[Do viagra and fertilization in vitro announce the end of etiologic treatments in andrology?].
Viagra and in vitro fertilization (IVF) with intraovocyte injection of spermatozoa (ICSI) have revolutionized the treatments of impotence and male sterility. They are able to treat successfully most of the cases whatever is the cause of the problem. The andrologist is tempted to renounce to look for an etiological factor and to treat directly his patient. The risk is to miss a diagnosis such as genital tract obstruction, testicular cancer, gonadotropin deficiency, sperm autoimmunity, coital disorders, or reversible toxin exposures, which could benefit from a specific treatment. Moreover IVF can endanger the woman's health and genetic consequences must not be overlooked if ICSI is performed. Concerning impotence a diagnosis of prolactinoma, diabetes or ischemic cardiopathy must not be missed because Viagra can also have cardio-vascular side-effects. This article reviews some etiological factors responsible for male infertility or impotence. The importance of a global appraisal of the patient is underlined in order not to limit his role to the one of a sperm producer.
Martin-Du-Pan
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Endocrinologue, chargé de cours à la maternité (Hôpital cantonal universitaire de Genève), 26 Bd Helvétique, 1207 Genève.
D007172:Erectile Dysfunction / Q000209:etiology / Q000628:therapy*; D005307:Fertilization in Vitro; D006801:Humans; D007248:Infertility, Male / Q000209:etiology / Q000628:therapy*; D008297:Male; D010879:Piperazines / Q000627:therapeutic use*; D011687:Purines; D012307:Risk Factors; D000068677:Sildenafil Citrate; D020554:Sperm Injections, Intracytoplasmic; D013450:Sulfones
D010879:Piperazines; D011687:Purines; D013450:Sulfones; D000068677:Sildenafil Citrate