Impending famine and a terrifying rate of consumption of natural resources are vital issues which have focussed public interest in the ecologic, social and political problems of ever increasing overpopulation in many countries of the world. As well as the vast material and intellectual expenditure lavished on family planning and birth control, the past decade has seen an immense research effort in the elaboration of improved methods of fertility control, both for men and for women. During the same period, however, research into the causes of male fertility disorders has proceeded with equal intensity, and a number of promising therapeutic approaches have become the subject of clinical trials. The wish of an individual or of a couple to have offspring is an absolute which requires no further justification, and there can be few challenges to a physician as essential as the spouses' predicament in a childless marriage. Only with a special knowledge of the function, pathology and pathophysiology of the reproductive system is he properly equipped to meet that challenge.

Anatomical and Functional Aspects of the Male Reproductive Organs.- A. Testis.- I. Development.- II. General Anatomy.- III. Cytological Features.- 1. Seminiferous Tubules.- a) Replication of Stem Cells.- b) Meiosis.- c) Spermiogenesis.- ?) Formation of the Acrosome.- ß) Development of the Flagellum.- ?) Nuclear Changes.- ?) Reorganization of Cell Organelles and Cytoplasm.- ?) Spermiation.- d) Sertoli Cells.- e) Seminiferous Cycle.- 2. Intertubular Tissue.- a) Lamina Propria of the Seminiferous Tubules.- b) Interstitial Cells.- c) Vasculature.- IV. Function.- 1. Control of Testicular Function.- 2. Spermatogenic Function.- 3. Steroidogenic Function.- B. Anatomy of the Male Reproductive Tract and Accessory Glands.- I. Introduction.- II. Embryogenesis of the Male Reproductive Tract.- III. Intratesticular Ducts.- 1. Transitional Distal Segment of Seminiferous Tubule.- 2. Rete Testis.- a) Septal Rete.- b) Mediastinal Rete.- c) Extratesticular Rete.- d) Cytological Features.- IV. Epididymis.- 1. Derivation and Development.- 2. General Anatomy.- a) Anatomical Relationships.- b) Vasculature.- ?) Arterial.- ß) Venous.- ?) Lymphatics.- c) Innervation.- 3. Cytological Features.- a) Ductuli efferentes.- ?) Epithelium.- ß) Lamina Propria and Muscularis.- b) Ductus Epididymidis.- ?) Epithelium.- ß) Lamina Propria.- ?) Muscularis.- 4. Function.- a) Absorption.- b) Secretion.- c) Androgen Dependence.- V. Ductus Deferens.- 1. Development.- 2. General Anatomy.- a) Anatomical Relationships.- b) Vasculature.- c) Innervation.- 3. Cytological Features.- a) Epithelium.- b) Lamina Propria.- c) Muscularis.- VI. Seminal Vesicles.- 1. Development.- 2. General Anatomy.- a) Anatomical Relationships.- b) Vasculature.- c) Innervation.- 3. Cytological Features.- a) Epithelium.- b) Lamina Propria.- c) Muscularis.- VII. Prostate.- 1. Development.- 2. General Anatomy.- a) Anatomical Relationships.- b) Vasculature.- c) Innervation.- 3. Cytological Features.- a) Epithelium.- b) Lamina Propria.- c) Muscularis.- VIII. Bulbo-urethral and Urethral Glands.- 1. Derivation and Development.- 2. General Anatomy.- 3. Cytological Features.- References.- Quantitative Morphology of the Prostate and Epididymis.- A. Introduction.- B. Theoretical Basis of Stereology.- I. Symbols and Definitions.- II. Basic Stereological Equations.- 1. Volume Density.- 2. Surface Density.- 3. Numerical Density.- III. Preconditions for Stereological Analysis.- IV. Stereological Procedure.- 1. General Stereological Model.- 2. Morphological Criteria.- 3. Sampling.- 4. Multistage Sampling.- 5. Test Systems (Point and/or Line Sets).- 6. Stereological Model of the Prostatic Gland.- V. Stereological Calculations.- 1. Level I.- 2. Level II.- 3. Level III.- 4. Absolute Values.- C. Ventral Prostatic Lobe of the Rat.- I. Light-Microscopic Analysis.- II. Ultrastructural Findings.- III. Stereological Data.- IV. Experimental Applications on the Ventral Prostatic Lobe.- V. Discussion of the Experimental Applications.- D. Dog Prostate (Normal and Spontaneous Hyperplasia).- I. Light-Microscopic Analysis.- II. Electron Microscopy.- III. Stereological Analysis.- E. Human Prostate.- I. Materials.- 1. Normal Human Prostate.- 2. Benign Prostatic Hyperplasia.- II. Results.- 1. Light-Microscopic Analysis.- 2. Ultrastructural Findings.- 3. Ultrastructural-Microscopic Analysis.- F. Epididymis.- I. Stereological Model.- II. Epididymal Head of the Rat.- III. Experimental Applications.- IV. Discussion of the Experimental Applications.- G. Conclusion and Outlook.- References.- Etiology of Fertility Disturbances in Man.- A. Introduction.- B. Primary Testicular Failure.- I. Genetic Abnormalities.- 1. Sertoli-Cell-Only Syndrome.- 2. Maturation Arrest.- 3. Structural Defects of Spermatozoa.- II. Chromosomal Abnormalities.- 1. Additional X Chromosomes (Klinefelter's Syndrome).- 2. Additional Y Chromosomes and Y Chromosome Abnormalities.- 3. Noonan's Syndrome (Male Turner's Syndrome).- 4. Autosomal Abnormalities and Translocations.- III. Developmental Abnormalities.- 1. Congenital Anorchism.- 2. Cryptorchidism.- 3. Intersexuality.- IV. Defective Androgenization.- 1. Inadequate Androgen Synthesis.- 2. Inadequate Androgen Utilization (Androgen Insensitivity) 180 V. Acquired "Primary" Testicular Failure.- C. Secondary Testicular Failure.- I. Hypothalamic Failure.- II. Pituitary Failure.- D. Extratesticular Disturbances of Male Fertility.- I. Infections.- 1. Gonorrhea.- 2. Tuberculosis.- 3. Smallpox.- 4. Viral Infections.- 5. T Mycoplasma Infections.- 6. Trichomonas vaginalis.- 7. Candida albicans.- 8. Reiter's Syndrome.- II. Stress.- III. Radiation.- IV. Drugs.- V. Ejaculatory Problems.- 1. Anorgasmy.- 2. Retrograde Ejaculation.- References.- Male Fertility Disorders - History and Clinical Examination.- A. History.- I. Past History.- II. Sexual History.- III. Drug History.- IV. Urinary Symptoms.- B. Clinical Examination.- I. Genital Tract.- II. General Examination.- 1. Typical Alterations of Physical Habit with Related Disorders of Spermatogenesis.- a) Early (Prepubertal) Castration.- b) Late (Postpubertal) Castration.- c) Congenital Hypogonadism: Werner's Syndrome.- d) Rothmund's Syndrome.- e) Lawrence-Moon-Biedel Syndrome.- 0 Prader-Labhardt-Willi Syndrome.- g) Klinefelter's Syndrome.- h) "Pseudo-"Klinefelter's Syndrome.- References.- Semen Analysis.- A. Introduction.- B. Collection of the Ejaculate.- C. Sexual Abstinence Before Collection of the Ejaculate.- D. Examination of the Ejaculate.- I. Coagulation and Liquefaction.- II. Volume.- III. Biochemical Analysis.- E. Microscopic Examination.- I. Motility.- II. Count.- III. Morphology.- IV. Supravital Staining.- F. Normal Values.- G. Outlook.- References.- Testicular Biopsy.- A. Introduction.- B. Technique.- C. Histologic Evaluation of the Testicular Biopsy.- References.- Radiologic Investigation of Male Fertility Disorders.- A. Demonstration of Patency in the Spermatic Tract.- I. Indications.- II. Technique.- III. Complications.- B. Imaging of Glandular Structures.- C. Assessment of Urethral Abnormalities.- D. Phlebography of Varicoceles.- References.- Endocrine Evalution of Male Fertility Disorders.- A. Introduction.- B. Hormone Base Levels.- I. Testosterone.- II. Prolactin.- III. Follicle-Stimulating Hormone (FSH).- IV. Luteinizing Hormone (LH).- C. Dynamic Tests.- I. Clomiphene Citrate Test.- II. GNRH Test.- III. Human Chorionic Gonadotropin (HCG) Test.- D. Usefulness of Hormonal Tests for Selection of Patients for Gonadotropin Therapy.- References.- Neurology of Male Fertility Disorders.- A. Anatomic and Physiologic Basis.- I. Spinal Centers Involved in Genital Function.- II. Peripheral Innervation of the Genitalia.- III. Genital Function: Erection, Emission and Ejaculation, Orgasm.- 1. Erection.- 2. Emission.- 3. Ejaculation.- 4. Orgasm.- 5. Synopsis: Sexual Function and Spinal Segments.- IV. Centrip…