A. Orchitis
Inflammation of testis tissue is most commonly due to bacterial infection, termed epididymo-orchitis. Viral infections also occur in the testis in the form of mumps orchitis. Orchitis…

Peripheral resistance to androgens occurs with 2 basic defects: (1) a deficiency of androgen production through the absence of 5α-reductase or (2) a deficiency in the androgen receptor. In…

The undescended testis is a very common urologic problem, observed in 0.8% of boys at 1 year of age. It is considered a developmental defect and places the affected testis at…

A. Radiation
The effects of radiotherapy on sperm production are well described. They are derived mainly from a series of remarkable experiments performed during the “atomic age” but only recently…

A. Renal Failure
Uremia is associated with infertility, decreased libido, erectile dysfunction, and gynecomastia. The cause of hypogonadism is controversial and probably multifactorial. Testosterone levels are decreased, and FSH…

A. Noonan Syndrome
Also called male Turner syndrome, Noonan syndrome is associated with clinical features similar to Turner syndrome (45,X). However, the karyotype is either normal (46,XY) or mosaic…

A. Pituitary Insufficiency
Pituitary insufficiency may result from tumors, infarcts, surgery, radiation, or infiltrative and granulomatous processes. In sickle cell anemia, pituitary and testicular microinfarcts from sickling of red…

The causes underlying male infertility are numerous but are conveniently grouped by effects at one or more of the following levels: pretesticular, testicular, and posttesticular.

The testis biopsy is a useful adjunct in the infertility evaluation because it provides a more precise clinical diagnosis for several infertility disorders. Most commonly, the technique involves…

Many adjunctive tests are available to help evaluate male-factor infertility if the initial evaluation fails to lead to a diagnosis. One guiding principle in this era of cost-containment is to…

An evaluation of the pituitary-gonadal axis can provide valuable information on the state of sperm production. In turn, it can reveal problems with the pituitary axis that can cause infertility…

Laboratory testing is an important part of the male infertility evaluation.

A complete examination of the infertile male is important to identify general health issues associated with infertility. For example, the patient should be adequately virilized; signs of decreased body hair or gynecomastia…

Given that a male factor can be identified as the cause of infertility in 30-40% of couples and is a contributing factor in 50% of cases, it is important to evaluate the male…

Fertilization normally occurs within the ampullary portion of the fallopian tubes. During the middle of the female menstrual cycle the cervical mucus changes, becoming more abundant and watery. These changes facilitate the…