Strategies for the infertile man

Male infertility is one of the most common, identifiable causes of human reproductive failure. Although considerable progress has been made toward understanding sperm physiology and the biology of gamete interaction, still more work is needed to achieve objectivity and standardization of some of the andrological diagnostic methods used in the clinical setting. More information is needed to definitively establish which tests are more accurate predictors of sperm performance and how they correlate with pregnancy potential following in vivo and in vitro interventions. Infertile men can be successfully treated with defined urological and medical therapies or with assisted reproductive technologies (ARTs). Among the latter, intracytoplasmic sperm injection (ICSI) has become a validated means to overcome multiple sperm deficiencies. Nevertheless, it is expected that simplified and more cost-efficient therapeutic modalities will be developed as additional basic (cellular-molecular) and clinical knowledge is gained.