Male infertility.

Male infertility is a common problem but only about one quarter of patients have specific or defined conditions that make them either sterile or severely infertile. About half of these patients have untreatable primary seminiferous tubule failure, and donor insemination or adoption are the only possibilities of having a family. The other half have potentially treatable conditions, including genital tract obstruction, sperm autoimmunity, gonadotropin deficiency, coital disorders, or reversible toxin effects. The majority of men seen for infertility (75%) have reduced semen quality, which impairs fertility to a variable degree. Thus far no treatments have been shown unequivocally to increase semen quality and fertility in this group. Assisted reproductive technology has improved the outlook for pregnancy in couples with male infertility and the new technique of intracytoplasmic sperm injection promises to further improve results for those with severe sperm defects or previous failure of in vitro fertilization.