Male Infertility: Aetiology and Management in Contemporary Practice

Abstract

Human reproduction, a pas de deux, is dependent on the functional competence of both male and female reproductive systems. Male factor infertility accounts for about half of the causes of infertility and strictly affects about 7% of all men. While most cases are idiopathic, a smaller proportion can be adduced to a wide variety of causes generally classified as pre-testicular, testicular, and post-testicular. Extrinsic factors bordering on behaviour and habits which are generally modifiable, should be given due attention in the evaluation and initial management of male infertility. A range of investigations can be employed in the evaluation of male infertility, however, semen analysis, the least invasive and most cost effective, is prognostic but does not always guarantee fecundity as multiple interrelated factors have been implicated in male infertility. Treatment options though varied, aim at improving semen quality and assisted reproductive technique (ART) is offered in cases of severe male infertility. This chapter provides an overview of male factor infertility with a focus on investigation and contemporary management in a dynamic world. It further provides insights into advances in stem cell therapeutics and artificial intelligence.