Male infertility

Male infertility is defined as the inability to achieve pregnancy in a fertile female partner after 12 months of regular unprotected sexual intercourse.

The pathophysiology of male infertility involves several mechanisms: hormonal imbalances, such as hypogonadotropic hypogonadism ans androgen insensitivity; testicular dysfunction, usually due to varicocele or cryptorchidism; genital tract obstruction (obstructive azoospermia), such as epididymal, vas deferens, intratesticular, or ejaculatory duct obstruction; genetic abnormalities, such as Klinefelter syndrome, Y-chromosome microdeletions, and cystic fibrosis; and oxidative stress and DNA fragmentation in sperm.

The prevalence of male infertility in the US is estimated at 11.4% in men aged 15-49 years and 12.8% in men aged 25-49 years.

Risk factors for male infertility can include older age, lifestyle factors (smoking, alcohol use, drug use), and environmental exposures (pesticides, heavy metals, radiation), comorbidities (diabetes, obesity, malignancy), and certain medications (such as anabolic steroid).

The prognosis of male infertility can vary greatly. In some cases, infertility can be treated with lifestyle changes or medical treatment, while others may require assisted reproductive technologies.