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 . Among these women, 50 percent conceived within three months, 72 percent within six months, and 85 percent within 12 months. Similar estimates were reported in later studies (figure 1).
There are four main causes of male infertility (table 1):
●Hypothalamic/pituitary disease (secondary hypogonadism) – 1 to 2 percent
●Testicular disease (primary spermatogenesis failure and hypogonadism) – 30 to 40 percent
●Posttesticular defects (disorders of sperm transport) – 10 to 20 percent