Introduction
- Male infertility as the sole cause accounts for 20%, & 30-40% as a contributory factor to infertility in couples
Definition
- Infertility is the inability to conceive despite regular unprotected sexual intercourse for 1 year
Etiology
- Hypothalamic pituitary disease (eg craniopharyngioma, Kallman syndrome, hyperprolactinemia, nutritional deficiencies, infiltrative disorders)
- Primary testicular disease (eg Klinefelter’s syndrome, cryptorchidism, myotonic dystrophy, orchitis, testicular torsion)
- Disorders of sperm production & transport
- Varicocele (most common known cause of male infertility)
- Cryptorchidism
- Obstructive azoospermia caused by abnormalities in the vas deferens, seminal vesicles, prostate, ejaculatory ducts
- Sexual dysfunction: premature ejaculation, erectile dysfunction, ejaculatory dysfunction secondary to spinal cord disease or autonomic dysfunction
- Germ cell malignancy & testicular microcalcification
- Genetic disorders
- Cystic fibrosis
- Karyotypic chromosomal abnormalities
- Y-chromosome microdeletions
- Idiopathic infertility - accounts for 30-40% of cases
- Cause of infertility is unclear, even w/ normal semen analysis & normal partner evaluation
- Infections
- Immune system disorders
- Iatrogenic causes (post-chemotherapy, post-surgery)
- Chronic illness [eg diabetes mellitus (DM), myocardial infarction, liver infection, chronic renal failure, rheumatoid arthritis, hepatic cirrhosis, bronchiectasis, sinusitis, dextrocardia]
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