Male factor infertility

Male factor infertility alone contributes up to 30% of cases of infertile opposite-sex couples and to an additional 30% to 40% in combination with other factors.

Most cases are of unknown aetiology.

Diagnosed if abnormal semen parameters in two semen analyses separated by 1 month.

Endocrine tests, genetic testing, and imaging can be helpful.

Treatment should be targeted to the aetiological factors whenever possible.

Assisted reproductive techniques are often the fastest and most effective method to achieve pregnancy regardless of the aetiology.

The clinical definition of male factor infertility is the presence of abnormal semen parameters or sperm functional assays, or the functional inability to adequately deliver semen into the vaginal canal, in the male partner of an opposite-sex couple unable to achieve conception after 1 year of unprotected intercourse. The World Health Organization defines male factor infertility as the presence of ≥1 abnormalities in the semen analysis or the presence of inadequate sexual or ejaculatory function.[1]Rowe PJ, Comhaire FH, Hargreave TB, et al. WHO manual for the standardized investigation and diagnosis of the infertile male. Cambridge, UK: Cambridge University Press; 2000.