Causes and Diagnosis of Male Infertility

Nam Cheol Park

doi:10.5124/jkma.2007.50.5.415

J Korean Med Assoc > Volume 50(5); 2007 > Article

Park: Causes and Diagnosis of Male Infertility

Focused Issue of This Month

Infertility

Journal of the Korean Medical Association

Journal of the Korean Medical Association 2007; 50(5): 415-423.

Published online: May 31, 2007

DOI: http://dx.doi.org/10.5124/jkma.2007.50.5.415

Causes and Diagnosis of Male Infertility

Nam Cheol Park, MD

Department of Urology, Pusan National University College of Medicine, Korea. pnc@pusan.ac.kr

Abstract

Male factors can be identified as the cause of infertility in 30~40% of couples and a contributing factor in 50% of cases. This situation means the reproduction ability in human is directly related not only to the underlying diseases of infertility but also to the general health status. Therefore, clinical approaches should be made by a comprehensive evaluation including a detailed history, careful physical examination, qualified semen analysis, and second-line specific tests under a thorough understanding of the anatomy and physiology of the reproductive organ, on both sides of the couple in parallel. Additionally, it is very important to evaluate male factors with rapid, noninvasive, and cost-effective modalities. This article will provide a review of clinical causes of male infertility as well as how to perform a comprehensive evaluation in infertile couples.

Male infertility; Cause; Diagnosis

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Figure 1

Algorithm for the workup of isolated abnormal semen parameters.

Table 1

Cause of male infertility

Table 2

Distribution of patients by diagnostic category after full evaluation

^*Includes exposure to chemotherapeutic agents and radiation, heat, drugs etc

^†Includes chromosomal abnormalitis such as Klinefelter syndrome and genetic abnormalities such as CFTR mutations

Table 3

Reference values of semen analysis

^*Multicentre population-based studies utilizing the methods of morphology assessment in this manual are now in progress

Data from assisted reproductive technology programmes suggest that, as sperm morphology fails below 15% normal forms using the methods and definitions descrived in this manual, the fertilization rate in vitro decreases

Table 4

Distribution of patients presenting with infertility by findings on semen analysis