Talk:2015 Group Project 2

2015-10-15T10:22:33Z

Z3462124: /* Peer Review */

{{ANAT2341Project2015discussionheader}}

--[[User:Z5016784|Z5016784]] ([[User talk:Z5016784|talk]]) 14:42, 13 October 2015 (AEDT) Just regarding the peer reviewing of other group projects, do we have to be assessing all 5 other projects?

--[[User:Z8600021|Mark Hill]] ([[User talk:Z8600021|talk]]) 11:16, 25 September 2015 (AEST) Hmm still a little thin. There should be some animal model info, histology images, physiological data, drug info, and genetic information.

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 17:15, 18 August 2015 (AEST) Hello there

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 16:12, 24 August 2015 (AEST) Hey guys! So I've gone and added a few subheadings that may be useful to start researching. For this weeks assessment we need to choose one each and find 3 articles to go with it etc. So if we all choose one and start researching it, that would be good :)

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 11:02, 26 August 2015 (AEST) Good article for treatment http://humupd.oxfordjournals.org/content/16/5/459.abstract?etoc

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 19:20, 26 August 2015 (AEST) Sweet, Thanks for putting up those headings to get things going. Lets all put up related documents by Thursday so we have can discuss things at the Lab this Friday!

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 19:29, 26 August 2015 (AEST) I've put up some interesting pubmed documents on our main page, Have a read through them (I haven't read them all yet)

=== '''Classifications of Ovarian Hyper-stimulation Syndrome''' ===
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Classification'''
! scope="col" width="650px"| '''Symptoms'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Mild'''
|style="height: 75px; background: #CCEEEE;"| '''Grade 1''' - Abdominal distention and discomfort
'''Grade 2''' - Abdominal distention, discomfort with nausea, vomiting and/or diarrhea and ovarian enlargement from 5~12cm
|-
|style="text-align:center; background: #EEEEEE;"| '''Moderate'''
|style="height: 75px; background: #EEEEEE;"| '''Grade 3''' - All features of Mild OHSS with ultrasonographic evidence of ascites
|-
|style="text-align:center; background: #CCEEEE;"| '''Severe'''
|style="height: 75px; background: #CCEEEE;"| '''Grade 4''' - All features of Moderate OHSS with the addition of clinical evidence of ascites and breathing difficulties present
'''Grade 5''' - All of the above symptoms along with a change in the blood volume, increased blood viscosity due to coagulation and diminished renal function
|}

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 11:40, 28 August 2015 (AEST) I wont be able to make it to uni today for the lab and the meetup after it. Got to take my cousin to the ER

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 12:07, 28 August 2015 (AEST) I was thinking to include the risk factors in the 'causative' subheading

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 13:22, 28 August 2015 (AEST) So basically in the Causative subheading, I was planning
1) Identify the different causes (including primary and secondary risk factors)
2) What difference occurs from a normal cycle (e.g. level of hCG normally)

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 13:36, 28 August 2015 (AEST) No problem! I hope your cousin is okay. Whoever added a sub heading called: Tests and Diagnosis, there already is the same kind of subheading, Symptoms and Diagnosis so we need to merge the two. It also needs to be in chronological order

--[[User:Z3372824|Z3372824]] ([[User talk:Z3372824|talk]]) 13:46, 28 August 2015 (AEST)Hope he gets well! Talking about sections, I'll try and work on Prevention, and get the research summaries done for that section by next week.

--[[User:Z3372824|Z3372824]] ([[User talk:Z3372824|talk]]) 14:00, 28 August 2015 (AEST) J and I had a little discussion about how we're going to go about completing this. We can all work on each others sections and collaborate that way. Let's focus on finding research articles, collating them, referencing them i.e. get to the meat of the matter. Once we've done that we can cut to the point and make it more easy-to-read/user-friendly. We also think that our 1 wiki page reference should be the OHSS Wiki page. Also, when writing about your section, always compare/refer to the Controlled Ovarian Stimulation case. Bring those picture/youtube suggestions in!

--[[User:Z3374116|Z3374116]] ([[User talk:Z3374116|talk]]) 00:12, 29 August 2015 (AEST) Sweet, thanks for the info. Will be on the lookout for youtube clips and pictures. Is the OHSS wikipage you are referring to https://en.wikipedia.org/wiki/Ovarian_hyperstimulation_syndrome
this one?? And I agree on helping each other with respective sections and then cutting it down to the fine details

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 21:49, 1 September 2015 (AEST) Yes, that's the wiki page :) I have already started taking down information from it in each section so when you see '''[OHSS Wiki]''', that's where the information is from. I just don't know how to reference something that is not pubmed yet haha

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 22:11, 1 September 2015 (AEST) Also guys please note, I have not used any info. from wiki in regards to TREATMENT and PREVENTION as it appears someone is already working on those subheadings and I don't want to interfere, so yea, that info. is still out there for you guys to use.

--[[User:Z3415911|Z3415911]] ([[User talk:Z3415911|talk]]) 11:51, 13 September 2015 (AEST) Hey guys, can everyone please send me an email with your full names so I can add you on fb and make group. I feel like we need a better way of communicating. Thanks, z3415911@student.unsw.edu.au.

--[[User:Z5016784|Z5016784]] ([[User talk:Z5016784|talk]]) 16:25, 13 October 2015 (AEDT) Hey guys, i am working on a few sections, mark said not to add to the project until the peer assessments are done, so i was thinking of bringing my information to class on Friday so yous can have a look and see if it is useful enough, i will place the link to one article, it has two tables in there that i think can be used, what are your thoughts about them?
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2842872/

Video that J found!
http://www.howcast.com/videos/511910-ovarian-hyperstimulation-syndrome-infertility/

==Peer Review==

This wikipage is very well put together. Your choice of headings, subheadings and tables and images is remarkable, it definitely makes the whole page flow very well. I particularly like the hand-drawn image which does a great job at simplifying the process of the pathogenesis of OHSS.

The introduction very concisely explains the contents of the page and I liked how it was finished off with a statement about the aim of the page. I thought it really brought the introduction together nicely. I can’t say much about the content except that it is very engaging and very well written so well done guys! Keep up the good work!

Some suggestions I have that could improve your page include adding more images. It would be nice to have some graphs to complement the statistical date from the epidemiology. Also, in some of the paragraphs e.g. in the last paragraph of ‘Epidemiology’ there isn’t a citation that accounts for the information at the end of the paragraph so that should be fixed.

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This page clearly and efficiently explains the topic of choice. It covers all relevant matters well and the text is descriptive and informative. After reading the page, I felt as though I had a greater understanding of the topic. The subheadings used are good, and are placed appropriately in order - providing an element of cohesiveness between the page and the topic in general. Good use of linking statements – connecting all the elements discussed on the page.

There is however an excessive amount of text used. Although the information is relevant and informative, the page is dense and reading all at once is tiresome. Reducing/sifting through the amount of text on the page – and also adding a great deal more media files will help to break up the denseness of the page. There is only 1 image on the whole page – greater attention needs to be paid to alternative media files and sources to help break up the page. Additional media files will also add to increasing the understanding of readers.
The diagram drawn is neat and cited correctly. --[[User:Z5015534|Z5015534]] ([[User talk:Z5015534|talk]]) 15:07, 13 October 2015 (AEDT)

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This Wiki covers the topic well. The content is very well written and easy to understand. Images and texts are correctly cited and referenced. In some of the sections, eg, ‘Ovulation Induction’, ‘Avoiding hCG during Luteal Phase Support’, more in-text reference will need to be added.

It is a great idea to have some bold texts in lines, which highlight the main points of paragraphs, and help readers to understand when skimming.

The hand-draw diagram of ‘pathogenesis of OHSS’ is excellent. It is well structured, and easy to understand and memorize. It will be great if more images, diagrams, videos can be added to the other sections.

Overall, the project page is very well developed. Some of the sections need to have more work on though. It would be nice if more graphs and tables can be added to balance the texts.

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So far your wiki page gives a very good coverage of Ovarian Hyper-Stimulation Syndrome. The progression of your subheadings progresses logically from one topic to another. It's good to see that you've included an excellent hand-drawn image which is well suited to the 'pathophysiology' subheading. The amount of textual information you have under each heading is vast and gives a comprehensive description of OHSS. Furthermore, you have an excellent range of sources to support your discussion.

I feel however that asides from your hand-drawn image, your use of images and other source of media is definitely lacking. As is, your page is largely text with little to no breaks, making it quite difficult to read. The use of images would not only help break up the monotony of the text, but also help reinforce some of your ideas. I feel that the inclusion of images in the 'symptoms' and 'complications' subheadings would be suitable.

It may also be worthwhile to include subheadings concerning current research, to inform readers about contemporary developments regarding OHSS. Furthermore, 'future research' could also be another potential subheading and could illuminate potential areas that are beginning to be or could be investigated in coming years.

Overall, a very impressive page so far, that could be enhanced with the addition of relevant images and other media.

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Great work, it looks like your group has a clear mindset and direction to where your group project is going, even if it is not there yet. Also great introduction! Your entire page's contents were introduced well and simple. However, all Text and no images were included except one image. Not a good look to go through. The information here is good but is also very dense and hard to follow without any images. It would be great if you could break it up a bit with more images, tables, diagrams and hand drawn pictures. This style of writing is very professional and would be perfect for a report or essay; however as a wiki page it is too hard to follow. Breaking up the information into tables and short videos would allow you to guide the reader through your topic. Well done on the use of bullet points make it easy to follow. Only one hand drawn image as well as one table uploaded onto the page contains adequate information explaining them, which is good.

Well done on use of “Glossary” section. It is indeed necessary and important.

There has clearly been a lot of research and work put into this project and that is very commendable and I do appreciate it. However on a whole as I mentioned, there is too much information without having any interactive techniques such as tables, diagrams and etc. One of my suggestions is to make a table for “Prevention” or “Genetics” section or even both. I also suggest adding another subheading for “current research findings” or “Future research” which requires more time and research. Therefore you can include more journal articles in this section .In this section pictures would also be good to help understand and engage readers. Overall, well done on your written information for each section. They’re very relevant to the topic and to the project as well.

Some sections like “Effect on the Newborn” or “Animal Models” seem to be untouched. I’m assuming you are still in the process of adding content. Please be aware of the deadline. Moreover, in text citation is crucial which are missing in some paragraphs. Citations should be carried through the entire page to know exactly where you have got your information from. Good job on referencing at the end of the page. All research articles seem to be relevant to all sections.

Overall, it is a really good project with the potential to be excellent because of the amount of effort you have put into the research. Keep up the good work, but just edit and add those things I mentioned to the project and finish the sections you need to. Very well done so far and good luck with finishing the project off.

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I found your topic very intriguing! It appears as though you have put a lot of time into researching your area and ensuring that your have addressed the main concepts.

'''COMMENDATIONS'''

• Fantastic introduction! It gave me a clear overview of what your group’s topic is, and it was easy to understand.

• Great overview of the symptoms. Your table added some colour to the page and the information was succinct.

• You are to be commended on your hand drawn image - very clear and neat. Good job!

• Clear reference list and good in text citations.

'''RECOMMENDATIONS'''

• A map in the Epidemiology section would put your text into perspective for the reader.

• Some words have been typed in bold (particularly in the Diagnosis section). The selected words seem to be a bit random. Maybe you could highlight phrases rather than words, or organise the information under subheadings.

• More images would break up the information and aid the reader’s understanding of the given concepts. Subheadings would also help organise the information to place ease on reading and comprehension.

• Your page features large chunks of text for the most part. I would recommend reading through your text and removing excessive bits of information; try and be a bit more succinct. You could use more tables and diagrams to communicate certain concepts as well (e.g. Treatment and Diagnosis).

• Information is absent under “Animal Models” and “Effect on the Newborn.”

With this said, your group has covered all the key concepts and it is evident that you have done a lot of in depth research. You are definitely on the right track.

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Collectively, this page is well structured and shows you have a well-rounded understanding of this topic. The introduction encapsulates the whole topic extremely well and provides a good framework for the rest of the page. The headings are relevant and follow the structure to discuss a disease, thus being very easy for the reader to grasp the key concepts of the syndrome. Perhaps consider using bullet points in your “Causative Agents” section and “Prevention” heading. You can also utilize numerical steps to describe the pathogenesis of OHSS to accompany the well-structured diagram, and to break up the text in your page.

I have also noticed that the page is lacking subheadings in a few sections, thus it prevents the reader from knowing the key points that are being discussed and explained. Together with the subheadings that are already present, they can also be used under “Diagnosis” for each diagnostic tool, “Genetics” for VEGF, LHR and BMP-15, and possibly in the “Animal Models” section. The content under each of these headings however, is very interesting and has been written well, showing you have gained a thorough understanding of OHSS. I am certain the content you add for the untouched headings will also be of a high standard. On that note, further explanation about treatments and complications of OHSS could be added. These sections are currently lists therefore they can be further expanded with more research and videos to explain things like surgery procedures.

The glossary provided is extremely beneficial however; more diagrams, tables, and videos should be incorporated to further enhance the reader’s understanding. At the moment it is quite content heavy and needs visual aids to make the page more interesting and easy to read.

This page also demonstrates that you have thoroughly researched each aspect of OHSS, and have used recent studies to support the content added. The resources have all been cited correctly, but perhaps search for more literature to further support your claims and theory regarding OHSS.

I am really impressed with your page so far. Using more references, visual aids, and adjusting the format of this page will guarantee a successful mark. Well done!

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I’d like to start by commending you on an exceptional choice of key points which you have chosen to research and elaborate on. They provide a good overview of the subject for your readers. They are clearly explained and taught at a peer level without dragging on with irrelevant points. Your introduction is well written, I especially like that you have included the aim of you wikipage in the introduction and the key points you will be focusing on to orient your reader. Including epidemiology was also a good choice as it shows the relevance and impact of Ovarian-stimulation syndrome in society. I also find that including prevention and treatment is great for visitors without an embryology background who are looking for general information on the topic, especially for women who can learn to better reduce their risk since this page is accessible to the public.

Other great aspects of your page include the inclusion of a glossary for readers to refer to when they are unclear on the terminology and that you have used relevant sources. The table used to organize the symptoms makes its easy to read and understand. I particularly liked your section on the pathophysiology. Not only is it explained well but you have included a great hand drawn diagram that is clearly drawn, complements the adjacent paragraphs well and includes a statement with permission to other visitors to reuse it.

Going forward your main focus’ should be conducting further research to complete your remaining key points on the effects on the Newborn and animal models (very relevant for embryology peers). Also, focus on including more supporting diagrams and figures since so far you only have one. A histological image of the ovaries would be very appropriate to your topic. Make sure you read over your page to edit your grammar and wording for example in the phrase “they are given to assistive medication”. Your citing is well done, but make sure when you are referencing websites that you include the retrieval date such as in reference 11.

Overall your page is well written, with my main concern being is it sounds more like a report than a peer teaching page. You can fix this by adding more images, diagrams, figures and tables to break up the text and help to explain your content. Adding a video would also be engaging. Otherwise, great progress so far!

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Everyone seems to have already commented on your introduction, but it will not deter me from giving you another amazing high five! That introduction is so well thought out and structured that it has set up the entire page in an easy to read and easy to understand way- amazing work!! The page as a whole was fantastically structured and I found it very easy to follow which made the experience of reading and learning about the topic. Furthermore the topic was outstandingly researched with a wide variety of sources and really demonstrated the time and effort that you guys have put into it so great job; however, one thing that lets you down here is that there are some citations missing or large chunks of writing that are not cited which is a shame because it is evident that you have put in the time and effort. The language that has been used through out the page, although very formal, was appropriate and made it easy to understand the information. This was further aided by the inclusion of the glossary which is a necessity and was very well planned. I also really enjoyed the inclusion of the section "Epidemiology" as it provided a comprehensive snap shot and scope of the disease.

Some aspects that you could improve on include the inclusion of more images, videos, graphs and tables. Again, everyone seems to have commented on this, there is too much writing and it makes it difficult to follow and stay concentrated on the information. Another point to improve on would be further explanations about the treatment and prevention, this would be highly beneficial as it not only would provide information to students but also relevant and useful information to the public as the site is public facing. Lastly, the information missing below the “Effect on the Newborn” and “Animal Models” section will add another layer of detail and ultimately complete the page.

Overall, you guys have done an amazing job- the main area of improvement is the inclusion of more interactive and visual elements that can break up the chunks of texts and make the page more well-rounded. Awesome work and I look forward to seeing the end result!!

User:Z3462124

2015-10-15T10:06:21Z

Z3462124:

Talk:2015 Group Project 1

2015-10-15T09:59:37Z

Z3462124:

{{ANAT2341Project2015discussionheader}}

==Stem cell presentation==
Hi, I have listed some papers which I am interested in doing because it is highly relevant to my own project. But I am more than happy if you post other papers and topics which interest you and we can work on them together and get ready earlier.

PMID 26295456

PMID 26439174

PMID 24837661

PMID 26418893

'''PMID 24981862'''

Hey, my pick would be C. Sturgeon et al. Wnt Signaling. purely on ease of doing a review. PMID 24837661. If that suites people. --[[User:Z3292373|Z3292373]] ([[User talk:Z3292373|talk]]) 15:51, 12 October 2015 (AEDT)
==Useful resources==

Here is a good source for overview and status of 3 Person IVF. http://www.geneticsandsociety.org/article.php?id=6527

==Mitochondria==
*discovered in muscle by Kölliker in 1857
*mitochondria are the "powerhouses" of the cell and the location where respiration occurs at the cellular level.
*mitochondria contain their own DNA (mitochondrial DNA or mtDNA) that has been originally inherited only from the oocyte (maternal inheritance).
*The spermatozoa (paternal) mitochondria- energy for fertilization motility but are generally destroyed during the first mitotic cell divisions.
*This pattern of inheritance has important implications for a variety of mitochondrial associated diseases, usually occurring in tissues requiring lots of energy (muscle, brain).

[[File:Mitochondria EM01.jpg|200px|thumb|Electron micrograph of mitochondria.]]

===Eukaryotic mitochondrial genomes===
*double stranded circular DNA (mitoDNA. mtDNA)
*1981 complete human sequence (16,569 nucleotides)
**37 genes
**encodes 13 polypeptides involved in oxidative phosphorylation
*remaining genes transfer RNA (tRNA) and ribosomal RNA (rRNA)
*multiple copies within the matrix
*maternally inherited
*remainder encoded by nuclear DNA
*proteins made in cytosol and imported into mitochondria

link to Embryology website [[Mitochondria]]

==Chat==

--[[User:Z8600021|Mark Hill]] ([[User talk:Z8600021|talk]]) 11:13, 25 September 2015 (AEST) OK so just text on your page to date and not yet a thorough coverage of the topic. Animal models, timeline, images, diseases.

--[[User:Z8600021|Mark Hill]] ([[User talk:Z8600021|talk]]) 16:07, 21 August 2015 (AEST) I think you will have 3 students and therefore will exist as a group.

--[[User:Z3251292|Z3251292]] ([[User talk:Z3251292|talk]]) 17:29, 21 August 2015 (AEST) hi all,sorry that I still could not make my way to uni today due to illness. I will definitely be back next week. I have added few sub-headings to the points you guys setup, feel free to change them. BTW, would you like to pick one of the 5 topics for now? and start working on it? or there was some good arrangement already? please let me know.

--[[User:Z3292373|Z3292373]] ([[User talk:Z3292373|talk]]) 20:51, 24 August 2015 (AEST) Hey, ummm sorry i lead us astray putting up those headings ''female fertility'' had been taken so we have to pick another. I put up the list of ones left. My choice would be three parent ivf. So ill do a bit of research and on that now (add some headings)just 'cuase i got some free time, but by all means if you guys would like to do something else that interests you I'm more then happy to change.

--[[User:Z3251292|Z3251292]] ([[User talk:Z3251292|talk]]) 13:19, 27 August 2015 (AEST) Hi all, I am good with your choice. let's work on 3 person embryo. i have added few papers I find good on this topic.

===General===

Note to self doing history benifits.

===Section===

==Peer Reviews==

===1===
This wiki page does well in covering a lot of areas relating to the topic, however the website does not outline the information found/used quite clear enough or to the right extent. The page would benefit largely in focusing much more attention to the mechanics of the process itself and how it physically works. There is lots of information regarding other various aspects relating to the topic, however the fundamentals of the topic are not clearly discussed on the page, and it is not clear what goes on in the process.

The page should also fix up some grammatical and syntax errors. Read through the page carefully and ensure all paragraphs make sense ensuring that the quality of the information portrayed is fully appreciated. To also make the page clearer, some thought should be given to rethinking the order of the subheadings. Having a natural cohesion throughout the page as a whole is important – some subheadings do not fit into place correctly and could be moved around a little bit. Also having linking sentences within paragraphs – involving each subheading with others and the topic as a whole – will make the page much more cohesive.

The page used a good amount of supporting pubmed articles, hwoever more images/media files could be used to break up the concentrated use of text. The video used is relevant and informative – however there is no copyright information.--[[User:Z5015534|Z5015534]] ([[User talk:Z5015534|talk]]) 22:44, 10 October 2015 (AEDT)

===2===
Hi guys! I'll start of by saying that the images and video you have included are excellent and are relevant to your topic of discussion. Also, you have a large number of reliable references which is good to see. However you have yet to include a hand drawn image, which is required for the wiki page. I feel like you could probably eliminate the typed out 'timeline of mitochondrial donation' and instead use this as an opportunity to use a hand drawn image of the timeline. Furthermore, the timeline under 'cystoplasmic transfer' feels a bit awkward and unnecessary. You could probably include this timeline alongside the 'timeline of mitochondrial donation'.

Under the 'Technical Progression' section it would be best to incorporate human embryo, mouse and human models under a sub-sub heading, as at the moment it feels a bit jumbled.

I would also recommend moving the 'Benefits' heading towards the end of the page. It feels odd reading about the benefits of three person embryos before I gain a proper understanding of how they work. Also it might be worth talking about the disadvantages (if there are any) to three person embryos to balance out the 'benefits' section. As has been previously stated, make sure you sort out the copyright information for your video as it would be a shame to lose marks if it was missing. Also, don't forget to add the 'student template' to the 'Swapping mitochondrial DNA mammalian oocytes' image as it is currently absent.

===3===
The entire project is presented simplistically and all the content is relevant and easy to understand. Majority of the flaws I found were based around poor grammar and syntax which could be fixed up with some editing. Below is a more detailed breakdown of some of the things you could fix.

Firstly, I liked that the introduction was brief and concise and gives the reader a basic understanding of the topic of three person embryo. The video was also informative and provided some background information around the topic. I was informed that mitochondrial DNA was the major factor concerning this topic however there was a lack of information about its importance to the body so a short summary could be included along with some examples of diseases it could cause.

Also, the use of a timeline to present the history is a great idea and I think it could be improved and would look more aesthetically pleasing if it were to be placed into a table. I also think the 1990s, 2000s and 2010s label could be removed to make it look less clustered since they aren’t particularly necessary.

Some information under the heading ‘Technical Progression’ has yet to be filled in but from what is there I’d like to suggest exchanging the bullet points for numbering instead for the information under ‘Pronuclear transfer’ and ‘Polar body transfer’ since they sounded like sequence steps as opposed to separate points.

Finally, I found the layout of the table under the heading ‘Legal status’ to be very well put together. There are however some countries placed under the incorrect continents and I found that the order was easily changed and mixed up. I also noticed that several of the countries were linked to the same sources which made the information very unspecific. Instead of just links I think a few sentences explaining the legislation would be more informative.

===4===

I liked how you guys started the introduction and provides partially a brief overview of what your project is about. But I believe it is not enough to allow the audience an insight to your project page. This is something that needs to be worked on and maybe add some images also. However, the choice of short video used in the introduction is great. This is definitely a benefit for your page as it will reinforce the information you have been trying to get across. Like I mentioned, one thing you could work on is adding images and explaining the content in more depth. There is great amount of reference at the end of the page in the reference list which is fantastic!, however there is no in- text referencing in each section such as introduction or in some of the parts of the “Technical Progression” like “Cytoplasmic transfer” or “Spindle-chromosome transfer”. Having in-text referencing will allow the audience to know exactly where the information was read from and for the interest of the audience can read that specific paper in detail.

I also noticed that there are no information for “Benefits” and “Legal Status” or there is limited information for such headings like “Ethics”. I’m assuming you didn’t get the chance to upload information there or you haven’t had the time. This is something you need to work on so that the audience has some note of what this page is about. Also you need to change the format of the page for example it is to move the 'Benefits' heading towards the end of the page after the audience gained a good level of understanding of the project. You included some great images but be careful with copyright as I didn’t see it. But also consider some more images, tables, diagrams as well as hand drawn images in some sections, to make it more inviting and not overwhelming with just content. I do appreciate that the section of “Technical Progression” is subdivided into “Human Model”, timeline” and etc. But maybe consider adding in the current research, historic research, limitations and disadvantages to ensure that you can get all the marks possible by addressing all the key concepts. The timeline is a great idea that outlines the significant progresses and in turn helps put major events into perspective, making it more effective for students to study and understand.

Well done on making the “Glossary” at the end. This is exactly what I would have expected to see and I used it while I was reading through your page. Also it is great to see the table in the “Prohibited” section but I would suggest you to write some sentences explaining the legislation rather than just pasting the links.

Overall, this project page has room for improvement by giving certain sections of the page the attention they deserve. Images are imperative in allowing a balance between text and the image itself. Diagrams, tables and animations can sometimes be refreshing, and less overwhelming to see them among paragraphs of content. Try and work on time management, or set a group deadline that everyone has to meet so that all the information can be well up before the due date so your group can have time to edit and add images and play around with the page comfortably. Goodluck!

===5===

It would be nice if the history section could start earlier in time e.g. who came up with the idea of 3 person embryos. It kind of feels as though 3 person embryos popped out of nowhere. This is just a small nuance but the first sentence in “Hereditary mitochondrial Disease” doesn't really make sense. It sounds incomplete. I think you have too many timelines going on in your page and it makes it a bit confusing. There is one under “History” and another timeline in “technical progression”. I understand they may be timelines for different things, but it’s all too much history. Maybe the “technical progression” timeline could be simplified into a paragraph?

Some sections have too many subsections e.g. “technical progression”, and this makes the section messy and hard to read. It is however good for the table of contents though as it makes it easier to specify what you want to read on the page so my suggestion would be to keep some subheading but cut down a bit. You guys are listing papers to read too often. People want to have the information summarized for them on a wiki page, not have to outsource all the information themselves. It’s too time consuming and if they wanted to read a bunch of articles, they would go on PubMed themselves. However, I do like that some articles have been listed but maybe cut it down to one or two great ones instead of 4-5 etc.

I really like the table under the subheading “prohibited”, however, it would be nice to have a little summary next to the links about what each countries stance is, because again it’s too time consuming to have to read all those links. I also think some sections need a lot more work e.g. “ethics” and “benefits” and some more words could be added to the glossary. For example, a definition of what the word gamete mean would be good as, whilst we may know what it means, other people who view your page may not.

I really likes the images you used in “technical” progression. They were easy to understand and simplified the text a lot. It would be good however to add a few more images, perhaps to “history”. Some hand-drawn ones would be good. You've got a good amount of references in there, just maybe add a few more. This indicates that you have done significant research and they appear to be correctly cited. The key points of your topic are clearly described and I feel as though your intro., whilst short, really opens up the topic well. Your page relates well to the learning aims of embryology.

To conclude, I think you've got a great framework and some really good information in there. Just makes sure your page doesn't look too busy and is easy to read. A little bit more work needs to be done in some of the sections and a bit more technical touch ups and you should be good!

===6===

Your group’s topic looks very interesting! You have addressed the key points of your topic, and the placement of the video gives the reader a great overview of your project.

'''COMMENDATIONS:'''

• Information has been organised well most of the time. Good use of bullet points and subheadings.

• The table under “Prohibitions” is a great way of summarising information, and it was easy to read.

• I like the addition of a glossary, however, more terms could be added here as a lot of jargon has been used in your text.

• Cytoplasmic transfer images were great as they aided the text well. These images could be re-sized as some of the text is blurry.

'''RECOMMENDATIONS:'''

• Be mindful of spelling and capitalisation, e.g. “Hereditary Mitochondrial Disease” rather than “Hereditory mitochndrial Disease.”

• In terms of formatting, more spacing between major headings will make reading the page easier and will allow your information to flow.

• I recommend adopting a set formatting scheme for each section: i.e. make sure that the subheadings are all the same size, that they are in bold/italic (if that is what you intended).

• Some references and PMIDs are placed throughout the page. These should all be under your References heading at the end of the page.

• Information is missing under certain headings, e.g. “Mitochondria Linked Infertility.” I’m assuming that information from the two links provided will be summarised for the final submission.

• Hand drawn image is absent – maybe you could hand draw one of your timelines? (Seeing that both of them currently take the same format/structure).

Great job so far!

===7===

Thus far, I think this page has a good layout to be a successful page on Three Person Embryos. The headings and subheadings are relevant and show that you have conducted literature searches to deduce what information needs to be covered. I suggest moving “Benefits” below “Technical Progression” as it is important for the reader to understand the process of three person embryos, before learning its advantages. You could also add information about disadvantages and controversial issues.

On a positive note, I am impressed with the way you have set up headings under “Technical Progression”. The consistency of discussing a model and current research provides a systematic approach to the viewing of your page, making it easy to understand. Delving further in each of these subheadings would provide a greater understanding of the current technologies available, such as including limitations and advantages, and statistics of their success rates. The timeline under “Cytoplasmic Transfer” could probably be incorporated with the timeline under “History” to equalize the amount of content under each heading.

The content under each heading still needs work in terms of editing and elaboration. There are quite a lot of grammatical and spelling errors such as “Timeline of Mitocondrial Donation” (missing an ‘h’ in mitochondrial), and some sentences aren’t finished. Proofreading would be key to making the information more understandable and effective to the reader. Information seems to be lacking under a few headings especially “Benefits”, “Hereditary Mitochondrial Disease”, “Mitochondria linked Infertility” and “Other approaches”. To make it a bit easier for yourselves, you may want to consider using a table, flow chart for pathogenesis of the disease, and a detailed diagram of the relevant heading. You have provided a table to explain the "Prohibited Section" however a very short description/summary of each source in the table would be very helpful.

I also noticed you have not included many images, videos or tables. These visual aids really help the reader to understand the content in front of them, and also keep their interest in the topic so it imperative to focus on them as much as the content.

The references have all been cited correctly and have shown you have performed adequate research to cover the important information for this topic. As you add more information, more references should be present within the body of your page.

Overall, I think this page has a really good framework for further information to be added. With more editing, content and diagrams, you are sure to produce a wonderful Wiki page.

===8===
Your project instills a great first impression on a visitor to the page! It is a well designed webpage that doesn’t come across as overwhelming and too wordy encouraging and drawing the reader to explore your page. Your choice of content is relevant and provides a good understanding of the topic so far. The introduction is nice and succinct, explaining easily and clearly what the topic is about with a great video that complements the introduction. Together they give the reader good background information on the topic, and are taught in a way that’s easy for someone with no prior knowledge on the topic or in embryology in general to understand.

Furthermore, the timelines you provided, the ethics section and the table on the legal status of the technique is a good way of showing how far the concept has come and good at placing the technique in the context of how it has been translated into modern society. I really like that you have included animal models in explaining the various techniques, provided the current research available, and included further reading. This is very relevant and interesting for other embryology students and researchers who visit your page! The diagrams you have already chosen are very appropriate and explain the technique clearly to visual learners and are very engaging.

In improving on your page I think the main focus is to elaborate on some key points further and add a few more diagrams and pictures so you can maintain a perfect balance of words and images and the engaging layout you already have begun. For example, maybe for the section “hereditary mitochondrial disease” you can talk about the type of hereditary diseases there are. Also, some of your wording and grammar need further editing so make sure you go through and reread your work.

Other things you should edit include, adding a reference to your introductory paragraph and maybe clarifying that three person embryos are now legal in the UK since your video says “its on the threshold of acceptance”. Also check your copyright on some of the images such as the one that says “Copyright © 2015 BBC. The BBC is not responsible for the content of external sites. Read about our approach to external linking”, I am not sure if this means you are allowed to use it so just clarify this.

Overall, you have great progress on your page so far, it has a great teaching element to it and shows extensive research and citing into the project!

===9===
It’s great to begin with a introductory video which defines your topic. I do suggest finding a reference for the first paragraph for the introduction. Besides that, references have been cited correctly and shows that you have conducted extensive research, but remember to reference as you add information ( [##] ). I think you guys did a great job with the heading and subheadings; it shows us that you have done extensive literature research, and have came to a conclusion as to what information was relevant. Just a grammatical error made in “Timeline of Mitocondrial Donation” which is missing a H in mitochonidral. I suggest proof reading all the text before uploading! This will make it easier for the audience to understand and also for yourself! As to the “Benefit” heading, I think it will be a good idea to add information and case studies on disadvantages towards three person embryos.

Nice to see that you guys have included a timeline, this shows the progress made throughout the years. But I think there is still information that can be added into this area; for example: different possible approaches or more controversial issues that has emerged. “Technical Progression” is an impressive choice of heading; I found it very interesting to read. The cytoplasmic transfer images used were great! They were very easy to understand. The “Timeline” under “Cytoplasmic transfer” could be merged with the history timeline heading above.

Overall, I think more information and content needs to be added under all the headings and subheadings. To make it easier for the audience to read, I suggest adding detailed images, tables and flowcharts. It will be more eye-catching for readers and will keep them interested. I see that you guys have a table under “Prohibited Section” however that just leads to another link, rather than having the link there; I think it would be a great improvement if there is a short summary of all the sources found.

I think your page is organised and formatted very well! With more information/content, detailed diagrams and tables; it will further improve your Wiki Page! Good Luck.

===10===
Firstly, this is a very impressive wiki and I think you guys are setting the bar very high. The resources you have used and referenced are of really high quality and demonstrate that you have carried out extensive research and identified the information that is most relevant and important. The introductory video and all the images you have included are awesome and really help to solidify the information that you are presenting; they also add more depth to the page and provide further explanation and clarification of the information. The "Technical Progression" section is really great, well structured and provides a lot of explanation about the procedure that I found aided my understanding about major the concepts of the page.

My suggestions to improve your wiki page would be to have a second look at the layout and headings; I found they were difficult to follow and disrupted the flow of the page, for example the heading "Benefits" followed immediately by "Mitochondrial linked information" which was followed again almost immediately by "Hereditary Mitochondrial Disease". These headings made me stop and think about whether there was some information missing and I was just a little confused about whether the two latter headings came under the first. I really liked the inclusion of the legislation and ethics surrounding the topic (very interesting reading), however I am a bit concerned that they are the biggest portions of the page; I think this would be easily rectified by simple adding further explanations of the current research and journal articles that you have referred to instead of providing only one or two sentences about each. Lastly, it would be really interesting to present information about the controversial opinions/incidents surrounding the topics and also about the disadvantages of the procedures.

Over all, I think you guys have done an awesome job thus far and with a few minor changes the page will be amazing! Good Luck!

2015 Group Project 4

2015-10-09T12:06:07Z

Z3462124: /* Risk Factors and Prevention */

{{ANAT2341Project2015header}}

=Male Infertility=

Infertility is defined as the inability to achieve a clinical pregnancy after 12 months of unprotected sexual intercourse <ref>The World Health Organisation,. (2015). Human Reproductive Programme | Sexual and Reproductive Health. Retrieved 4 September 2015, from http://www.who.int/reproductivehealth/topics/infertility/definitions/en/ </ref>. Male infertility is the inability for a male to successfully impregnate a fertile female. Infertility is an ever increasing issue that affects one in six Australian couples as reported in the Australian Government Department of Health, ''National Women's Health Policy''. <ref>The Department of Health,. (2011). Department of Health | Fertility and infertility. Health.gov.au. Retrieved 2 September 2015, from http://www.health.gov.au/internet/publications/publishing.nsf/Content/womens-health-policy-toc~womens-health-policy-experiences~womens-health-policy-experiences-reproductive~womens-health-policy-experiences-reproductive-maternal~womens-health-policy-experiences-reproductive-maternal-fert</ref> Of these couples who are considered infertile, one in five experience problems that lie solely with the male.

==Background Information==
[[File:Components and structure of Spermatozoa.jpeg|300px|thumb|right|Virtual preparation of the spermatozoon showing the acrosome, the nucleus and nuclear envelopes, the mitochondrial sheath of the main piece of the flagellum]]
[[File:Structure of the seminiferous tubule.jpeg|300px|thumb|right|Structure of the seminiferous tubule: site of the germination, maturation, and transportation of the sperm cells within the male testes]]
===Structure of spermatozoa===
The shape of spermatozoa are suitable for the transport to female gametes via the uterine tube. For this reason the nucleus of the spermatozoa is highly condensed, covered by an acrosome filled with enzymes for establishing contact to the female gamete. The enzyme within the acrosome degrades the zona pellucida of the oocyte (female gamete), allowing membrane fusion. Spermatozoa also consist of a flagellum for progressive motility during the transport throughout the epididymal ducts. The motility is supported by the mitochondrial sheath found in the mid piece of the spermatozoa. <ref><pubmed>14617369</pubmed></ref> <ref>Holstein AF, Roosen-Runge EC. Atlas of Human Spermatogenesis. Berlin: Grosse; 1981</ref>

===Spermatogenesis===
The complete process of male germ cell development is called spermatogenesis, male germ cells develop in the seminiferous tubules of the testes throughout life from puberty to old age. The product of spermatogenesis are mature male gametes called spermatozoa. There are three major stages in spermatogenesis:

1. Spermatogoniogenesis

2. Maturation of spermatocytes

3. Spermiogenesis (which is the cytodifferentiation of spermatids)

Spermatogoniogenesis is the process where spermatogonia multiplicate continuously in successive mitosis. However, the daughter cells will still be interconnected by cytoplasmic bridges and is only dissolved in advanced stages of spermatid development. The stage of meiosis is manifested through changes in the structure of the nucleus after the last spermatogonial division. Cells undergoing meiosis are called spermatocytes. As the process of meiosis comprises two divisions, cells before the first division are called primary spermatocytes and before the second division secondary spermatocytes. During the prophase the duplication of DNA, the condensation of chromosomes, the pairing of homologuous chromosomes and crossing over take place. After division the germ cells become secondary spermatocytes. They do not undergo DNA-replication and divide quickly to the spermatids. This results in four haploid cells, namely the spermatids. These differentiate into mature spermatids, a process called spermiogenesis which ends when the cells are released from the germinal epithelium. At this point, the free cells are called spermatozoa. During spermiogenesis three processes takes place; condensation of the nucleus, formation of acrosome cap filled with enzymes and the development of flagellum structures and their attachment to the head/mid piece of the developing spermatozoa. <ref><pubmed>14617369</pubmed></ref>

===Physiology of fertility in Males===
Normal reproductive functioning in males is controlled by gonadotropin releasing hormone (GnRH), androgens and gonadatropins. The correct metabolism and functioning of all three types of hormones is essential to the normal and efficient production of spermatazoa, as well as over all reproductive health. GnRH is synthesised and released by the hypothalamus, which stimulates the anterior pituitary to release two gonadatropins: follicle stimulating hormone (FSH) responsible for spermatogenesis in the Sertoli cells and luteinizing hormone (LH) responsible for stimulating the release of androgens by the Leydig cells. Testosterone, the primary androgen, is released into the testes and aids FSH by further promoting spermatogenesis. Furthermore, testosterone is vital to the normal development of many accessory reproductive organs, including the accessory glands. A negative feedback loop of testosterone and inhibin (secreted by Sertoli cells) acts on the anterior pituitary, either decreasing or stimulating the release of FSH and LH. <ref>Stanfield, L. C. Pearson New International Edition ''Principles of Human Physiology Fifth Edition''</ref>

==Male infertility disorders==

'''Types of Male Infertility'''
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Type'''
! scope="col" width="500px"| '''Description'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Oligospermia'''
|style="height: 50px; background: #CCEEEE;"| Low spermatozoon count
|-
|style="text-align:center; background: #EEEEEE;"| '''Asthenospermia (asthenozoospermia)'''
|style="height: 50px; background: #EEEEEE;"| Reduced motility of spermatozoa within the semen
|-
|style="text-align:center; background: #CCEEEE;"| '''Teratozoospermia'''
|style="height: 50px; background: #CCEEEE;"| Abnormal spermatozoa morphology within the semen
|-
|style="text-align:center; background: #EEEEEE;"| '''Oligoasthenozoospermia'''
|style="height: 50px; background: #EEEEEE;"| Combination of reduced motility of spermatozoa (asthenospermia) and low spermatozoa count (oligospermia)
|-
|style="text-align:center; background: #CCEEEE;"| '''Obstructive Azoospermia'''
|style="height: 50px; background: #CCEEEE;"| Absence of spermatozoa within the semen due to a blockage in the genital tract obstructing the pathway for sperm to enter the penis from the testes
|-
|style="text-align:center; background: #EEEEEE;"| '''Non-obstructive Azoospermia'''
|style="height: 50px; background: #EEEEEE;"| Absence of spermatozoa within the semen due to sperm producing cells being damaged or destroyed
|}

==Causes of Infertility==
Due to the increasing rates of male infertility worldwide, researchers have been focusing on aetiological factors for its treatment and prevention. There are numerous causes of male infertility, however, the most common causes are those that relate to the correct development and adequate supply of spermatozoa to result in pregnancy, or inefficient transport of spermatozoa. The three key parameters for assessing male infertility are spermatozoa count, viability and motility<ref><pubmed>21243017</pubmed></ref>.

<html5media height="300" width="400">https://www.youtube.com/watch?v=joTrmeDf1dY</html5media>
Infertility: Causes Behind Infertility <ref>St Pete Urology. (2011, September 14) Infertility: Causes Behind Infertility. Retrieved from https://www.youtube.com/watch?v=joTrmeDf1dY </ref>

===Major Causes of Male Infertility===

====Varicocele====

[[File:Varicocele induced cytoplasmic apoptosis.jpg|thumb|right| Varicocele induced cytoplasmic level apoptosis in animals: inadequate energy supply results in the cells ability to utilise lipids as a secondary energy source to be reduced, therefore reducing normal cellular functioning and division and ultimately leading to cytoplasmic level apoptosis.]]

Varicocele is one of the leading causes of infertility in males and affects one third of individuals classified as infertile. Varicocele is the abnormal dilation of the internal spermatic veins and creamasteric veins from the panpiniform plexus as a result of back flow of blood. This downward flow of blood into the panpiniform plexus is due to the absence or presence of incomplete valves within the veins. <ref>Marmar, L.J. (2001) Varicocele and Male Infertility Part II: The pathophysiology of varicoceles in the light of current molecular and genetic information. ''Human Reproduction Update, Vol. 7, No. 5 pp. 461-472'' retrieved 2nd September 2015, from http://humupd.oxfordjournals.org/content/7/5/461.long</ref> As previously mentioned, the three key markers of spermatozoa quality and of male infertility, spermatozoa viability, count and motility, are also heavily associated with varicocele. <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref> Other causes of varicocele include an increase in programmed cell death (apoptosis), increased scrotal temperature of approximately 2.5 degrees Celcius and reduced androgen secretion leading to testosterone deprivation. <ref>Marmar, L.J. (2001) Varicocele and Male Infertility Part II: The pathophysiology of varicoceles in the light of current molecular and genetic information. ''Human Reproduction Update, Vol. 7, No. 5 pp. 461-472'' retrieved 2nd September 2015, from http://humupd.oxfordjournals.org/content/7/5/461.long</ref> Testosterone is one of the hormones that play a major role in the correct physiological functioning of the male reproductive system. It is therefore evident that a deprivation of testosterone severely affects the rate of production of spermatozoa, their maturation as well as the male reproductive systems ability to effectively ejaculate semen (related to the development of accessory glands).

====Male Reproductive Cancers====

Male reproductive cancers, including prostate cancer and testicular cancer, have been shown to dramatically decrease the quality of semen prior to treatment, being comparable with that of infertile and subfertile men. <ref><pubmed>25837470</pubmed></ref> A link between testicular cancer and male infertility has been established by the identification of Testicular Dysgenesis Syndrome (TDS). The improper or abnormal development of the testicles associated with TDS has direct links to Sertoli and Leydig cell disfunction leading to failure of gonocyte maturation and therefore insufficient or low production of mature spermatozoa; one of the key indicators of male infertility. <ref><pubmed>21044369</pubmed></ref>. Furthermore, the presence of tumors in the male reproductive system have systemic effects including immunological and cytotoxic effects on the germinal epithelial leading to reduction in the quality of sperm produced and changes in the processes of spermatogenesis. <ref><pubmed>15192446</pubmed></ref> Finally, it has also been suggested that the fever and malnutrition associated with cancer may lead to alterations in spermatogenesis, a large decrease in spermatozoa concentration and evem azoospermia, the absence of motile spermatozoa. <ref><pubmed>11929007</pubmed></ref>

====Chromosomal Abnormalities====

Chromosomal Abnormalities are responsible for approximately 5% of all cases of male factor infertility and result in azoospermia (absence of spermatozoa) and oligozoospermia (low spermatozoa concentration). <ref><pubmed>20103481</pubmed></ref> Aneuploidy is the presence of an incorrect number of chromosomes and is the most common error of chromosomal abnormality resulting in infertility. <ref><pubmed>16491264</pubmed></ref> Klinefelter syndrome occurs in approximately 5% of severe oligozoospermic and 10% of azoospermic men and causes the cessation of spermatogenesis at the primary spermatocyte stage. <ref><pubmed>15509635</pubmed></ref> Another aneuploidy associated with male infertility is Y-chromosome microdeletions, present in 10-15% of azoospermic and 5-10% of severe oligozoospermic men, that can result in lack of spermatozoa in ejaculate (AZFa deletion), arrest of spermatogenesis at primary spermatocyte stage (AZFb deletion) and low concentration of spermatozoa (AZFc deletion). <ref><pubmed>11294825</pubmed></ref><ref><pubmed>26385215</pubmed></ref>

====Damage to DNA====

[[File:Causes of Increased DNA Damage.jpg|thumb|right| Factors associated with an increase in the risk of DNA fragmentation resultant in male infertility.]]

DNA damage in the germ cell population of males has been shown to be a contributing factor to many adverse clinical outcomes including poor semen quality, low fertilisation rates and impaired pre-implantation development; an outcome significant in the use of Assisted Reproductive Technologies when treating infertility. <ref><pubmed>16793992</pubmed></ref> The integrity of spermatzoa can be negatively impacted by deficits in the DNA repair pathways resulting in decrease in germ cell survival and the production of spermatozoa. <ref><pubmed>18175790</pubmed></ref> It has been demonstrated that common inherited variants within genes that encode enzymes utilised in the mismatch repair pathway have a negative relationship with the maintenance of genome integrity, meiotic recombination and even gametogenesis, therefore increasing the risk of DNA damage in spermatozoa and male infertility. <ref><pubmed>22594646</pubmed></ref> Finally, it has been demonstrated that an increase in age is associated with increased spermatozoa DNA damage resulting in a decline in semen volume, spermatozoa motility and morphology and over all semen quality. <ref><pubmed>22429861</pubmed></ref>

====Lifestyle Factors====

[[File:Non-viable spermatazoa.jpg|thumb|right|Non-viable spermatozoa: Spermatozoa stained pink by eosin due to a damaged membrane resulting in poor semen quality.]]

There are numerous lifestyle factors that are associated with a decrease in male fertility that often cause irreversible damage to processes in gametogenesis resulting in poor semen quality. Tobacco smoking has been seen to increase risk of male infertility by up to 30% due to the competitive binding of cadmium to DNA polymerase, replacing zinc and causing damage to the testes. <ref name= PMID16192719><pubmed>16192719</pubmed></ref> It was also suggested by the same study that excessive alcohol intake has an adverse affect on spermatozoa quality and chromosome number. <ref name=PMID16192719><pubmed>16192719</pubmed></ref> Another lifestyle factor that produces adverse clinical outcomes to male infertility is obesity and its association with hypogonadatropic hypogonadism; a condition characterised by a decrease in functional activity of the gonads (hormone production and therefore gametogenesis). <ref name=PMID21546379><pubmed>21546379</pubmed></ref> Studies conducted on animals demonstrates that a sensitivity to leptin in the hypothalamus as a result of obesity, decreases Kiss1 expression, therefore decreasing the release of gonadatropin releasing hormone (GnRH) and ultimately resulting in hypogonadatropic hypogonadism. <ref name=PMID21546379><pubmed>21546379</pubmed></ref> Studies have demonstrated vigorous physical exercise such as bicycle riding and horse riding, has been associated with urogenital disorders including erectile dysfunction, torsion of the spermatic cord and infertility. <ref name=PMID15716187><pubmed>15716187</pubmed></ref>

====Immunological Infertility====

Spermatogenesis commences at puberty after the body has developed a neonatal immune tolerance, therefore, without the necessary and correctly functioning physiological mechanisms such as the blood-testis barrier to separate the spermatozoa from the body's immune response, Sperm-reactive antibodies (SpAb) form and can be found attached to spermatozoa or within the semen. <ref name=PMID12385832><pubmed>12385832</pubmed></ref> <ref name=PIMD2069684><pubmed>2069684</pubmed></ref> SpAb's have been found present in approximately 5-6% of infertile males.<ref name=PMID12385832><pubmed>12385832</pubmed></ref> <ref name=PIMD2069684><pubmed>2069684</pubmed></ref> Various microbial pathogens can infect the testes via the circulating blood or the urogenital tract, which can result in orchitis (the inflammation of one or both testicles); characterised by the infiltration of leukocytes into the testes and damage of the seminiferous epithelium, ultimately contributing to male infertility. <ref><pubmed>24954222</pubmed></ref> The disruption of tight junctions within the epididymis, rete testes and even efferent ducts due to inflammation or trauma can result in the exposure of spermatozoa proteins to the immune system and therefore the formation of SpAb's. <ref name=PMID12385832><pubmed>12385832</pubmed></ref> The presence of SpAb's on the surface of spermatozoa contribute to infertility by causing agglutination in seminal plasma, reduced motility characterised by "shaking" of spermatozoa and even the reduced ability of spermatozoa to penetrate the cervical mucous of the female. <ref name=PMID12385832><pubmed>12385832</pubmed></ref>

==Diagnosis==
Male infertility is a widespread condition. There are different diagnostic techniques to detect male infertility, from medical histories, physical examinations to sophisticated tests such as blood tests, ultrasounds and semen analysis. Most cases, there are no obvious signs showing infertility. Sexual intercourse, erections and ejaculations occur usually without any difficulty; the quantity and sperm count of the ejaculated semen are not noticeable with the naked eye.

[[File:Stages of spermatogonia.jpeg|300px|thumb|right|Infertile patient with arrest of spermatogenesis at the stage of spermatogonia]]

===Physical examination===
The physical examination focuses on the size and consistency of the genitals (testicles, epididymus and vas deferens) but also the overall body build. Noting the distribution of body hair and presence or absence of gynecomastia, which is the enlargement of male breasts due to the imbalance of hormones or hormone therapy. In some cases, by examining the size and consistency of the scrotum it is possible to palpate whether or not the epididymis may have hardened from a possible inflammation. Other cases may suggest obstruction within the ducts,this is determined by observing and examining the prostate size and consistency, checking for the presence of cysts or enlarged seminal vesicles.<ref><pubmed>21243017</pubmed></ref> Varicoceles are the most common abnormal finding in infertile men, typically diagnosed by physical examination of Valsalca manoeuvre. It is performed by forceful attempts of exhalation against closed airways by closing one's mouth and pinching their nose while pressing out. This strain increases their intrathoracic pressure and causes the venous return to the heart to decrease and increases the peripheral venous pressure.<ref><pubmed>16903932</pubmed></ref>

Varicoceles can be diagnosed by conducting Valsalva manoeuvre. <ref><pubmed>16903932</pubmed></ref> <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref>

'''Classifications of Valsalva manoeuvre'''
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Grade'''
! scope="col" width="500px"| '''Description'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Grade 1'''
|style="height: 50px; background: #CCEEEE;"| Varicocele (vein dilatation) only palpable during Valsalva manoeuvre on physical exam

|-
|style="text-align:center; background: #EEEEEE;"| '''Grade 2'''
|style="height: 50px; background: #EEEEEE;"| Varicocele palpable on physical exam without Valsalva manoeuvre
|-
|style="text-align:center; background: #CCEEEE;"| '''Grade 3'''
|style="height: 50px; background: #CCEEEE;"| Varicocele visible through the scrotal skin without performing Valsalva manoeuvre
|}

===Semen Analysis===
Although the semen parameters of fertile men can vary, semen analysis is an initial and crucial laboratory test when determining male infertility. <ref><pubmed>21243017</pubmed></ref> Every 2 to 4 weeks, at least two semen samples should be collected. 2 to 4 days prior to the collection is the abstinence period; this is important as it will increase the sperm destiny by 25%. Semen samples are obtained by masturbation or by using a latex free, spermicide free condom during intercourse.

Semen samples are required to liquefy before being studied under the microscope.

===Testicular Colour Dopple Ultrasound===
High resolution color Doppler ultrasound is a noninvasive means of simultaneously imaging and evaluating the blood flow to the testes in infertile men. It is not generally performed as a routine examination, however physical examination may miss intrascrotal abnormalities readily detected by dopple ultrasound. Non-palpable intrascrotal abnormalities includes testicular and epididymal lesions and tumour. <ref><pubmed>16903932</pubmed></ref>

<pubmed>25038770</pubmed>

<pubmed>21243017</pubmed>

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==Risk Factors and Prevention==

'''Risk Factors of Male Infertility'''
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Risk Factors'''
! scope="col" width="500px"| '''Description'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Smoking'''
|style="height: 50px; background: #CCEEEE;"| Semen quality is significantly affected by cigarette smoke. Light smoking has been associated with asthenozoospermia and heavy smoking has been associated with asthenozoospermia, teratozoospermia and oligozoospermia. <ref><pubmed>17304390</pubmed></ref>
|-
|style="text-align:center; background: #EEEEEE;"| '''Alcohol Consumption'''
|style="height: 50px; background: #EEEEEE;"| Alcohol abuse in men has been associated with impaired production of testosterone and therefore infertility. <ref name= PMID20090219><pubmed> 20090219</pubmed></ref> One study demonstrated that a typical weekly alcohol consumption of ~40 units resulted in a 33% decrease is spermatozoa concentration. <ref><pubmed>25277121</pubmed></ref> Alcohol abuse adversely affects spermatozoa morphology and production ultimately causing asthenozoospermia and therefore reducing the quality of semen. <ref name= PMID20090219><pubmed>20090219</pubmed></ref>
|-
|style="text-align:center; background: #CCEEEE;"| '''Overweight/Obesity'''
|style="height: 50px; background: #CCEEEE;"| An increase in waist circumference is associated with impaired semen parameters in infertile men. <ref><pubmed>24306102</pubmed></ref> A high body mass index (BMI) is negatively associated with normal spermatozoa morphology, spermatozoa concentration and motility, total spermatozoa count and percentage of vital spermatozoa, therefore negatively affecting male fertility. <ref><pubmed>26067627</pubmed></ref>
|-
|style="text-align:center; background: #EEEEEE;"| '''Psychiatric Considerations'''
|style="height: 50px; background: #EEEEEE;"| Stress has been demonstrated to have a negative affect on fertility, reducing testosterone levels and spermatogenesis. <ref><pubmed>22177463</pubmed></ref>
|-
|style="text-align:center; background: #CCEEEE;"| '''Physical trauma'''
|style="height: 50px; background: #CCEEEE;"| It has been demonstrated that physical traumas and vigorous exercise (often a combination of the two) can result in adverse urogenital disorders such as torsion of the spermatic cord, penile thrombosis, hematuria and infertility. <ref name=PMID15716187><pubmed>15716187</pubmed></ref>
|}

==Treatments==

Current treatments for male infertility aim to eliminate the causative factors mentioned above. These may involve improving the male's fertility using drug therapies or surgical procedures, however many assisted reproductive technologies have been introduced and have proven successful. Both methods of treatment have shown evidence of efficacy, thus having great implications on infertile couples worldwide.

===Non-surgical Treatments===

In order to effectively treat male infertility, it is imperative to correctly identify the specific cause and contributing factors. Currently, the different treatment strategies used or investigated tend to the specific aetiological factors for male infertility. Apart from theoretically allowing natural conception, these treatments also have an implication on the assisted reproductive technologies (ARTs) that are currently available.

====Injectable Hormones & Fertility Drugs====

Hormonal imbalance is a non-obstructive cause for male infertility. The efficiency of spermatogenesis depends on stimulation and regulation mainly by gonadotropins, GnRH and testosterone, without which may cause infertility. Males that have a deficiency in these hormones are being targeted by research involving injectable hormones such as human chorionic gonadotropin (hCG) and human menopausal gonadotropin (hMG), and Clomiphene citrate, a fertility drug. hCG and hMG are gonadotropins that are used to treat male hypogonadotropic hypogonadism (MHH), a condition associated with infertility causing an underproduction of sperm or testosterone, or both <ref name=PMID26019400><pubmed>26019400</pubmed></ref>. These gonadotropins have been utilised in infertile males to stimulate the synthesis of testosterone and sperm directly, bypassing the pituitary gland that normally releases gonadoptropins LH and FSH. LH triggers Leydig cells to release testosterone, and FSH plays a vital role in spermatogenesis maintenance as it promotes Sertoli cell maturation <ref name=PMID22958644><pubmed>22958644</pubmed></ref>.

Additionally, clomiphene citrate also increases secretion of GnRH from the hypothalamus, and FSH and LH from the pituitary gland by blocking feedback inhibition of serum estradiol <ref name=PMID22958644><pubmed>22958644</pubmed></ref>. Normally, males have more testosterone levels than estrogen however those with MHH and consequent infertility, may have the opposite <ref><pubmed>16422830</pubmed></ref>. This was investigated in a study conducted in 2013 by Hussein et al. showing that hCG, hMG and clomiphene citrate are suitable treatments particularly for azoospermia, increasing levels of FSH, LH and total testosterone <ref name=PMID22958644><pubmed>22958644</pubmed></ref>. Therefore the administration of these substances may correct abnormal hormone levels that contribute to male infertility, thus stimulates spermatogenesis to increase spermatozoa count, motility and viability.

====Antioxidants====

There has been increasing evidence that infertility may be directly linked to oxidative stress, thus various antioxidants have been experimented with to determine their efficacy as a treatment. Reactive oxygen species (ROS) formed during oxidation plays a vital role in sperm function, particularly in capacitation, acrosome reaction, hyperactivation and sperm-oocyte fusion <ref name=PMID24675655><pubmed>24675655</pubmed></ref>. In low concentrations, ROS are essential for the synthesis of energy, and contribute to signal transduction pathways within the cell. Usually ROS levels are regulated by natural antioxidants within the seminal plasma <ref name=PMID24675655><pubmed>24675655</pubmed></ref>. However an influx of ROS and/or a deficiency in antioxidants due to abnormal sperm or environmental stress, can lead to oxidative stress. Spermatozoal cell membranes contain high amounts of polyunsaturated fatty acids that consist of several electron-containing double bonds. The electrons of these fatty acids contribute to the formation of ROS and oxidative stress, thus causing a disruption in the flexibility of the spermatozoal membrane and diminishing the motility and sustainability of sperm <ref name=PMID19439288><pubmed>19439288</pubmed></ref>. This may result in sperm membrane lipid peroxidation, DNA fragmentation, and apoptosis <ref name=PMID24675655><pubmed>24675655</pubmed></ref>. The following are a few antioxidants that have been proven to treat oxidative stress, hence improves male fertility.

'''1. Carotenoids'''
: Carotenoids are naturally occurring pigments produced by plants, algae, and photosynthetic bacteria <ref name=Higdon>Higdon, J., & Drake, V. (2009). Carotenoids | Linus Pauling Institute | Oregon State University. Lpi.oregonstate.edu. Retrieved 5 October 2015, from http://lpi.oregonstate.edu/mic/articles/dietary-factors/phytochemicals/carotenoids</ref>. They can be divided into 2 different categories based on their chemical composition including carotenes that contain oxygen, and xanthophylls that only contain hydrocarbons <ref name=Higdon>Higdon, J., & Drake, V. (2009). Carotenoids | Linus Pauling Institute | Oregon State University. Lpi.oregonstate.edu. Retrieved 5 October 2015, from http://lpi.oregonstate.edu/mic/articles/dietary-factors/phytochemicals/carotenoids</ref>. The main source of these chemical compounds in the human diet are from fruits and vegetables as they give them their yellow, red and orange pigments. The role of carotenoids within the healthcare industry are forever growing as they have been suggested supplements for the human body, and as treatments for various cancers and possibly infertility disorders <ref><pubmed>12134711</pubmed></ref>. The antioxidant activity of carotenoids is performed by quenching (deactivating) singlet oxygen that is formed during photosnythesis by plants.
[[File:Proposed Mechanisms of Lycopene Treatment for Idiopathic Male Infertility.jpeg|300px|thumb|right|Proposed Mechanisms of Lycopene Treatment for Idiopathic Male Infertility]]

: '''Lycopenes''' are a type of carotene carotenoid that is found in various fruits and vegetables such as tomatoes and watermelon. Despite it being a source of vitamin A, it also possesses strong antioxidant properties as it is one of the most effective quenchers of singlet oxygen <ref name=PMID12899230><pubmed>12899230</pubmed></ref>. Although the exact mechanism of lycopenes is yet to be known, they have a role inneutralizing ROS and hindering their activity, achieved by their ability to donate an electron to free radicals <ref name=PMID19439288><pubmed>19439288</pubmed></ref>. As a result of this antioxidation pathway, lipid peroxidation is inhibited allowing for spermatozoal membranes to be retained and protected from further damage. Lycopenes have also been suggested to increase natural antioxidant enzymes indirectly, and also decrease the production of pro-inflammatory agents.

: '''Astaxanthin''' is a keto-carotenoid produced naturally from the microalgae ''Hematococcus pluvialis'' <ref>Willett, E. (2015). Studies Show Astaxanthin May Improve Sperm Health & Fertilization Rates. Natural-fertility-info.com. Retrieved 7 October 2015, from http://natural-fertility-info.com/astaxanthin-for-sperm-health.html</ref>. Due to its higher antioxidant activity in comparison to vitamin E, a fat solube antioxidant found in soybean and margarine, it has been suggested as an effective treatment and supplement for male factor infertility. An experimental trial to test Astaxanthin’s influence on sperm function was carried out in 2005 in 27 infertile men <ref name=PMID16110353><pubmed>16110353</pubmed></ref>. It was found that Astaxanthin allowed for the following:
*Increased motility concentration
*Improved sperm morphology and motility
*Decrease in ROS and Inhibin B (a regulator of spermatogenesis) levels

[[File:Model of the Activities of Cerium Dioxide Nanoparticles.jpeg|300px|thumb|right|Model of the Activities of Cerium Dioxide Nanoparticles]]
'''2. Cerium dioxide nanoparticles (CNPs)'''
: Cerium dioxide nanoparticles have been used extensively in the health care industry as potential pharmacological agents to treat various conditions from cancer to male infertility. These products are formed by cerium combining to oxygen obtaining a strong crystalline structure <ref name=Xu>Xu, C., & Qu, X. (2014). Cerium oxide nanoparticle: a remarkably versatile rare earth nanomaterial for biological applications. NPG Asia Materials, 6(3), e90. http://dx.doi.org/10.1038/am.2013.88</ref>. CNPs have the ability to interchange Ce 3+ and Ce 4+ ions that are present on its surface, leading to defects in oxygen within its crystal lattice structure. These regions on the surface of CNPs are ‘reactive sites’ to attract free radicals <ref name=PMID26097523><pubmed>26097523</pubmed></ref>. A research team experimented on male rats to observe CNP effects on male health and infertility, providing further evidence that oxidative stress plays a key role in preventing proper spermatogenesis <ref name=PMID26097523><pubmed>26097523</pubmed></ref>. Therefore, the electronic structure of CNPs, and thus its antioxidant properties make this material a promising therapeutic for male infertility caused or affected by oxidative stress.

'''3. Vitamin E and C'''
: Vitamin E is a fat – soluble antioxidant that exists in 8 chemical forms of different biological activity. The only form of vitamin E required by the human body is alpha-tocopherol <ref name=Wen>Wen, J. (2006). The Role of Vitamin E in the Treatment of Male Infertility. Nutrition Bytes, 11(1), 1-6. Retrieved from http://escholarship.org/uc/item/1s2485fw</ref>. This chemical compound is found in various foods such as wheat germ oil, sunflower seeds and oil, and almonds <ref name=National>National Institutes of Health,. (2013). Vitamin E — Health Professional Fact Sheet. Ods.od.nih.gov. Retrieved 7 October 2015, from https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/</ref>. Currently, the recommended dietary allowance (RDA) of vitamin E is 15 mg with an adult maximum of 1000 mg <ref name=National>National Institutes of Health,. (2013). Vitamin E — Health Professional Fact Sheet. Ods.od.nih.gov. Retrieved 7 October 2015, from https://ods.od.nih.gov/factsheets/VitaminE-HealthProfessional/</ref>. Due to the ability for vitamin E to prevent the peroxidation of PUFA, it has extremely positive implications on infertile men as spermatozoa have high levels of these compounds. From previous studies, vitamin E (alpha – tocopherol) levels decreased to 66.54% and 66.04% in oligospermic and azoospermic males respectively compared to fertile men <ref><pubmed>11225982</pubmed></ref>. Therefore there is a positive association between alpha – tocopherol levels and sperm count and motility .

: On the other hand, vitamin C is a water-soluble antioxidant <ref name=Evert>Evert, A., & Wang, N. (2015). Vitamin C: MedlinePlus Medical Encyclopedia. Nlm.nih.gov. Retrieved 7 October 2015, from https://www.nlm.nih.gov/medlineplus/ency/article/002404.htm</ref>. As an electron donor it neutralizes free radicals and also prevents ROS synthesis. As the human body does not produce or store vitamin C, daily intakes of vitamin C – containing foods are required to maintain its levels internally. Such foods with the highest vitamin C content include citrus fruits (oranges), kiwi fruit, broccoli and cauliflower. The RDA for vitamin C in male adults is 90mg/day <ref name=Evert>Evert, A., & Wang, N. (2015). Vitamin C: MedlinePlus Medical Encyclopedia. Nlm.nih.gov. Retrieved 7 October 2015, from https://www.nlm.nih.gov/medlineplus/ency/article/002404.htm</ref>. A study published in March 2015 demonstrated that infertile men administered with vitamin C had a significantly better sperm motility rate and morphology. Although it had little/no effect on sperm count, it is still a well recognizable and effective treatment for male infertility <ref><pubmed>26005963</pubmed></ref>.

====Traditional Chinese Medicine====

More recently discovered treatments for male infertility involve the hollistic principles of traditional Chinese medicine (TCM). Disregarding the conventional medicines more commonly prescribed in today’s society, the effects of Chinese herbal therapy, massage and acupuncture, have been suggested to improve sperm motility and viability of infertile males <ref name=PMID23775386 ><pubmed>23775386</pubmed></ref>. Acupuncture and massage has been proven to alleviate stress, increase blood flow to reproductive organs, regulate the immune system, and improve dysfunctions in male infertility <ref name=PMID23775386 ><pubmed>23775386</pubmed></ref>.

Additionally, Chinese herbal medicines have been widely used in experiments to prove their beneficial effects on treating infertility. The following are examples of a few herbal therapies that have been investigated.

'''Examples of Chinese Herbal Therapies'''
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Herb'''
! scope="col" width="500px"| '''Evidence'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Yi Kang Decoction'''
|style="height: 50px; background: #CCEEEE;"| 100 immune infertile males treated with this herb had greater sperm motility, agglutination, and overall increased pregnancy rates in comparison to prednisone, a steroid that reduces sperm antibody levels <ref><pubmed>16705853</pubmed></ref>
|-
|style="text-align:center; background: #EEEEEE;"| '''Hu Zhang Dan Shen Yin'''
|style="height: 50px; background: #EEEEEE;"| 60 treated infertile men showed a higher antisperm antibody reversing ratio than prednisone, thus allows for greater sperm production <ref><pubmed>16970170</pubmed></ref>
|-
|style="text-align:center; background: #CCEEEE;"| '''Zhibai Dihuang'''
|style="height: 50px; background: #CCEEEE;"| This herb was used to treat 80 cases of male immune infertility in the form of a pill, resulting in increased sperm motility and viability <ref><pubmed>25632744</pubmed></ref>
|}

===Surgical Treatments===

====Varicocele Surgery====

Varicocele repair can be performed by either percutaneous radiographic embolization or surgery to correct male infertility <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref>. The desired outcome of these procedures is to lower the temperature of the scrotum for normal spermatogenesis to occur.

Percutaneous radiographic embolization involves the catheterization of the internal spermatic vein and its occlusion using a sclerosant (injectable irritant) or solid embolic devices such as stainless steel coils <ref name=PMIDPMC2422968 ><pubmed>PMC2422968</pubmed></ref>. The administration of the sclerosant and solid embolic devices are given at the level of the inguinal crease and ligament respectively to prevent the backflow of blood into the pampiniform plexus. This method is much less invasive than surgical procedures and has very high success rates, and low recurrence rates <ref name=PMIDPMC2422968 ><pubmed>PMC2422968</pubmed></ref>.

As for the surgical approach, these methods are far more invasive but variable in terms of success rates and recurrence. It is important to note that all of these varicocele repair methods, surgery and embolisation, aim to impede increasing temperature of the scrotum caused by the pampiniform plexus.

'''Surgical Approach to Varicocele Repair'''
{| class="wikitable" style="text-align:center
|-
! scope="col" width="70px"| '''Surgical Method of Varicocele Repair'''
! scope="col" width="500px"| '''Description'''
|-
|style="text-align:center; background: #CCEEEE;"| '''Inguinal Surgery '''
|style="height: 50px; background: #CCEEEE;"|
*Involves opening the inguinal canal and the incision of the varicocele vein <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref>
*Allows preservation of lymphatic vessels
*Takes longer to heal
|-
|style="text-align:center; background: #EEEEEE;"| '''Subinguinal Surgery'''
|style="height: 50px; background: #EEEEEE;"|
*Incision below external inguinal ring
*Less pain due to the area of incision as it avoids the aponeurosis (flat tendon) of the abdominal external oblique muscle <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref>
|-
|style="text-align:center; background: #CCEEEE;"| '''Retroperitoneal Surgery'''
|style="height: 50px; background: #CCEEEE;"|
*Ligation of the internal spermatic vein
*Can be performed as a mass ligation involving the artery, vein and lymphatic vessels, or artery sparing ligation preserving lymphatic vessels <ref name=Cocuzzo>Cocuzzo, M. Cocuzzo, M. A. Bragais, F. M/ P. Agarwal, A. (2008) The role of varicocele repair in the new era of assisted reproductive technologies. ''Clinics Vol. 63, No. 6'' retrieved 2nd September 2015, from http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322008000300018&lng=en&nrm=iso&tlng=en</ref>
|-
|style="text-align:center; background: #EEEEEE;"| '''Laparoscopic Varicocelectomy'''
|style="height: 50px; background: #EEEEEE;"|
*At the level of the internal inguinal ring, the internal spermatic vein is ligated while sparing the corresponding artery <ref name=Tu>Tu, D., & Glassberg, K. (2010). Laparoscopic varicocelectomy. BJU International, 106(7), 1094-1104. http://dx.doi.org/10.1111/j.1464-410x.2010.09709.x</ref>
*Allows for a more accurate identification of vessels within the area
|}

====Ejaculatory Duct Resection====

====Vasectomy Reversal====

===Male Infertility Treatments with Assisted Reproductive Technologies (ARTs)===

It is known that males with fertility problems have little/no chance of conceiving a child with a woman. To address this issue many ARTs have been developed to allow for a successful pregnancy, which all involve the process of sperm retrieval.

====Intrauterine Insemination (IUI)====

====In Vitro Fertilisation (IVF)====

====Intracytoplasmic Sperm Injection (ICSI)====

Some ARTs allow for the male's genetic material to be passed onto the offspring, contingent upon a successful sperm extraction/retrieval such as intracytoplasmic sperm injection (ICSI). Although only a spermatozoon (single sperm) is required for this particular procedure, these treatment methods ultimately aim to "maximize the sperm retrieval yield" <ref name=PMID22958644><pubmed>22958644</pubmed></ref>.

==References==

<references/>

==External Resources==

2015 Group Project 4

2015-10-09T12:04:34Z