The conventional management of male infertility.
Although the male reproductive function is impaired in about half of infertile couples, the evaluation of male infertility is underrated or neglected even today. In addition to a physical examination and imaging techniques, semen analysis as well as endocrine and genetic analyses should be part of the routine investigation. Few disorders have become subjects of rational treatment of the infertile male, even though, as examples, hypogonadotropic hypogonadism is treatable by gonadotropins and obstructive azoospermia by reconstructive surgery. Early treatment of maldescended testes and sexually transmitted diseases can prevent infertility. Similar pregnancy rates from patients with varicocele following surgery or counseling demonstrate the important role of the physician in the treatment of infertility. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Instead, symptomatic treatment by assisted reproductive techniques has become a central tool to overcome otherwise untreatable male infertility.
Center for Reproductive Medicine and Andrology, University of Münster, Germany; Center of Excellence in Genomic Medicine Research, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: eberhard.nieschlag@ukmuenster.de.
Eberhard
E
Nieschlag
Andrea
A
Lenzi
D019317:Evidence-Based Medicine / Q000379:methods; D005260:Female; D006801:Humans; D007248:Infertility, Male / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D008297:Male; D010819:Physician's Role; D011247:Pregnancy; D018873:Pregnancy Rate; D027724:Reproductive Techniques, Assisted
Clinical treatments; Maldescended testes; Male infertility; Semen analysis, Sexually transmitted diseases