Epidemiology and etiology of Male Infertility.

 

Infertility is defined as a couple's inability to achieve pregnancy following one year of unprotected intercourse. It has been estimated that 15-20% of couples attempting to achieve pregnancy are unable to do so. A male factor is contributory in more than 50% of couples presenting for fertility evaluation. In many studies male factor infertility is the most common single diagnostic category. 

Therefore, a thorough evaluation of the male partner should be pursued as strongly as a female evaluation at the same time. It has been shown that the longer couples remain infertile, the worse their chance for an effective treatment. Initial screening of the male partner should be considered whenever patient presents with chief complaint of infertility regardless of length of infertility.Most studies have determined male factor infertility based on conventional criteria of sperm quality. Nevertheless, these criteria are not absolute. Significant proportion of men with normal semen quality will be infertile because of defective sperm function, while men with abnormal sperm quality will have normal sperm function.

Idiopathic male infertility remains the most common single diagnostic entity, although this classification may be changed with recent advances in the genetics of male infertility.The common causes of male infertility are varicocele, accessory gland infection, immunological factor, congenital abnormalities; obstructive azoospermia; iatrogenic systemic and endocrine causes.

Etiology of Male Infertility
Gonadotropin deficiency

Genetic disorders

Excurrent ducts obstruction

Environmental toxins,Recreational Drugs 

Medications, Chemotherapy, Radiation 

Systemic Diseases 

Infection  

Varicocele 

Immunologic abnormalities 

Ejaculatory failure 

 

Selected Bibliography

  1. Irvine DS. Epidemiology and aetiology of male infertility. Hum Reprod 1998;13, suppl 1:33-44.
  2. Greenberg SH. Lipshultz LI. Wein AJ. Experience with 425 subfertile male patients. 1978 ;Journal Urology. 119(4):507-10,
  3. Baker HW. Male infertility. Endocrinology & Metabolism Clinics of North America. 1994;23(4):783-93
  4. Dubin L.,Amelar RD. Etiologic factors in 1294 concecutive cases of male infertility.Fertil.Steril. 1971;22:469

 

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