Abstract
Multidisciplinary andrology deals with clinical application and modern technology for the evaluation and differential diagnosis of male infertility with emphasis on morphological, anatomical, biochemical, immunological, hereditary, and microbiological parameters. Little is known about the effects of diet, disease, stress, environmental, and drugs on male-related unexplained infertility of couples. Regional, national, and international centers of multidisciplinary andrology should provide (1) extensive and unique clinical services; (2) a computerized “patient referral center,” (3) self-learning packages (slides/ tape programs) for patients; and (4) a computer link to the National Library of Medicine and the Drug Information Center. Specialized laboratories and clinics can be served by expert consultants, visiting professors, bilingual and well-trained clinicians, nurses, laboratory technologists, computer operators, and related allied health personnel. Patient education pamphlets, updated every fews years, can be distributed during training workshops when an extensive network of remote teleprinters can be utilized. Qualified client location may install a printer to allow on-site printing of reports in the shortest possible time. Special mailing containers are provided to clients who wish to mail their laboratory specimens. Other clinical services may include the following:
1. Central source of communication and information in andrology
2. International roster of multidisciplinary andrology centers
3. Patient referral to centers and consultations for developing countries
4. Screening of husbands and wives for in vitro fertilization/embryo transfer (IVF/ET)
5. Screening of couples with unexplained infertility for sexually transmitted diseases (STDs) including AIDS
6. Exchange of research material and methodology
7. Coordination of multicenter research
8. Organizing training workshops for clinicians, nurses, and laboratory technicians
9. Establishing a repository of films, video tapes, slides, catalogs, instrumentation, books, SEM photos, and atlases
10. Publication and editorial assistance
11. Consultation for the appropriate selection, purchase, and quality control of instrumentation (all on one computer system)
12. Evaluation of new diagnostic tools for idiopathic infertility and fertility regulation
13. Laboratory manuals may include the following technical details: (a) commercially available kits for semen analysis evaluation of structure, ultrastructure, motility patterns, capacitation, and fertilizability of spermatozoa; (b) simplified kits for tissue culture media—RIA evaluation of steroids, gonadotropins, and other endocrine profile and differential diagnosis of sexually transmitted diseases including AIDS; (c) CO2/02 incubators; (d) disposable glassware; (e) water ultrafiltration systems, microporous membrane filtration, deionization, deionization reverse, osmosis, air filtration (laminar flow); (f) microscopy stereoscopy, cinematography, invertoscopy, epifluorescence, and fiber optics.