Gynecology And Obstetrics Chapter 245. Within the seminiferous tubules, Sertoli's cells sustain and regulate maturation, and Leydig's cells produce testosterone required for maintenance of spermatogenesis. Endocrine regulation of the testes is discussed under Male Hypogonadism in Ch. Varicoceles are more common on the left side, where the spermatic vein empties into the left renal vein. A varicocele results in pooling of blood and higher intrascrotal temperatures.
Endocrine disorders associated with defective spermatogenesis are uncommon.
A history is obtained and physical examination is performed to search for causes of infertility. Mumps orchitis, cryptorchidism, testicular injury, exposure to industrial or environmental toxins, excessive heat exposure, acute illness or prolonged fever within the previous 3 mo, recreational drug use, alcohol intake, and exposure to diethylstilbestrol or anabolic steroids should be excluded. Semen analysis is the major test for evaluating male infertility. It should be performed after 2 to 3 days of sexual abstinence. For men who have difficulty with this method, special condoms free of lubricants and chemicals toxic to sperm can be used.