The male fertility investigation and the role of the andrology laboratory.

The laboratory diagnosis and treatment of male infertility has been a topic of study for numerous decades. Despite significant advances in the understanding of male reproductive physiology, clinical tests with high predictive value related to fertility are still greatly needed in the assessment of semen fertility. Due to the variety of possible sperm and semen abnormalities, a comprehensive approach using several tests is generally employed to assess the integrity of semen specimens. Following assessment, the most common sperm treatment for couples with difficulties conceiving is the use of different sperm-processing procedures prior to intrauterine insemination. If this treatment is unsuccessful following several insemination cycles, the couple may then consider therapeutic donor insemination. The use of donor semen can result in pregnancy in many circumstances in which the couple's only other options might have been adoption or more costly assisted reproductive procedures. Donor programs using frozen sperm have become far more sophisticated in recent years, paying close attention to the efficacy and safety of specimens as well as the emotional needs of the recipient couple. This review is designed to present an overview of the methods of evaluation and treatment of male infertility as well as some of the controversies surrounding some of these approaches.