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Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Andrologie (11662654) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The aim of these Association Française d'Urologie (AFU) and Société d'Andrologie de Langue Française (SALF) common recommendations are to provide practice guidelines for the French Urological and Andrological community regarding the evaluation of infertile men., Material and Methods: Literature search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2020. To inform the level of evidence, the HAS grading system (2013) was applied., Results: Concerning the evaluation of infertile men, the AFU and the SALF recommend : (1) a systematic interview exploring the family history, the fertility history of the man outside the couple, the patient's personal history that may have an impact on his fertility, lifestyle habits, treatments, symptoms and possible sexual difficulties of the couple; (2) a general physical examination to assess signs of hypogonadism and secondary sexual characters; (3) a scrotal physical examination performed by an urologist or andrologist to assess (i) the testes for volume and consistency, (ii) vas deferens and epididymes for total or partial absence or nodules, and (iii) presence of varicoceles; (4) Performing two semen analyses, according to World Health Organization guidelines, if the first one has at least one abnormaly; (5) a scrotal ultrasound as part of routine investigation, that can be completed with an endorectal pelvic ultrasound according to the clinic; (6) an endocrine evaluation with at least a Testosterone and FSH serum determination; (7) Karyotype analysis in infertile men with a sperm concentration ≤10 10 6 /mL; (8) assessment of Yq microdeletions in infertile men with a sperm concentration ≤1 10 6 /mL; (9) Cystic fibrosis transmembrane conductance regulator gene evaluation in case of suspicion for bilateral or unilateral congenital agenesis of vas deferens and seminal vesicles. The interest of tests analyzing DNA fragmentation (TUNEL, SCSA) is still under investigation., Conclusion: These guidelines can be applied in routine clinical practice in all infertile men., (Copyright © 2020 Elsevier Masson SAS. All rights reserved.)

Objectives: To review the state of progress of the various male contraceptive methods (with the exception of deferential methods)., Material and Methods: A review of the literature was performed by using the key words: male/contraception, limiting the search to original articles in English and French. Articles on vasectomy and the other deferential methods of contraception are not considered in the present review., Results: Three methods of male contraception are widely used at the present time: withdrawal, male condom and vasectomy, although other types of male contraception have been shown to be effective, including hormonal contraception, which appears to be the most promising technique and the subject of the majority of research. Other contraceptive methods (immunological, thermal...) could constitute possible alternatives., Conclusion: Male contraception remains under-used, as only male condoms are commonly used (apart from withdrawal and vasectomy). Consequently, new research protocols in the field of male contraception must be strongly encouraged.

The deleterious effects of chimio or radio-therapy on spermatogenesis of men treated for testicular cancer are well known. Retroperitoneal lymphadenectomy is a risk for ejaculation process. Semen cryopreservation seems to be obligatory before any deleterious treatment. Prophylactic measures do exist such as lead protection during x-rays therapy, drugs with less toxicity but similar efficiency, selective lymphadenectomy. Moreover, positive results were reported form realised in animals to protect spermatogenesis. In men treated for testicular cancer, 4 protective studies were reported using either GnRH analogs (3 studies) or medroxyprogesterone (one study). No protective effects were obtained in these trials, and the reasons for such failure are discussed. Finally, new potential possibilities of spermatogenesis protection are suggested supported by the results of animal experiments or the occurrence of new drugs such as use of steroids, GnRH antagonist or testicular hypothermia.

Assessment of the contraceptive efficacy of a daily mild increase (1 degree C to 2 degree C) in testicular temperature during waking hours is reported in nine couples using two techniques of immobilization of the testes in a supra-scrotal position (close to the inguinal canal). With technique 1 (3 couples and 42 cycles), immobilization was achieved with a specific underwear; there was one undesired pregnancy from a man who stopped the heating for 3 weeks. With technique 2 (6 couples and 117 cycles), immobilization was achieved by adding a supplementary ring to the specific underwear; there was no pregnancy. Reversibility and safety were evaluated. These results suggest that a daily mild increase in testis temperature could be a potential contraceptive method for men.

Results of a 1981 study are complemented and analyzed with respect to epididymal histology in 94 patients undergoing uni- or bilateral epididymo-deferential anastomosis. Testicular histology was normal in all patients. Epididymal histology could be differentiated into two main groups: one with normal or only slightly altered epididymis, the other with major epididymal lesions. Repermeabilization was more frequent and of better quality (10 X 10(6) sperm/ml or more) in the first group, in which there were also all the pregnancies. Previous genital infection or injury is of poor prognosis due to the severe epididymal lesions present.

70 patients, out of a total of 664 infertile subjects with a varicocele, presenting a sperm count of less than 5 X 10(6)/ml, were operated and followed for a mean period of 8 months. 80% of the 70 varicoceles were voluminous, compared with 23% in the general population. There was a statistically significant difference between the presence of a large varicocele and the presence of testicular hypotrophy or a sperm count of less than 5 X 10(6)/ml. Histological examination of 80 testes revealed a defect of maturation in 36% of cases (T2), corresponding to reversible histological lesions. The histological lesions predominantly involved the tube (66%) followed by the basement membrane (52%) and the interstitium (42%). The difference between the pre- and post-operative sperm counts was statistically significant (p less than 0.001). We obtained a 36% paternity rate after a mean post-operative delay of 8 months. The authors consider that the larger the varicocele, the more severe the histological lesions (maturation defect = T2). These cases have a very good chance of post-operative improvement as a result of restoration of spermatogenesis. This improvement is more marked when the lesions of the basement membrane and interstitial lesions are less severe. This concept of a "large pathogenic varicocele" which responds well to surgical cure raises doubts about the concept of sub-clinical pathogenic reflux detected by Doppler examination or by phlebography resulting, far too often at the present time, in an embolisation procedure.