Male Infertility: Current Concepts

Abstract

The purpose of the article is to review the current concepts regarding the etiology and treatment of male-factor infertility. The following general conclusions can be drawn: (a) conventional parameters for sperm quality and male fertility are inadequate and any assessment should involve several different tests of sperm cell function to increase the fertility prognosis; (b) the causes of disturbed sperm quality are still poorly understood; (c) the role of the varicocele is still controversial but some of the discrepancies reported in the literature may be explained by the negative influence of other factors such as smoking, epididymal pathology or glandular infections operating either in conjunction or independent of the varicocele; (d) the role of chronic inflammatory processes in the reproductive organs, in particular the involvement of chronic chlamydial infections, has been underestimated, largely because it is often asymptomatic and difficult to demonstrate objectively; (e) partial androgen insensitivity may account for a significant number of cases of severe oligozoospermia; (f) no major advances have been made in the medical treatment of poor sperm quality; (g) assisted fertilization techniques such as IVF and GIFT offer encouraging possibilities for the treatment of male-factor infertility; and (h) recent advances in microsurgical techniques are increasing the treatment possibilities for certain forms of obstructive azoospermia and severe oligozoospermia.

Prevalence of Chlamydia trachomatis, Neisseria gonorrhoeae, Mycoplasma genitalium and Ureaplasma urealyticum infections using a novel isothermal simultaneous RNA amplification testing method in infertile males

“…C. trachomatis , N. gonorrhoeae , M. genitalium and U. urealyticum are common genitourinary tract pathogens and are widely studied in the current literature. It is also difficult to identify these infections due to their being clinically silent nature, the possibility of contamination with other organisms and the culture difficulty [9]. …”

Pesticide Exposure and Health Related Issues in Male and Female Reproductive System

“…Approximately 6% of adult males are thought to be infertile (Purvis & Christiansen, 1992). Male factors are responsible for at least 20% of cases of infertility.…”

“…Male infertility is related to impaired semen quality and may be due to a variety of causes including genetic (Klinefelter's syndrome), congenital (cryptorchidism), endocrine (hypogonadism), obstructive (vasectomy), infective (chlamydia), vascular (varicocele), neoplastic (carcinoma of the testis), lifestyle, and environmental (heat, drugs, pesticides, irradiation) factors. Others causes include sexual dysfunction related to erection and ejaculation (Purvis & Christiansen, 1992;Dohle et al, 2005). However, in many cases male infertility is regarded as idiopathic (40-75%), and no cause can be identified.…”

Impact of Co-administered Lopinavir/Ritonavir and Sulfamethoxazole/Trimethoprim on Reproductive Indices of Male Albino Rats

“…Infertility is defined as the inability to achieve pregnancy after one year of unprotected intercourse [1]. Infertility is reported to be on the increase over the past decade due to the number of couples seeking consultation for infertility problems with about 50% attributed to male factors [2,3].…”