Fertility Blog

Causes of Male Infertility

The following is a brief classification of causes of infertility in a man.

PRE-TESTICULAR CAUSES OF INFERTILITY

  1. Hypothalamic disease
    1. Isolated gonadotropin deficiency (kallmann’s syndrome)
    2. Isolated LH deficiency (‘Fertile eunch’)
    3. Isolated FSH deficiency
    4. Congenital hypoganadrotropic syndromes
  2. Pituitary disease
    1. Pituitary insufficiency (tumours, infiltrative processes, operation, radiation)
    2. Hyperprolactinemia
    3. Hemochromatosis
    4. Exogenous hormones (estrogen-androgen excess, gluccorticoid excess, hyper and hypothyroidism)

TESTICULAR CAUSES OF INFERTILITY

  1. Chromosomal abnormalities (klinefelter’s syndrome, xx disorder (sex reversal syndrome), (xyy syndrome)
  2. Genetic (y micro-deletions)
  3. Noonan’s syndrome (male Turner’s syndrome)
  4. Myotonic dystrophy
  5. Bilateral anorchia (vanishing testes syndrome)
  6. Sertoli-cell-only syndrome (germinal cell aplasia)
  7. Gonadotoxins (drugs, radiation)
  8. Orchitis
  9. Trauma
  10. Systemic disease (renal failure, hepatic diseae, sickle cell disease)
  11. Defective androgen synthesis or action
  12. Cryptochidism
  13. Varicocele

POST TESTICULAR

  1. Obstructive:
    1. Epidydimis (Cogenital, infective)
    2. Deferens (Congenital, acquired)
  2. Epididymal hostility
  3. Accessory Gland (Infection)
  4. Immunological

To make a diagnosis, a comprehensive andrological clinical evaluation will need to be performed and this usually consists of thorough history taking, physical examination and laboratory tests.