Materiały źródłowe

• #1 Male infertility – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/male-infertility/symptoms-causes/syc-20374773

  The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. […] In some cases, however, an underlying problem such as an inherited disorder, hormonal imbalance, dilated veins around the testicle or a condition that blocks the passage of sperm causes signs and symptoms. Signs and symptoms you may notice include: Problems with sexual function for example, difficulty with ejaculation or small volumes of fluid ejaculated, reduced sexual desire, or difficulty maintaining an erection (erectile dysfunction) […] A lower than normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate).

• #2 Male Infertility: Causes, Symptoms, Tests & Treatment

  https://my.clevelandclinic.org/health/diseases/17201-male-infertility

  Infertility is a common problem for many men. […] If you have male infertility, it means you have repeated unprotected sexual intercourse for over a year but your female partner doesnt get pregnant. […] The primary symptom of male infertility is being unable to have a biological child. But male infertility can also lead to many psychological and emotional symptoms, including feelings of: Depression, Loss, Grief, Inadequacy, Failure. […] Sometimes, male infertility can be associated with a low production of testosterone from the testicles. In this case, symptoms such as tiredness, impotence, depression, weight gain and apathy may occur. […] Many biological and environmental factors can cause male infertility. […] Semen is the whitish-gray liquid that releases from a penis upon orgasm (ejaculation). Semen contains sperm, as well as fluids that help deposit sperm toward the back of the vagina, and proteins, vitamins and minerals that help nourish the sperm.

• #2 Understanding the Symptoms of Male Infertility | Nova IVF Fertility

  https://www.novaivffertility.com/fertility-help/what-are-symptoms-male-infertility

  Male infertility is equally common as female infertility. Ignoring the signs and symptoms of this problem can lead to serious future consequences such as lack of confidence or emotional and psychological disturbances due to the inability to father a child. Some of the common symptoms of male infertility are: […] The „ejaculation disorder” is one of the most common symptoms of male infertility. Some men experience rare ejaculation or early ejaculation, while some others have a very low volume of semen during ejaculation. All of this come under ejaculation disorder. If the ejaculation is not in order, there is no orgasm achieved and thus hampering their sexual life. […] Usually, men produce a greater amount of testosterone, a hormone responsible for their libido or sex drive. If due to some hormonal issues, there is a dip in the testosterone, then their sexual desire or drive decreases.

• #3 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  Infertility is usually defined as the inability of a couple to conceive even after 1 year of unprotected, frequent sexual intercourse. The male is solely responsible in about 20% of cases and is a contributing factor in another 30% to 40% of all infertility cases. […] Overall, the male factor substantially contributes to about 50% of all cases of infertility. […] The initial evaluation includes a detailed sexual history and physical examination, together with 2 separate semen analyses. […] The key purpose for evaluating a male for infertility is to identify the contributing factors, offer treatment for those that are reversible, determine if the patient is a candidate for assisted reproductive techniques, and offer counseling for irreversible and untreatable conditions. […] Up to 6% of men evaluated for male infertility will be found to have more serious underlying pathology, such as cancer. […] This is an additional reason to do a comprehensive evaluation of the male partners of infertile couples so that any significant, underlying medical conditions can be identified and treated.

• #3 Male Infertility Explained: Causes, Symptoms, Testing, & More

  https://www.pfcla.com/blog/male-infertility-explained

  What Are the Symptoms of Male Infertility? While there may be no obvious signs of male infertility, there are a few warning flags to look out for, such as: Trouble ejaculating – either no ejaculation or very low volume of semen. Problems with sexual function – difficulty obtaining and maintaining an erection. Reduced sexual desire or loss of libido. Pain, swelling, or a lump in the testicle area. Signs of hormonal imbalance, such as decreased facial or body hair, abnormal breast growth (gynecomastia) etc. Unusual loss of or reduction in the sense of smell. A lower-than-normal sperm count (fewer than 15 million sperm per milliliter of semen or a total sperm count of less than 39 million per ejaculate) can be determined by an extensive semen analysis. […] Men should be evaluated for infertility if they have not participated in a successful pregnancy after 12 months of timed intercourse. They should be evaluated sooner if there are infertility risks below: Erection or ejaculation problems, low sexual drive, or other problems with sexual function. Pain, discomfort, a lump, or swelling in the testicle area. A history of testicle, prostate, or sexual problems. A groin, testicle, penis, or scrotum surgery. A partner over age 35.

• #4 Understanding Male Infertility – Symptoms & Treatment | Carle.org

  https://carle.org/conditions/male-infertility

  There are usually no symptoms associated with male infertility. […] About 35% to 50% of infertility is due to a male factor such as low sperm count, abnormal sperm shape, or abnormal sperm motion (motility).

• #5 Male Infertility – American Urological Association

  https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/male-infertility

  Male infertility can be due to a variety of genetic, anatomic, and environmental conditions, many of which will be briefly discussed below. […] A semen analysis may show abnormalities in sperm count or concentration, sperm motility, sperm morphology, and a host of other factors. […] When a cause for an abnormal semen analysis cannot be found, it is termed idiopathic. […] In contrast, when a man is infertile with a normal semen analysis and workup, the term unexplained infertility is used (presuming there is not any identifiable female-factor cause). […] It is hypothesized that genetic defects (either not yet identified or unable to be tested for) underlie unexplained infertility in some patients. […] Male factor infertility also has important implications for overall health. It is estimated that men with semen analysis abnormalities have a higher risk for malignancy and even death relative to their peers.

• #6 What are the signs and cause of male infertility?

  https://www.fertifa.com/post/what-are-the-signs-and-causes-male-infertility

  Testicular pain is famously sore. Thankfully, it is usually temporary, however continued soreness in the testicles, swelling and bruising can indicate more serious problems which can lead to male infertility: […] It may seem unlikely, but a lack of sense of smell (anosmia) is unlikely to be related to issues with fertility. However, it can be an indication of Kallmann Syndrome a congenital condition which effects the development of sex characteristics during puberty. If the loss of smell is caused by Kallmann Syndrome, you may experience infertility as another symptom of the condition. […] A loss facial or bodily (especially pubic) hair can be an indication of the genetic disorder Klinefelter Syndrome (KS). A genetic condition One impact KS can have is preventing sperm production, thus leading to infertility.

• #7 Know What is Male Infertility and What Causes It

  https://www.careinsurance.com/blog/health-insurance-articles/what-is-male-infertility-and-its-causes-and-symptoms

  For a woman to get pregnant, the sperm from the mans semen needs to fertilise the egg the female releases in her fallopian tube after having sexual intercourse. Male infertility refers to that condition where the man is not able to fertilise the egg released by his partner. Thus, the process of conception fails, and the man is unable to get his partner pregnant. As per the World Health Organisation (WHO), a man or a couple may be declared infertile when they are unable to achieve pregnancy after at least 12 months of unprotected and frequent sexual intercourse. An estimate states that 40 to 50 per cent of all infertility cases are due to the male factor, and hence the issue of male infertility is a major one. Around 40 per cent of male infertility is found in Indian men. […] Mostly, male infertility is asymptomatic. It does not have any easily visible symptoms. However, in order to address the question what are the symptoms of infertility in males, often the following symptoms may be observed in some males:

• #8 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  The semen analysis is the cornerstone of laboratory evaluation of male infertility. […] The outcomes and prognosis of male infertility greatly depend upon the semen analysis results as well as the female partner’s fertility status, along with the categorization of whether fertility is primary or secondary. […] In general, a raised FSH level is indicative of spermatogenesis abnormalities. […] Low testosterone with high FSH and LH suggests primary hypergonadotropic hypogonadism, which would affect both sperm production (FSH) and testosterone levels (LH). […] When left untreated, some infertile couples still manage to achieve a pregnancy. […] Studies have shown that 23% of untreated infertile couples conceive after 2 years, which goes up to 33% after 4 years. […] Reasonable healthy lifestyle changes should be recommended or at least discussed with all male infertility patients. […] These changes include stopping smoking, limiting or eliminating alcohol intake, adopting a more nutritious diet, weight loss measures if obese, increased exercise, avoiding potentially toxic artificial lubricants during sexual activity, reducing stress, eliminating illegal and recreational drug use (such as marijuana), minimizing prescription drugs, avoiding exposure to pesticides and heavy metals (such as lead, mercury, boron, and cadmium), and eliminating any unnecessary chemical exposures.

• #9 Symptoms of male infertility – Give Legacy

  https://www.givelegacy.com/resources/symptoms-of-male-infertility/

  Infertility affects one in seven heterosexual couples, and male-factor infertility contributes in half of all cases. […] Generally, infertility is diagnosed after one year of trying to conceive without success, and further testing is necessary to understand the root cause of infertility. […] Here, we cover six symptoms of male infertility to be aware of. […] A few common symptoms of hormone imbalance include: hair loss, weight gain or loss, low sex drive, erectile dysfunction, and fatigue. […] Erectile dysfunction is the inability to achieve or maintain an erection. […] One study shows that erectile dysfunction and premature ejaculation have a prevalence of one in six infertile men. […] Ejaculatory dysfunction can take different forms, including premature ejaculations, retrograde ejaculation (or dry orgasm), and delayed ejaculation.

• #10 Low sperm count – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/low-sperm-count/symptoms-causes/syc-20374585

  See a healthcare professional if you and your partner haven’t been able to become pregnant after a year of regular sex without using birth control. This is how the condition known as infertility is defined. […] Low sperm count can be caused by health conditions such as: Varicocele. A varicocele (VAR-ih-koe-seel) is a swelling of the veins that drain the testicle. It’s a common cause of male infertility. It can lower sperm count and quality. […] Some infections can impact sperm health or the body’s ability to make sperm. […] Ejaculation is the release of semen from the penis. It usually happens during orgasm. If semen enters the bladder during orgasm instead of leaving through the tip of the penis, that’s called retrograde ejaculation. […] Cancers and tumors that aren’t cancer both can affect the male reproductive organs directly.

• #11 Common Male Infertility Symptoms & Causes – Viera Fertility

  https://www.vierafertility.com/blog/common-male-infertility-symptoms-causes/

  The main symptom of infertility is not being able to conceive a baby with your partner after a year or longer. However, you may experience other issues that signify a male infertility issue, such as the following: […] Sexual dysfunction means that you have a problem at some point during sexual intercourse. For example, you may have reduced sexual desires or you might struggle to achieve an erection. On the other hand, you may have difficulty maintaining an erection adequate for sexual relations. Sexual dysfunction could also include having difficulty achieving an orgasm. […] You may notice that you only ejaculate small amounts when you reach climax. A low volume of semen could mean you have an issue with the stage of ejaculation that occurs when the semen accumulates in the urethral bulb before being released.

• #12 What are the signs of male infertility | The Clinic @ 78

  https://clinic78.co.uk/blog/what-are-the-signs-of-male-infertility/

  We advise seeking medical help if youve been trying for a baby for a year or two without success. […] There can be many different reasons for male fertility problems. […] You may have: Too few sperm in your semen, Sperm that are abnormally shaped, Sperm that dont move in the right way. […] You may have: Erectile dysfunction struggle to maintain an erection, Delayed ejaculation you are unable to ejaculate inside your partners vagina, Anorgasmia unable to reach orgasm, Retrograde ejaculation your semen is released backwards into your bladder, rather than out of your body. […] This is an insufficient quantity of the hormone testosterone that affects your sex drive and sperm count. […] We can successfully remedy many causes of male infertility once we have established the cause. It is important to seek help early on so you can begin treatment.

• #13

  https://birdandbe.com/blogs/the-nest/male-infertility-signs-and-symptoms?srsltid=AfmBOorn7U4jC9hlZiFSEEPSwA4Xhu9gJvcSXCZ7YgykIYOQSyvvnGa-

  Unfortunately, many couples and prospective parents only find out they have a significant male factor component to their infertility once they undergo a semen analysis at their doctors office. […] Varicoceles are a common, treatable, cause of male infertility that may occur in about 35 to 40 percent of male-factor infertility cases. […] The presence of varicoceles are associated with increased oxidative stress and inflammation. […] Oxidative stress happens when there are too many free radical particles without antioxidants to keep them in check and de-activate them. […] Both hormonal and testicular factors can affect sperm production and quality, but there are other genetic, dietary, lifestyle, and environmental factors that play a role. […] When to test your sperm: Traditionally if you have been trying to conceive for 12 months without success (or six months if you and your partner are older than 35), its best to test your semen and find out if those sperm are functioning.

• #14 Male Infertility – American Urological Association

  https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/male-infertility

  Primary infertility describes a man who has never fathered a child while secondary infertility is the term used when a man has previously fathered a child but is now having trouble conceiving. […] Azoospermia refers to the absence of sperm in the ejaculate. […] Azoospermia can result from absent/markedly impaired sperm production within the testicle, known as non-obstructive azoospermia, or it can result from some type of obstruction within the genital tract, known as obstructive azoospermia. […] Obstructive azoospermia is due to an obstruction/blockage somewhere between the testicle and the seminal vesicles. […] Nonobstructive azoospermia is a failure of the testis to produce sperm. […] A varicocele refers to the abnormal dilation of the veins of the pampiniform plexus. […] This is the most common cause of secondary infertility and also a common cause of primary fertility.

• #15 Understanding the Symptoms of Male Infertility | Nova IVF Fertility

  https://www.novaivffertility.com/fertility-help/what-are-symptoms-male-infertility

  This is the primary sign of infertility in men. If one’s testicles are too tiny to produce the testosterone hormone, then their fertility gets affected badly. Usually, a man born with one or more additional X chromosome, also known as the Klinefelter’s syndrome faces such issues. Such men have low facial hairs, thin bodies and excess fat around their chest area. […] The inability to maintain an erection during a sexual intercourse is known as erectile dysfunction. This is also a widely common symptom of infertility in men. It could be caused due to various neurological and psychological reasons. […] When the veins of one’s testicles swell and block the flow of sperm then a condition called varicocele occurs. Over 10-15% of men of reproductive age are affected by this problem. It is difficult to impregnate your partner with this condition. But the good news, with some minor surgery this problem can be corrected easily.

• #16 Male Infertility: Causes, Symptoms and Treatments | U.S. NewsCalifornia Consumer Privacy Act (CCPA) Opt-Out Icon

  https://health.usnews.com/conditions/articles/male-infertility-causes-symptoms-and-treatments

  Male infertility is a condition of the male reproductive system that is characterized by the inability to achieve conception with a fertile female partner, typically after one year of unprotected sex. […] Common signs or symptoms of male infertility, particularly if you aren’t actively trying to conceive, include: Low libido, Erectile dysfunction, Difficulties ejaculating, Testicular discomfort, Testicular atrophy, Chronic dull, aching pain. […] The dull, aching pain may get worse throughout the day if you’re experiencing varicocele.

• #17 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  The prevalence of infertility is variable, and epidemiologically, male infertility has been documented less in developing countries. […] In 20% to 30% of infertility cases, males can be solely responsible, with an overall contribution to infertility in couples of about 50%. […] With regard to male infertility, the exact prevalence is still uncertain, as male infertility is not a reportable disease. […] A study by Bayasgalan et al estimated the cause of infertility due exclusively to a male factor at 25.6%. […] Men with infertility issues tend to have more health-related comorbidities than normally fertile males. […] Infertile men with abnormal semen parameters have an increased risk of testicular cancer, with the highest risk in azoospermic individuals. […] COVID-19 appears to cause somewhat reduced fertility and even infertility in some recovered males, especially if the infection is severe. […] Further investigations are needed to better elucidate both the mechanisms of damage and possible remedies specific to COVID-19 infection-related infertility.

• #18 Male Infertility – American Urological Association

  https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/male-infertility

  Workup for male factor infertility is indicated for any couple who has been attempting to conceive via unprotected sexual intercourse for one year or longer without success. […] Men with risk factors for infertility, such as those with known hypogonadism, history of orchiopexy other testicular surgery, prior chemotherapy or pelvic radiation, or those with family history of male factor infertility should undergo more expeditious evaluation. […] The purpose of evaluation is to identify potentially treatable causes of male factor infertility or to identify non-treatable causes that may require alternative treatment pathways such as assisted reproductive techniques (intrauterine insemination, in vitro fertilization) or even the use of donor sperm or adoption. […] Many anatomic, hormonal, and genetic abnormalities can cause male infertility.

• #19 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  There are multiple causes for male infertility, which can be broadly classified due to their general underlying etiology. […] These are broad estimates only, as accurate statistics are unavailable due to general underreporting, cultural factors, and regional variations. […] Male infertility can also be classified based on the medical interventions that can potentially assist conception as follows: Treatable causes of male infertility are found in 18% of cases – obstructive azoospermia, ejaculatory duct and prostatic midline cysts, gonadotropin deficiency, sexual function disorders, sperm autoimmunity, varicoceles, and reversible effects of toxins. […] Uncorrectable male infertility or subfertility is found in 70% of cases – oligozoospermia, asthenozoospermia, teratozoospermia, and normospermia with functional defects. ART will generally be necessary for reproduction.

• #20 Male Infertility – American Urological Association

  https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/male-infertility

  Primary infertility describes a man who has never fathered a child while secondary infertility is the term used when a man has previously fathered a child but is now having trouble conceiving. […] Azoospermia refers to the absence of sperm in the ejaculate. […] Azoospermia can result from absent/markedly impaired sperm production within the testicle, known as non-obstructive azoospermia, or it can result from some type of obstruction within the genital tract, known as obstructive azoospermia. […] Obstructive azoospermia is due to an obstruction/blockage somewhere between the testicle and the seminal vesicles. […] Nonobstructive azoospermia is a failure of the testis to produce sperm. […] A varicocele refers to the abnormal dilation of the veins of the pampiniform plexus. […] This is the most common cause of secondary infertility and also a common cause of primary fertility.

• #21 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  The semen analysis is the cornerstone of laboratory evaluation of male infertility. […] The outcomes and prognosis of male infertility greatly depend upon the semen analysis results as well as the female partner’s fertility status, along with the categorization of whether fertility is primary or secondary. […] In general, a raised FSH level is indicative of spermatogenesis abnormalities. […] Low testosterone with high FSH and LH suggests primary hypergonadotropic hypogonadism, which would affect both sperm production (FSH) and testosterone levels (LH). […] When left untreated, some infertile couples still manage to achieve a pregnancy. […] Studies have shown that 23% of untreated infertile couples conceive after 2 years, which goes up to 33% after 4 years. […] Reasonable healthy lifestyle changes should be recommended or at least discussed with all male infertility patients. […] These changes include stopping smoking, limiting or eliminating alcohol intake, adopting a more nutritious diet, weight loss measures if obese, increased exercise, avoiding potentially toxic artificial lubricants during sexual activity, reducing stress, eliminating illegal and recreational drug use (such as marijuana), minimizing prescription drugs, avoiding exposure to pesticides and heavy metals (such as lead, mercury, boron, and cadmium), and eliminating any unnecessary chemical exposures.

• #22 Low sperm count – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/low-sperm-count/symptoms-causes/syc-20374585

  During pregnancy, one or both of an unborn baby’s testicles sometimes don’t drop down into the scrotum. The scrotum is the sac that usually contains the testicles. Lower fertility is more likely in adults who were born with this condition. […] A part of the brain called the hypothalamus and a gland at the base of the brain called the pituitary gland make hormones that are needed to create sperm. […] Some genetic changes passed from parent to child cause the male reproductive organs to develop in irregular ways. […] Anabolic steroids taken to boost muscle strength and growth can cause the body to make less sperm. Use of cocaine or marijuana might lower the number and quality of sperm as well. […] Heavy or ongoing alcohol use can lower testosterone levels and cause the body to make less sperm.

• #23 Male Infertility Facts: Obesity, Age, Tests, Treatments, & More

  https://www.webmd.com/infertility-and-reproduction/male-fertility-test

  Varicoceles are enlarged varicose veins that develop in the scrotum and prevent blood from flowing properly. […] Excessive exercise; studies have shown that exercising too much may lead to the release of too many steroid hormones. […] Stress […] Obesity […] Use of drugs such as marijuana and cocaine, taking steroids, drinking alcohol, and smoking can reduce sperm counts. […] Exposure to toxins and environmental hazards; pesticides, lead, radiation, radioactive substances, mercury, and heavy metals may affect fertility. […] High temperatures in the testicles could reduce sperm production. […] If you’re a guy who has been diagnosed with infertility, you should talk to your doctor about any behavioral changes you can make that might increase your chances of conceiving. […] If your sperm count is low, your doctor may recommend having intercourse less frequently in order to build up a better concentration of sperm.

• #24 Male Infertility – American Urological Association

  https://www.auanet.org/meetings-and-education/for-medical-students/medical-students-curriculum/male-infertility

  Male infertility can be due to a variety of genetic, anatomic, and environmental conditions, many of which will be briefly discussed below. […] A semen analysis may show abnormalities in sperm count or concentration, sperm motility, sperm morphology, and a host of other factors. […] When a cause for an abnormal semen analysis cannot be found, it is termed idiopathic. […] In contrast, when a man is infertile with a normal semen analysis and workup, the term unexplained infertility is used (presuming there is not any identifiable female-factor cause). […] It is hypothesized that genetic defects (either not yet identified or unable to be tested for) underlie unexplained infertility in some patients. […] Male factor infertility also has important implications for overall health. It is estimated that men with semen analysis abnormalities have a higher risk for malignancy and even death relative to their peers.

• #25 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  Infertility is usually defined as the inability of a couple to conceive even after 1 year of unprotected, frequent sexual intercourse. The male is solely responsible in about 20% of cases and is a contributing factor in another 30% to 40% of all infertility cases. […] Overall, the male factor substantially contributes to about 50% of all cases of infertility. […] The initial evaluation includes a detailed sexual history and physical examination, together with 2 separate semen analyses. […] The key purpose for evaluating a male for infertility is to identify the contributing factors, offer treatment for those that are reversible, determine if the patient is a candidate for assisted reproductive techniques, and offer counseling for irreversible and untreatable conditions. […] Up to 6% of men evaluated for male infertility will be found to have more serious underlying pathology, such as cancer. […] This is an additional reason to do a comprehensive evaluation of the male partners of infertile couples so that any significant, underlying medical conditions can be identified and treated.

• #26 Male Infertility Causes, Symptoms, and Treatments

  https://www.upmc.com/services/womens-health/conditions/male-infertility

  Male infertility can be diagnosed by your primary care provider at a routine check-up. […] Semen analysis is one of the most important tools in determining male infertility and sperm abnormalities. […] Male infertility is sometimes caused by a genetic disorder, such as Klinefelters syndrome. […] Doctors have several options for treating male infertility, depending on the cause of your infertility. […] In certain cases, your doctor may simply recommend that you refrain from heavy alcohol consumption or drug use. […] Your doctor might prescribe an oral hormone treatment to balance your hormones or a medication to treat erectile dysfunction. […] If you have abnormally formed tubes in the testicles that are blocking the transport of sperm from the testicles to the penis, you may need surgery to repair them. […] Couples who need assistance to get pregnant can find assisted reproductive technology (ART) to be very effective in producing a fertilized egg.

• #27 Male Infertility – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK562258/

  Male infertility can also be classified as follows: Pre-testicular causes include hypogonadotropic hypogonadism, erectile dysfunction, or coital disorders such as retrograde ejaculation, anejaculation, genetic factors, and chromosomal abnormalities. […] Testicular disorders include testicular tumors, orchiectomy, primitive testicular dysfunction, cryptorchidism, and atrophic testes. […] The purpose of evaluating the male partner of a couple suffering from infertility is as follows: To determine if the male factor is contributing to the couple’s infertility issue. […] To identify the small percentage of cases (about 20%) that can be normalized with treatment. […] While an initial evaluation such as a history and physical can be performed by primary care clinicians and an initial semen analysis ordered, it is generally recommended that all infertile men have an evaluation performed by a male reproductive specialist, especially if any abnormalities are found, as the workup and treatment are complex.

• #28 Male Infertility: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/436829-overview

  The semen analysis is the cornerstone of the male infertility workup and includes assessment of the following: Semen volume (normal, 1.5-5 mL), Semen quality, Sperm density (normal, 15 million sperm/mL), Total sperm motility (normal, 40% of sperm having normal movement), Sperm morphology (sample lower limit for percentage of normal sperm is 4%). […] Infertile men may have deficiencies in sperm formation, concentration (eg, oligospermia [too few sperm], azoospermia [no sperm in the ejaculate]), or transportation. The causes can be categorized as obstructive or nonobstructive. […] The following causes of infertility, if identified, can often be treated by medical means: Endocrinopathies, Antisperm antibodies, Retrograde ejaculation, Poor semen quality or number, Lifestyle issues, Infections.

• #29 Male Infertility Facts: Obesity, Age, Tests, Treatments, & More

  https://www.webmd.com/infertility-and-reproduction/male-fertility-test

  Although some people still think of fertility as a „woman’s problem,” in 20% of infertile couples, the problem is solely with the male partner. […] Infertility in men may be the only reason that a couple can’t conceive, or it may simply add to the difficulties caused by infertility in their partner. […] It’s also important that men do it early. […] If the first semen analysis is normal, your doctor may order a second test to confirm the results. […] Two normal tests usually are interpreted to mean that the man doesn’t have any significant infertility problems. […] There are a wide number of reasons for male infertility. […] Some are caused by physical problems that prevent the sperm from being ejaculated normally in semen. […] Others affect the quality and production of the sperm itself.

• #30 Male factor infertility – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/497

  1st investigations to order include sperm concentration, sperm motility, sperm morphology, seminal fluid parameters. […] Investigations to consider include sperm viability, sperm membrane function, hormonal assays, MRI of the pituitary and hypothalamus, colour flow Doppler imaging, post-ejaculation urine testing for retrograde ejaculation, genetic analysis, sperm DNA assays, anti-sperm antibody (ASA) serology, acrosome reaction test, sperm longevity test, electron microscopy, testicular biopsy.

• #31 Male Infertility: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/436829-overview

  Infertility in men can result from deficiencies in sperm formation, concentration, or transportation. This general division allows an appropriate workup of potential underlying causes of infertility and helps define a course of action for treatment. […] The initial step in the evaluation of an infertile male is to obtain a thorough medical and urologic history. Such a history should include consideration of the following: Duration of infertility, Previous fertility in the patient and the partner, Timing of puberty (early, normal, or delayed), Childhood urologic disorders or surgical procedures, Current or recent acute or chronic medical illnesses, Sexual history, Testicular cancer and its treatment, Social history (eg, smoking and alcohol use), Medications, Family history, Respiratory disease, Environmental or occupational exposure, Spinal cord injury.

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