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Infertility in Males

Infertility in Males

Male infertility affects millions of couples worldwide, arising from various factors that impact different stages of the reproductive process. An endocrine imbalance resulting from conditions like hypogonadism, Klinefelter syndrome, or pituitary disorders can disrupt hormone levels and reduce sperm production. Testicular defects, such as tumors, cryptorchidism, atrophic testes, abnormal sperm morphology, and low sperm count or motility, may arise due to genetic factors, structural...

Infertility in Females

Infertility in Females

Female infertility is defined as the inability to conceive after a year of regular, unprotected intercourse and affects about 10–15% of couples worldwide. The primary cause of female infertility is ovulatory disorders, which hinder the release of eggs. These disorders can be classified as hypothalamic amenorrhea, polycystic ovarian syndrome (PCOS), premature ovarian failure, and hyperprolactinemic anovulation disorders.
Endometriosis, a condition characterized by abnormal growth of...

Spermatogenesis

Spermatogenesis

Spermatogenesis is the process by which haploid sperm cells are produced in the male testes. It starts with stem cells located close to the outer rim of seminiferous tubules. These spermatogonial stem cells divide asymmetrically to give rise to additional stem cells (meaning that these structures “self-renew”), as well as sperm progenitors, called spermatocytes. Importantly, this method of asymmetric mitotic division maintains a population of spermatogonial stem cells in the male...

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Updates to Male Infertility: AUA/ASRM Guideline (2024).

Robert E Brannigan¹, Linnea Hermanson², Janice Kaczmarek²

¹Department of Urology, Northwestern University, Feinberg School of Medicine, Chicago, Illinois.

The Journal of Urology

|August 15, 2024

Summary

This 2024 Guideline Amendment updates male infertility evaluation and management. It incorporates new evidence, offering revised guidance on genetic testing, imaging, and sperm retrieval for infertile couples.

Keywords:

ART IVF assisted reproductive technology in vitro in vitro fertilization infertility intrauterine insemination male male infertility miscarriage pregnancy loss

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Published on: September 16, 2021

Area of Science:

Reproductive Medicine
Urology
Andrology

Background:

The American Urological Association (AUA) previously published male infertility guidelines in 2020.
An Update Literature Review (ULR) was requested in 2023 to integrate new scientific evidence.
This amendment addresses the male partner's role in infertile couples.

Purpose of the Study:

To provide updated, evidence-based recommendations for the evaluation and management of male infertility.
To incorporate new literature published since the 2020 guideline.
To guide clinicians in the care of infertile males.

Main Methods:

An updated literature search identified 4093 new abstracts in 2023.
125 eligible studies met inclusion criteria after initial screening.
22 studies formed the evidence base for the Guideline amendment.

Main Results:

Evidence- and consensus-based statements were developed by the Panel.
Updated guidance addresses key areas of male infertility management.
New insights inform current clinical practice.

Conclusions:

Revised thresholds for Y-chromosome microdeletion testing are provided.
Indications for pelvic magnetic resonance imaging (MRI) in infertile males are updated.
Guidance on using testicular sperm in nonazoospermic males is included.