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Male Infertility

Roughly half of all instances of infertility are due to male infertilityRoughly half of all instances of infertility are due to male infertility

Roughly half of all infertility cases are due to male infertility and can be due to a range of factors. If you suspect that your partner may be infertile, you should speak to your doctor, who will probably suggest a spermogram to measure your partner's sperm count. If the spermogram reveals that your partner has a low sperm count, you might want to consider visiting a urologist, or a male infertility specialist, who should be able to provide you with further advice. Sperm count is not an exact measure of infertility, but can give an indication of a potential problem.

The WHO recommends that, when undergoing a spermogram, two semen analyses are performed after two to three days of sexual abstinence. Scientists also believe that there is an urgent need to develop a method capable of assessing the fertilisation? capacity of sperm. For example, a recent study by Dr F.C. Wu indicates that assessment of infertility among men could be significantly improved by studying sperm functional capacities, the testicular production of hormones, the metabolism of these hormones, tests to assess the correct functions of the Sertoli cells? and the epididymus.

If you are planning to use DuoFertility to help you conceive and you suspect that your partner may be infertile, we recommend that you speak to your doctor to ask for advice. It is worth noting however, that even in cases of major male infertility, using DuoFertility may still help you to conceive, although using DuoFertility is more effective in certain cases of infertility than in others.


The most common causes of male infertility are:



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Scientific references (Click here)

Human Semen and Semen-Cervical Mucus? Interaction.

WHO Laboratory Manual for the Examination of Human Semen and Semen-Cervical Mucus Interaction, Fourth edition. Cambridge, Cambridge University Press. 1999; pp. 23-25.

Definition and current evaluation of subfertile men.

Int Braz J Urol. 2006 Jul-Aug;32(4):385-97.

Shefi S, Turek PJ. Department of Urology, University of California San Francisco, San Francisco, California 94143-1695, USA.

Male infertility affects 10% of reproductive aged couples worldwide and is treatable in many cases. In addition to other well-described etiologies, genetic causes of male infertility are now more commonly diagnosed. Using principles of evidence-based medicine, this review outlines diagnostic and treatments options to inform clinical management. In order of importance, randomized controlled clinical trials, basic? scientific studies, meta-analyses, case-controlled cohort studies, best-practice policy recommendations and reviews from peer-reviewed literature were incorporated that provide organized and timely guidelines to the current management of male infertility. The strength of evidence for treatment recommendations is also classified when appropriate. PMID: 16953904 [PubMed - indexed for MEDLINE]

 

Consensus workshop on advanced diagnostic andrology techniques

Hum Reprod. 2002 Sep;17(9):2237-42. Links Hum Reprod. 1996 Jul;11(7):1463-79. Links Consensus workshop on advanced diagnostic andrology techniques. ESHRE (European Society of Human Reproduction and Embryology) Andrology Special Interest Group. [No authors listed] The Workshop reviewed four areas of advanced diagnostic andrology identified in the World Health Organization's 1992 Laboratory Manual for the Examination of Human Semen and Sperm-Cervical Mucus Interaction as 'research tests'. These were computer-assisted sperm analysis (CASA), acrosome reaction tests, the zona-free hamster egg? penetration test and sperm-zona pellucida binding tests. For each topic, the Workshop Report comprises an overview of the particular field, a chronicle of the discussion that followed and a statement of the specific consensus points that were established. Free discussion allowed the elaboration of several general concepts that are presented here as the Workshop participants' perceived framework for future work in this area. While it was recognized that large-scale screening of male partners using advanced sperm function tests is almost certainly totally impractical on grounds of cost and lack of adequate services, urgent consideration was recommended for the development of a sperm function testing strategy capable of providing the likelihood of pregnancy for given diagnostic situations within certain timeframes. Establishing a clear definition of the role of diagnostic andrology in male infertility should be a primary focus of the Special Interest Group's activities. Further initiatives, including training courses, workshops, symposia and multicentre research studies, will be accorded high priority. Similar consideration will also be given to protocols for facilitating rational management decisions to ensure cost-effective therapeutic strategies, including consideration of the hierarchy of complexity and cost versus predicted fecundity. In addition, it was recognized that we need a greater understanding of the genetic basis of male infertility and how this impacts on the achievement of a viable pregnancy, while also minimizing the burden of genetic defects on the next generation. PMID: 8671487 [PubMed - indexed for MEDLINE]

 

 

Clin Obstet Gynaecol. 1985 Sep;12(3):531-55.Links

Male Hypogonadism--current concepts and trends.

Wu FC.

Important advances have been made recently in our knowledge of hypothalamic-pituitary-testicular functions. Current understanding of the hypothalamic control of pituitary gonadotrophin secretion and the mechanisms of testicular feedback is beginning to yield benefits in the clinical management of certain reproductive disorders. But much remains to be learned about the neuroendocrine control of hypothalamic GnRH? secretion--an area which encompasses the mechanisms regulating the onset of puberty. Spermatogenesis is a highly complex process involving subtle interactions between endocrine, paracrine and autocrine regulators acting on different cell populations within and without the testis. Until basic research can advance the very limited knowledge in this area, we cannot expect to improve the currently unsatisfactory management of infertile men. It is not surprising that only limited information can accrue from conventional semen analysis and measurement of systemic hormones. Nor is it unexpected that empirical or seemingly rational treatments for male infertility are of dubious benefit. In future, assessment of the infertile man should be improved by studying sperm functional capacities and testicular synthesis and metabolism of gonadal steroids and by the definition of representative markers of Sertoli cell and epididymal functions. Reversible male contraception is another objective that remains beyond our reach at present. Hormonal disruption of spermatogenesis is often incomplete and invariably suppresses Leydig cell? function, so that androgen replacement for sustaining sexual function is mandatory. Alternative approaches to male contraception aimed at the epididymis and sperm-egg interaction seem more promising avenues for future exploration.

PMID: 3933878 [PubMed - indexed for MEDLINE]

 

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