Infertility in Men: Overview

About 15% of couples are unable to achieve a pregnancy after one year of unprotected intercourse. As data available prove that in approximately 30% of cases pathology is found in the man alone, and in another 20% both the man and woman are abnormal. Therefore, a male factor is at least partly responsible for couple infertility in conception in roughly 50% of cases.

Chances for an effective cure are becoming worse depending on duration. The longer couple remains subfertile, the more difficult to treat both partners. Because of this reason early evaluation and treatment of the male along with is a comprehensive program for the infertile couple is critical.

There are many causes of male factor infertility and early treatment may help in most of cases. It is recommended to start clinical evaluation after 12 months of unprotected intercourse. But the initial evaluation may take place whenever the patient presents with the chief complaint of infertility.
Effectiveness of the whole treatment process depends on the correct diagnosis of male infertility. Rationale and effective medical and surgical regimens in the treatment of these disorders are defined according to the diagnosis.
Serious medical conditions, even life threatening are the cause of 1% infertility in men.

The use of standard techniques for evaluating medical problems in general, such as complete history, physical examination, and laboratory tests is essential for this purpose. Early treatment of such conditions is vital and can save the life.

Possible Causes of Male Infertility
There are many male factors that can prohibit a couple to become pregnant. This includes the following factors:
a) Conditions:
• diabetic neuropathy
• extreme obesity
• Liver and Kidney disease
b) Testicular causes of infertility
• Chromosomal abnormalities (Klinefelters syndrome, XX disorder (sex reversal syndrome), XYY syndrome)
• Noonans syndrome (male Turners syndrome)
• Myotonic dystrophy
• Bilateral anorchia (vanishing testes syndrome)
• Sertoli-cell-only syndrome (germinal cell aplasia)
• Gonadotoxins (drugs, radiation)
• Orchitis
• Trauma
• Systemic disease (renal failure, hepatic disease, sickle cell disease)
• Defective androgen synthesis or action
• Cryptorchidism
• Varicocele
c) Additional factors:
• Certain medicated drugs
• Anabolic steroids
• Diet low in folic acid
• Excessive exercise
• Radiation therapy
• Wearing tight-fitting pants and underwear