male%20infertility
MALE INFERTILITY

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.

Introduction

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

Definition

  • Infertility is the inability to conceive despite regular unprotected sexual intercourse for 1 year

Etiology

  • Hypothalamic pituitary disease (eg craniopharyngioma, Kallman syndrome, hyperprolactinemia, nutritional deficiencies, infiltrative disorders)
  • Primary testicular disease (eg Klinefelter’s syndrome, cryptorchidism, myotonic dystrophy, orchitis, testicular torsion)
  • Disorders of sperm production & transport
    • Varicocele (most common known cause of male infertility)
    • Cryptorchidism
    • Obstructive azoospermia caused by abnormalities in the vas deferens, seminal vesicles, prostate, ejaculatory ducts
    • Sexual dysfunction: premature ejaculation, erectile dysfunction, ejaculatory dysfunction secondary to spinal cord disease or autonomic dysfunction
    • Germ cell malignancy & testicular microcalcification
  • Genetic disorders
    • Cystic fibrosis
    • Karyotypic chromosomal abnormalities
    • Y-chromosome microdeletions
  • Idiopathic infertility - accounts for 30-40% of cases
    • Cause of infertility is unclear, even w/ normal semen analysis & normal partner evaluation
  • Infections
  • Immune system disorders
  • Iatrogenic causes (post-chemotherapy, post-surgery)
  • Chronic illness [eg diabetes mellitus (DM), myocardial infarction, liver infection, chronic renal failure, rheumatoid arthritis, hepatic cirrhosis, bronchiectasis, sinusitis, dextrocardia]
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