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• W2000682138 abstract "For many years, testicular function assessment has been the focus of infertility specialists who are aiming to better understand and improve treatment of male-factor infertility. Although much is known about the overall function of both testes, research so far has had little success in elucidating and defining split testicular function. In view of the extreme importance of each testicular unit in manipulating fertility, we believe that testing of split testicular function is a missed opportunity to scavenge the fertility of those at risk. Data comparing testicular and renal physiology have been accumulating, and four noteworthy features have been revealed.1Turek PJ Male infertility.in: Tanagho EA McAninch Smith's general urology. 15th edn. Lange Medical Books/McGraw-Hill, New York2000: 750-787Google Scholar First, testes are like the kidneys—paired organs that have a functional reserve that is called on when needed. Second, few semeniferous tubules have the potential to preserve fertility in the same way that few nephrons can secure normal renal functions. Third, traditional semen analysis, expressing the overall function of the two testes, may seem normal even when much testicular function is lost because of obstruction or otherwise. A similar phenomenon to what might happen when overall renal functions test normal despite substantial loss of the contribution of one or more renal units. Fourth, substantial pathological insults can affect one or both testes before a clinically evident change in the total testicular function can be detected. At that time intervention might be too late to be effective. Split renal function tests were effectively designed to assess each kidney separately.2Gates GF Split renal function testing using 99mTcDTPA: a rapid technique for determining differential glomerular filtration.Clin Nucl Med. 1983; 8: 400-407Crossref PubMed Scopus (172) Google Scholar Unfortunately, similar tests do not seem to be available for the testes. Finding an effective way of testing split testicular function could have important implications for prophylaxis and treatment of various male infertility disorders. Such tests may offer a screening tool for normal individuals who are at increased risk of gradual loss of testicular reserve. Availability could add to management of patients with borderline semen variables, such as men who have very low testicular reserves; estimation of the functional contribution of each testis may show the reduction of function to be attributable to only one testicular side that needs urgent treatment. Third, in cases of severe male-factor infertility, tests might show areas most likely to harbour sperm,3Westlander G Hamberger L Hanson C et al.Diagnostic epididymal and testicular sperm recovery and genetic aspects in azoospermic men.Hum Reprod. 1999; 14: 118-122Crossref PubMed Scopus (49) Google Scholar improve outcome of testicular biopsy for intracytoplasmic sperm injection,3Westlander G Hamberger L Hanson C et al.Diagnostic epididymal and testicular sperm recovery and genetic aspects in azoospermic men.Hum Reprod. 1999; 14: 118-122Crossref PubMed Scopus (49) Google Scholar, 4Jow WW Steckel J Schlegel PN Magid MS Goldstein M Motile sperm in human testis biopsy specimens.J Androl. 1993; 14: 194-198PubMed Google Scholar, 5Rosenlund B Kvist U Ploen L Ekstrom U Hovatta O Percutaneous cutting needle biopsies for histopathological assessment and sperm retrieval in men with azoospermia.Hum Reprod. 2001; 16: 2154-2159Crossref PubMed Scopus (15) Google Scholar and prevent cancellation of in-vitro fertilisation cycles." @default.
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• W2000682138 title "Split testicular function testing in testicular reserve assessment" @default.
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• W2000682138 doi "https://doi.org/10.1016/s0140-6736(02)07868-6" @default.
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