Male Infertility – Causes, Diagnosis and Management. A Review

Abstract: The World Health Organization defines infertility as an inability to get pregnant after a year of regular intercourse, 3-4 times a week, without use of preventive methods. The problem of infertility concerns about 15% of the population, in 20-30% of cases the cause is on the male side, in 20-35% couples struggle with female infertility, and in 25-40% of cases fertility problems concern both partners. Male infertility is defined as the inability of a man to cause pregnancy in a fertile woman. Male infertility is caused by change in sperm concentration and/or motility and/or morphology in at least one sample of two semen analyses. The reasons for male infertility can be divided into four main groups: primary testicular defects in spermatogenesis, endocrine and systemic disorders, sperm transport disorders, idiopathic male infertility. There are also many reasons that worsen semen quality, resulting in difficulty in conceiving offspring, we can distinguish neurological disorders, obesity, smoking, autoimmune diseases or intensive sports. The causes of infertility can lie on both the male and female side, therefore it is important to examine both partners. Diagnosis of male infertility usually includes: medical history, physical examination, semen analysis, scrotal and transrectal ultrasound, hormonal tests, testicular biopsy. Further diagnosis and treatment depends on the results of semen analysis. Much of the causes of male infertility are idiopathic, however if the cause is determined, treatment is targeted and results in high success rate. Both conservative methods and surgical procedures are used in therapy. It should also be borne in mind that male infertility is often a multifaceted problem; supportive therapy is necessary in addition to targeted therapy.

Authors:
Agata Golik, Joanna Kacperczyk-Bartnik, Pawel Bartnik, Agnieszka Dobrowolska-Redo, Ewa Romejko-Wolniewicz

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