[Testosterone deficiency and the problem of normal values]

[Testicular sperm extraction and intracytoplasmic sperm injection : Are there useful predictors of pregnancy and take home baby rate?]

Among married couples in Germany, 3-9% suffer from infertility. Due to the tremendous changes in reproductive medicine, several successful approaches including ICSI after operative sperm retrieval are available.The age of the woman has a positive predictive value for the ICSI outcome, but for the male partner no predictive value for any parameter before TESE and ICSI has been demonstrated. Therefore we investigated whether there is a parameter before TESE that will elucidate the question of success of assisted reproduction after successful sperm retrieval.The outcome of 108 married couples that were treated consecutively for infertility with one or more TESE were investigated to determine whether the man's age, FSH concentration or testicular volume has a significant influence on the success of this therapy. None of the parameters had a positive predictive value about the outcome that could enhance the counselling of these couples before operative sperm retrieval.

[LOH (late-onset hypogonadism) or the "aging male"]

Due to lacking evidence of the data about testosterone deficiency of the aging male or LOH (late-onset hypogonadism), this subject is still a challenge for urologists, endocrinologists, and dermatologists or andrologists. This challenge faces basic research as well as clinical investigations. We have to accept responsibility for solving this challenge to better understand and better treat our patients beyond the scope of current guidelines.