Infertility is the inability to conceive despite regular unprotected sexual intercourse for one year.

Male infertility as the sole cause accounts for 20% & 30-40% as a contributory factor to infertility in couples.

Causes include: hypothalamic pituitary disease, primary testicular disease, disorders of sperm transport, genetic disorders, idiopathic infertility, infections, immune system disorders, iatrogenic causes, and chronic illness.

Lifestyle Modification

Alcohol & Smoking
  • Alcohol consumption should be limited to 3-4 units/day
  • Cessation of smoking should be encouraged
  • Excessive alcohol intake & smoking may affect sperm quality
Body Weight
  • Men w/ body mass index (BMI) of >30 kg/m2 are at greater risk of being infertile
  • Obesity may lead to androgen to estrogen conversion, decreased SHBG levels, secondary to insulin resistance
  • Weight loss should be encouraged especially for patients w/ alterations in the hypothalamic-pituitary-testicular axis & impaired scrotal thermoregulation
Caffeine Intake
  • There are inconsistent evidences concerning the effect of consumption of caffeinated beverages on fertility
Control of Body Temperature
  • Tight underwear are associated w/ elevated scrotal temperature & reduced semen quality
  • Wearing boxer shorts & loose underwear are more advisable
  • Avoid going to hot baths & saunas w/c can increase scrotal temperature
Discontinue Offending Medications & Exposures
  • Many common medications & occupational hazards may affect male sexual function
    • Eg antidepressants, antipsychotics, anti-arrhythmics, many antihypertensives, anti-androgens & steroids
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