Male infertility approaches

One in six couples are infertile, and in 50% of these couples, a male factor plays a role. Therefore, it is imperative that physicians become comfortable in the basic evaluation of the infertile male. By performing a thorough history and physical examination, physicians can usually establish a differential diagnosis and proceed to laboratory testing that will help to establish an etiology for infertility. The purpose of this review is to provide general guidelines for a physician seeking to evaluate a man's fertility status and to suggest the most common pathologies that might be found through a directed work-up...

Male subfertility is common, and it causes significant duress to couples. Although the most common cause of male subfertility is idiopathic failure of spermatogenesis, a significant percentage of male subfertility is medically treatable. Compared to reproductive specialists, endocrinologists may see a population of men that have a higher prevalence of treatable causes of subfertility including sexual disorders, endocrinopathies, obesity, drugs, and ejaculatory dysfunction. Seminal fluid analysis is the most important diagnostic study, and at least 2 samples should be analyzed...