Infertility, male

Infertility, male

Male infertility may be suspected whenever a couple fails to achieve pregnancy after about 1 year of regular unprotected intercourse. Between 40% and 50% of infertility problems in the United States are totally or partially attributed to the male. (See also “Infertility, female,” page 443.)


Factors that cause male infertility include:

  • varicocele, a mass of dilated and tortuous varicose veins in the spermatic cord

  • semen disorders, such as volume or motility disturbances or inadequate sperm density

  • proliferation of abnormal or immature sperm, with variations in the size and shape of the head

  • systemic disease, such as diabetes mellitus, neoplasms, liver or kidney disease, or viral disturbances, especially mumps orchitis

  • genital infection, such as gonorrhea, tuberculosis, or herpes

  • disorders of the testes, such as cryptorchidism, Sertoli-cell–only syndrome, varicocele, ductal obstruction (caused by absence or ligation of the vas deferens or infection), hydrocele (collection of fluid in the testes), or infection (orchitis and epididymitis).

  • genetic defects, such as Klinefelter’s syndrome (chromosomal pattern XXY, eunuchoidal habitus, gynecomastia, and small testes) or Reifenstein’s syndrome (chromosomal pattern 46XY, reduced testosterone, azoospermia, eunuchoid-ism, gynecomastia, and hypospadias)

  • immune disorders, such as autoimmune infertility and allergic orchitis

  • endocrine imbalance (rare) that disrupts pituitary gonadotropins, inhibiting spermatogenesis, testosterone production, or both; such imbalances occur with Kallmann’s syndrome, panhypopituitarism, hypothyroidism, and congenital adrenal hyperplasia

  • chemicals and drugs that can inhibit gonadotropins or interfere with spermatogenesis, such as arsenic, methotrexate, medroxyprogesterone acetate, nitrofurantoin, monoamine oxidase inhibitors, and some antihypertensives

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Jun 16, 2016 | Posted by in GENERAL & FAMILY MEDICINE | Comments Off on Infertility, male

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