Assessment of the infertile male

Abstract

Key content Male factors alone account for up to 30% of subfertile couples undergoing in vitro fertilisation. Male infertility may be due to problems with sperm production or transport and also sexual dysfunction. The underlying cause in most cases is idiopathic. Modifiable lifestyle factors can have an impact on male fertility, but medical treatments have a limited value in enhancing semen quality. Most treatments are based on assisted fertilisation techniques, rather than treatment of the underlying cause. The number and quality of sperm that can be recovered, either from the ejaculate or surgically, determines the available options for assisted conception. Intracytoplasmic sperm injection (ICSI) is considered relatively safe; however, because of the ability to bypass natural barriers to conception, there are concerns regarding its potential to transmit genetic defects. Learning objectives To review appropriate practice in the assessment and investigation of the infertile male. To critically appraise the currently available investigations for male fertility. To summarise the treatment options for subfertile men. Ethical issues Does ICSI propagate genetic causes of male infertility? Could there ever be a role for the use of artificial sperm in assisted reproduction?

Testosterone and Gonadotropins in Infertile Men with Sertoli Cell Only Syndrome from Gaza Strip

“…This coincides with the idea that varicocele contributes to male infertility. 17,18 The proposed pathophysiologic mechanisms by which varicocele impairs male fertility may include hypoxia and stasis, elevated testicular temperature, reflux of adrenal catecholamines, and increased oxidative stress. 19 Hormonal problems were also significantly higher in patients than controls implying that Sertoli cell only syndrome is associated with hormonal disturbances.…”

The social construction of male infertility: a qualitative questionnaire study of men with a male factor infertility diagnosis

“…); anatomical or mechanical issues can also cause infertility, with environmental, lifestyle or co‐morbidity factors are also linked (Karavolos et al . , Skakkebaek et al . ).…”

Fertility History: Assessment of Performance and Quality Improvement

“…The couple needs to be asked about any history of sexually transmitted diseases or pelvic infections to assess tubal factors (vas deferens obstruction in males) of sub-fertility [6]. This has gone up from 78% to 84% for women (Fig.…”