Male Infertility Overview

Male infertility data available over the past twenty years reveal that in approximately 30% of cases pathology is found in the man alone, and in another 20% both the man and woman are abnormal. Approximately 15% of couples attempting their first pregnancy struggle to conceive. Most authorities define patients as infertile if they have been unable to achieve a pregnancy after one year of unprotected intercourse. Conception normally is achieved within twelve months by 80-85% of couples who use no contraceptive measures. If a couple cannot get pregnant after one year they should consider the possibility of being infertile and schedule an appointment with a fertility specialist.

Important issues related to the evaluation of male factor infertility include the timing of the male evaluation, the most efficient format for a comprehensive male exam, and effective medical and surgical treatment of any discovered disorders. It is extremely important in the evaluation of infertility to consider the couple as a unit in evaluation and treatment and to proceed in a parallel investigative manner until a problem is uncovered. It has been shown that the longer a couple remains subfertile (less than normal capacity for reproduction), the worse their chance for an effective cure. Many couples experience significant apprehension and anxiety after only a few months of failure to conceive. The initial screening male fertility should be considered whenever the patient suspects infertility. The initial evaluation should be rapid, non-invasive and cost effective. Of interest is the fact that pregnancy rates of up to 50% have been reported when only the woman has been investigated and treated, even when the man was found to have moderately severe abnormalities of semen quality.