Causes of Male Infertility

Abstract

Of all sexually active couples, 12–15% are infertile. When broken down by gender, a male component can be identified 50% of the time either in isolation or in combination with a female factor. The majority of the causes of male infertility are treatable or preventable, so a keen understanding of these conditions is paramount. Despite advancements in assisted reproductive technologies, the goal of a male infertility specialist is not simply to retrieve sperm. Instead, the male infertility specialist attempts to optimize a male’s reproductive potential and thereby allow a couple to conceive successfully through utilization of less invasive reproductive techniques. Often, this involves the use of sperm or testicular tissue cryopreservation prior to fertility insult. At the same time, the male fertility specialist is wary of underlying or causal, potentially serious medical or genetic conditions that prompted reproductive evaluation. Previous research in a US male fertility clinic analyzing 1,430 patients identified causes of infertility from most to least common: varicocele, idiopathic, obstruction, female factor, cryptorchidism, immunologic, ejaculatory dysfunction, testicular failure, drug effects/radiation, endocrinology, and all others. The focus of this book on the role of reactive oxygen species (ROS) is easily applied to the majority of the listed conditions (described in detail in later chapters) which comprise this chapter’s overview of pre-testicular, testicular, and post-testicular causes of male infertility.