Update in andrology

Context: This is an invited review based on a presentation at the 2007 Annual Scientific Meeting of The Endocrine Society. Objective: The objective of the review was to highlight a selection of the most important peer-reviewed papers in andrology published over the last 1-2 yr. Evidence Acquisition: This was a comprehensive survey of all papers published in major endocrinology journals over the last 2 yr augmented by personal knowledge and literature searching as well as an e-mail survey of more than 40 leading andrologists. Evidence Synthesis: From the list of suggested papers, the findings of a short list considered the most important were reviewed, aiming to focus on findings that influence thinking and practice in the field of andrology. Conclusions: Important advances highlighted included establishing genetic paternity for men with Klinefelter's syndrome as a realistic therapeutic option via testicular sperm aspiration coupled with intracytoplasmic sperm injection in vitro fertilization, using population registry linkage data to define the natural history of Klinefelter's syndrome in the community and identifying active cellular uptake mechanisms for SHBG-bound testosterone challenging the quasi-axiomatic status of the free hormone hypothesis. Other important recent contributions reviewed are on testosterone effects on the prostate, hormonal male contraception, possible temporal trends in blood testosterone concentrations in American men, and The Endocrine Society's position papers on testosterone assays and guidelines on testosterone prescribing.