 | Infertility |
| Infertility: Introduction | ||
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Q. What is infertility?
A. Infertility is defined as the inability of a couple to conceive a child after one year of unprotected intercourse. Q. How often is infertility attributable to the male partner? A. Approximately 12 percent of couples are unable to initiate a pregnancy without some form of assistance or therapy. In about 30% these cases, the male appears to be singularly responsible; in an additional 20 percent of cases, both male and female factors can be identified. Thus, a male factor is partly responsible for difficulties in conception in roughly 50% of cases. Q. What are the most common causes of male infertility? A. Male infertility can be caused by a number of factors (see Table 1), including problems with sperm production, blockage of the sperm delivery system, antibodies against sperm, injury to the testicle, testicular tumors, undescended testicles, hormonal problems, and anatomical problems such as a varicocele (varicose vein around the testicle). All of these conditions may affect sperm quality and quantity. Past illnesses, infections, various diseases, and medications can also contribute to infertility. Q. Can male infertility be corrected? A. Yes. Very few men will have a problem that is not correctable or treatable through either a single, or combination of procedures. Statistics show that 65 percent of infertile couples who seek medical help eventually succeed in having children through a variety of medical procedures and treatments available today. Any man with sperm in his ejaculate (and even one with no sperm in the ejaculate) has the potential to become a biologic father. Q. What is the best way for a couple to seek treatment? A. Couples who have an infertility problem should seek out physicians - gynecologists, urologists, reproductive endocrinologists - who are experienced in fertility management. From the male point of view, it is important to choose a urologist who is specifically trained to understand the infertile couple and who is skilled in the latest techniques. The urologist should have a good working relationship with the gynecologist since the "team" approach offers the best chance of achieving a pregnancy.
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| Table 1 | ||
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Distribution of final diagnostic categories found in a male fertility clinic* Based on a sample of 1430 men | ||
| Diagnosis | Percentage | |
| Varicocele | 42.2 | |
| Idiopathic | 22.7 | |
| Obstruction | 14.3 | |
| Normal male | 7.9 | |
| Undescended testicle | 3.4 | |
| Immunologic (antisperm antibodies) | 2.6 | |
| Ejaculatory dysfunction | 1.3 | |
| Testicular failure | 1.3 | |
| Drugs / Radiation | 1.1 | |
| Endocrinologic | 1.1 | |
| Infection | 0.9 | |
| Sexual dysfunction | 0.3 | |
| Systemic disease | 0.3 | |
| Sertoli-cell only | 0.2 | |
| Ultrastructural defect | 0.2 | |
| Genetic | 0.1 | |
| Testis cancer | 0.1 | |
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Table published in Infertility in the Male, Mosby, St. Louis, Third edition, 1997, ed. Lipshultz and Howards. | ||
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