The local control of spermatogenesis.

The major features of spermatogenesis -- The seminiferous cycle -- The hormonal control of spermatogenesis -- Why consider local control? -- Evidence for local control -- Leydig cell-seminiferous tubule interaction -- Sertoli cell-germ cell interaction -- The Sertoli cell and initiation of testicular differentiation -- Sertoli cell division establishes the framework for subsequent sperm production -- Interactions between stem cell factor and c-kit are critical for several processes in testicular development -- Local factors influencing gonocyte development -- Local factors affecting spermatogonial progression -- Local factors regulating development of the postmitotic germ cell -- Acknowledgement -- References -- 5 Some misconceptions of the human epididymis -- Introduction -- Comparative morphology and physiology of the mammalian epididymis -- Explanations for apparent redundancy of the human epididymis in sperm maturation -- Current concepts of epididymal function in animal models and their applicability to the human epididymis -- Function of the initial segment in absorbing testicular fluid -- Sperm maturation in animal models and evidence for the phenomenon in the human epididymis -- Sperm storage in the epididymis -- Conclusions -- Acknowledgements -- References -- 6 Transport of spermatozoa to the egg and fertilization success -- How does the spermatozoon reach the egg? -- Interactions between spermatozoa and the egg vestements -- Penetration of the cumulus -- Interactions with the zona pellucida -- Interaction with the oolema -- Excitation-secretion coupling: acrosome reaction as a parallel to transmitter release -- Ca2+ and secretion of neurotransmitter -- Structure of the transmitter release site -- Proteins of transmitter release -- The acrosome reaction -- Participation of VOCCs in the acrosome reaction -- Ca2+ in the acrosome reaction.

Other sources of Ca2+ for the acrosome reaction -- Future research -- References -- 7 Changes in human male reproductive health -- Introduction -- Testicular cancer -- Cryptorchidism and congenital malformations of the male genital tract -- Changing semen quality: historical evidence in normal men -- Changing semen quality: historical data on infertile men -- Changing semen quality: meta-analysis -- Changing semen quality: contemporary data in favour -- Changing semen quality: contemporary data against -- Changing semen quality? -- Regional variations: a possible clue? -- The cause of changes in male reproductive health? -- Conclusions -- References -- Part 2 Implications of the new technologies -- 8 ICSI: the revolution and the portents -- Introduction -- The ICSI revolution -- The ICSI failures -- The ICSI assault on infertility surgery in the male -- ICSI: the ultimate rape of the oocyte? -- The brave new world of ICSI -- References -- 9 The genetic basis of male infertility -- Background information -- Male infertility with a gene disorder -- Kallmann's syndrome -- Immotile cilia syndrome -- Cystic fibrosis and congenital absence of the vas deferens -- Androgen insensitivity -- Myotonic dystrophy -- Male infertility with chromosomal aberrations -- Klinefelter's syndrome -- 47,XYY syndrome -- Noonan's syndrome -- Prader-Willi's syndrome -- Y-chromosome deletions -- 46,XX males -- Down's syndrome -- Group of rare structural aberrations -- Robertsonian and reciprocal translocations -- Inversions -- Conclusions and future directions -- Usher's syndrome -- AKAP-82 -- References -- 10 The treatment of azoospermia with surgery and ICSI -- ICSI for oligoasthenospermia -- Sperm retrieval and ICSI for obstructive azoospermia -- Sperm retrieval for testicular failure -- The genetics of infertile men about to undergo ICSI.

Genetics of oligozoospermia and germinal failure -- Cystic fibrosis -- References -- 11 The challenge of asthenozoospermia -- Introduction -- Challenge 1: A physiologically based definition -- Measurement of sperm motility -- Subjective assessment as part of standard semen analysis -- Objective and quantitative measurements -- Motility assessment in washed sperm preparations -- Asthenozoospermia and fertility -- Prediction by conventional seminology -- Quantitative motility measurements and CASA -- Challenge 2: defining the causes of asthenozoospermia -- Metabolic defects -- Defects in the axoneme -- Defects of cell regulation -- Challenge 3: Treatment of asthenozoospermia -- Conclusions -- Acknowledgements -- References -- 12 Molecular techniques for the diagnosis of inherited disorders and male reproductive malfunction -- Introduction -- Molecular techniques -- Karyotyping -- PCR techniques -- PCR -- Nested PCR amplification -- Multiplex PCR -- Fluorescent PCR -- Quantitative PCR -- Primer extension preamplification (PEP) -- Long PCR -- Reverse transcriptase -PCR (RT-PCR) -- In situ hybridization (ISH) -- FISH -- Post-PCR analysis -- Restriction enzymes -- DNA sequencing -- Future techniques -- Comparative genomic hybridization (CGH) -- Recombinant protein expression -- Analysis of DNA damage -- Comet assay -- Chromomycin A3 and in situ nick translation -- TUNEL assay -- Diagnosis of inherited disorders -- Inherited disorders -- Chromosomal abnormalities -- Sex-linked diseases -- Single-gene defects -- Mitochondrial point mutations -- Prenatal diagnosis -- Diagnosis of male reproductive malfunction -- Semen analysis -- Testicular biopsy techniques -- Y chromosome microdeletions -- Cytoplasmic disorders and ICSI -- Spermatozoa and mitochondrial mutations -- ICSI and paternal mtDNA inheritance -- Other chromosomal abnormalities.

Suggestions and predictions -- References -- 13 Gazing into the crystal ball: future diagnosis and management in andrology -- Introduction -- History -- Diagnosis -- The seduction of ICSI -- Future management -- Genetics of male infertility -- Epigenetic factors in fertilization -- Laboratory training and quality control -- Demographic factors in male infertility -- Diagnostics - the future? -- Computers, artificial intelligence and the Internet -- Infertility - an evolutionary perspective -- Variability and human origins -- Can we prevent or delay the onset of male infertility? -- Training of andrologists -- Conclusions -- References -- Index.