Medical Treatment of Male Infertility

[Nelson Vergel]

Infertility is a major medical problem in the United States, affecting approximately 2.4 million, or an estimated 1 in 6, couples.1 Infertility is described as the inability to conceive after 1 year of unprotected, adequately timed intercourse. An individual who has never conceived before has primary infertility, whereas a person who has had a prior pregnancy and then fails to conceive has secondary infertility. However, in general, the evaluation and treatment of male infertility in either condition is nearly identical. Infertility seems to have increased in the past decade, yet this may be related to the following factors: voluntary delay in childbearing with an age-correlated decline in fertility status, use of contraceptive techniques, increased number of sexual partners with an increased risk of acquiring sexually transmitted diseases, and an increasing willingness to obtain medical assistance for infertility.

Normal fertile couples of reproductive age have a conception rate of 20% to 25% per month, with more than 90% conceiving within 1 year. Male factor infertility is involved in approximately 50% of infertile couples, and in 30% of the cases, an abnormality is discovered solely in the man.2 Despite the enormity of these numbers, the medical treatment of male infertility is continually frustrating, in light of the numerous etiologies but few which are truly amenable to effective medical management.

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