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Evaluation of male infertility

INTRODUCTION

Infertility in a couple is defined as the inability to achieve conception despite one year of frequent unprotected intercourse. Use of this time period, while arbitrary, was based upon a study of 5574 English and American women engaging in unprotected coitus who ultimately conceived between 1946 and 1956 [1]. Among these women, 50 percent conceived within three months, 72 percent within six months, and 85 percent within 12 months.

One population-based study found the following distribution of causes when evaluating infertile couples [2] (see "Causes of male infertility"):

  • Male factor — 23 percent
  • Ovulatory dysfunction — 18 percent
  • Tubal damage — 14 percent
  • Endometriosis — 9 percent
  • Coital problems — 5 percent
  • Cervical factor — 3 percent
  • Unexplained — 28 percent

The causes of male infertility can be divided into four main areas (table 1):

  • Hypothalamic pituitary disease (secondary hypogonadism) — 1 to 2 percent
  • Primary hypogonadism — 10 to 15 percent
  • Post-testicular defects (disorders of sperm transport) — 10 to 20 percent
  • Seminiferous tubule dysfunction — 60 to 80 percent including microdeletions of the Y chromosome

                                       

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Literature review current through: Apr 2013. | This topic last updated: Oct 26, 2012.
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