Skip to main content
SpringerLink
Log in

Causes of Male Infertility

  • Chapter
  • First Online:
Male Infertility

Abstract

It is estimated that 12%–15% of sexually active couples are infertile. When broken down by gender, a male component can be identified approximately 50% of the time either in isolation or in combination with a female factor. Previous research in a US male fertility clinic analyzing 1430 patients identified causes of infertility from most to least common: varicocele, idiopathic, obstruction, female factor, cryptorchidism, immunologic, ejaculatory dysfunction, testicular failure, drug effects/radiation, endocrinology, and all others. However, despite recent technologic and diagnostic advances, idiopathic infertility remains a common diagnosis, with approximately 25% of patients not having an identifiable cause of infertility. Regardless, many recognizable causes of male infertility are treatable or preventable; thus, a keen understanding of these conditions is paramount. This chapter comprises an overview of etiologies of male infertility, divided into pre-testicular, testicular, and post-testicular causes.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Mosher WD. Reproductive impairments in the United States, 1965–1982. Demography. 1985;22:415–30.

    Article  CAS  PubMed  Google Scholar 

  2. Tielemans E, Burdorf A, te Velde E, Weber R, van Kooij R, Heederik D. Sources of bias in studies among infertility clients. Am J Epidemiol. 2002;156:86–92.

    Article  PubMed  Google Scholar 

  3. Sigman M. Male infertility. Med Health R I. 1997;80:406–9.

    CAS  PubMed  Google Scholar 

  4. Pierik FH, Van Ginneken AM, Dohle GR, Vreeburg JT, Weber RF. The advantages of standardized evaluation of male infertility. Int J Androl. 2000;23:340–6.

    Article  CAS  PubMed  Google Scholar 

  5. Organization WH. Towards more objectivity in diagnosis and management of male fertility. Int J Androl. 1997:1–53.

    Google Scholar 

  6. Buvat J. Hyperprolactinemia and sexual function in men: a short review. Int J Impot Res. 2003;15:373–7.

    Article  CAS  PubMed  Google Scholar 

  7. Carter JN, Tyson JE, Tolis G, Van Vliet S, Faiman C, Friesen HG. Prolactin-screening tumors and hypogonadism in 22 men. N Engl J Med. 1978;299:847–52.

    Article  CAS  PubMed  Google Scholar 

  8. Colao A, Vitale G, Cappabianca P, et al. Outcome of cabergoline treatment in men with prolactinoma: effects of a 24-month treatment on prolactin levels, tumor mass, recovery of pituitary function, and semen analysis. J Clin Endocrinol Metab. 2004;89:1704–11.

    Article  CAS  PubMed  Google Scholar 

  9. Glezer A, Bronstein MD. Prolactinomas. Endocrinol Metab Clin N Am. 2015;44:71–8.

    Article  Google Scholar 

  10. Patel SS, Bamigboye V. Hyperprolactinaemia. J Obstet Gynaecol. 2007;27:455–9.

    Article  CAS  PubMed  Google Scholar 

  11. Fasano S, Meccariello R, Cobellis G, et al. The endocannabinoid system: an ancient signaling involved in the control of male fertility. Ann N Y Acad Sci. 2009;1163:112–24.

    Article  CAS  PubMed  Google Scholar 

  12. Rettori V, De Laurentiis A, Fernandez-Solari J. Alcohol and endocannabinoids: neuroendocrine interactions in the reproductive axis. Exp Neurol. 2010;224:15–22.

    Article  CAS  PubMed  Google Scholar 

  13. Hsieh A, DiGiorgio L, Fakunle M, Sadeghi-Nejad H. Management strategies in opioid abuse and sexual dysfunction: a review of opioid-induced androgen deficiency. Sex Med Rev. 2018;6:618–23.

    Article  PubMed  Google Scholar 

  14. Safarinejad MR, Asgari SA, Farshi A, et al. The effects of opiate consumption on serum reproductive hormone levels, sperm parameters, seminal plasma antioxidant capacity and sperm DNA integrity. Reprod Toxicol. 2013;36:18–23.

    Article  CAS  PubMed  Google Scholar 

  15. O'Rourke TK Jr, Wosnitzer MS. Opioid-induced androgen deficiency (OPIAD): diagnosis, management, and literature review. Curr Urol Rep. 2016;17:76.

    Article  PubMed  Google Scholar 

  16. McBride JA, Coward RM. Recovery of spermatogenesis following testosterone replacement therapy or anabolic-androgenic steroid use. Asian J Androl. 2016;18:373–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Samplaski MK, Loai Y, Wong K, Lo KC, Grober ED, Jarvi KA. Testosterone use in the male infertility population: prescribing patterns and effects on semen and hormonal parameters. Fertil Steril. 2014;101:64–9.

    Article  CAS  PubMed  Google Scholar 

  18. Seminara SB, Hayes FJ, Crowley WF Jr. Gonadotropin-releasing hormone deficiency in the human (idiopathic hypogonadotropic hypogonadism and Kallmann's syndrome): pathophysiological and genetic considerations. Endocr Rev. 1998;19:521–39.

    CAS  PubMed  Google Scholar 

  19. Quinton R, Duke VM, Robertson A, et al. Idiopathic gonadotrophin deficiency: genetic questions addressed through phenotypic characterization. Clin Endocrinol. 2001;55:163–74.

    Article  CAS  Google Scholar 

  20. Dode C, Hardelin JP. Kallmann syndrome. Eur J Hum Genet. 2009;17:139–46.

    Article  CAS  PubMed  Google Scholar 

  21. Fechner A, Fong S, McGovern P. A review of Kallmann syndrome: genetics, pathophysiology, and clinical management. Obstet Gynecol Surv. 2008;63:189–94.

    Article  PubMed  Google Scholar 

  22. Raivio T, Falardeau J, Dwyer A, et al. Reversal of idiopathic hypogonadotropic hypogonadism. N Engl J Med. 2007;357:863–73.

    Article  CAS  PubMed  Google Scholar 

  23. Hardelin JP, Dode C. The complex genetics of Kallmann syndrome: KAL1, FGFR1, FGF8, PROKR2, PROK2, et al. Sex Dev. 2008;2:181–93.

    Article  CAS  PubMed  Google Scholar 

  24. Nagler HMGA. Varicocele. In: Lipshultz LIHS, Niederberger CS, editors. Infertility in the male. 4th ed. New York, NY: Cambridge University; 2009.

    Google Scholar 

  25. Organization WH. The influence of varicocele on parameters of fertility in a large group of men presenting to infertility clinics. Fertil Steril. 1992:1289–93.

    Google Scholar 

  26. Masson P, Brannigan RE. The varicocele. Urol Clin North Am. 2014;41:129–44.

    Article  PubMed  Google Scholar 

  27. MacLeod J. Seminal cytology in the presence of varicocele. Fertil Steril. 1965;16:735–57.

    Article  CAS  PubMed  Google Scholar 

  28. Paduch DA, Niedzielski J. Semen analysis in young men with varicocele: preliminary study. J Urol. 1996;156:788–90.

    Article  CAS  PubMed  Google Scholar 

  29. Paul C, Murray AA, Spears N, Saunders PT. A single, mild, transient scrotal heat stress causes DNA damage, subfertility and impairs formation of blastocysts in mice. Reproduction. 2008;136:73–84.

    Article  CAS  PubMed  Google Scholar 

  30. Dada R, Gupta NP, Kucheria K. Spermatogenic arrest in men with testicular hyperthermia. Teratog Carcinog Mutagen. 2003;(Suppl 1):235–43.

    Google Scholar 

  31. Esfandiari N, Saleh RA, Blaut AP, et al. Effects of temperature on sperm motion characteristics and reactive oxygen species. Int J Fertil Womens Med. 2002;47:227–33.

    PubMed  Google Scholar 

  32. Bedford JM. Effects of elevated temperature on the epididymis and testis: experimental studies. Adv Exp Med Biol. 1991;286:19–32.

    Article  CAS  PubMed  Google Scholar 

  33. Hjollund NH, Bonde JP, Jensen TK, Olsen J. Diurnal scrotal skin temperature and semen quality. The Danish first pregnancy planner study team. Int J Androl. 2000;23:309–18.

    Article  CAS  PubMed  Google Scholar 

  34. Wang C, McDonald V, Leung A, et al. Effect of increased scrotal temperature on sperm production in normal men. Fertil Steril. 1997;68:334–9.

    Article  CAS  PubMed  Google Scholar 

  35. Ivell R. Lifestyle impact and the biology of the human scrotum. Reprod Biol Endocrinol. 2007;5:15.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Mostafa T, Anis T, Imam H, El-Nashar AR, Osman IA. Seminal reactive oxygen species-antioxidant relationship in fertile males with and without varicocele. Andrologia. 2009;41:125–9.

    Article  CAS  PubMed  Google Scholar 

  37. Esteves SC, Agarwal A. Afterword to varicocele and male infertility: current concepts and future perspectives. Asian J Androl. 2016;18:319–22.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Allamaneni SS, Naughton CK, Sharma RK, Thomas AJ Jr, Agarwal A. Increased seminal reactive oxygen species levels in patients with varicoceles correlate with varicocele grade but not with testis size. Fertil Steril. 2004;82:1684–6.

    Article  PubMed  Google Scholar 

  39. Abd-Elmoaty MA, Saleh R, Sharma R, Agarwal A. Increased levels of oxidants and reduced antioxidants in semen of infertile men with varicocele. Fertil Steril. 2010;94:1531–4.

    Article  CAS  PubMed  Google Scholar 

  40. Raboch J, Starka L. Hormonal testicular activity in men with a varicocele. Fertil Steril. 1971;22:152–5.

    Article  CAS  PubMed  Google Scholar 

  41. Sirvent JJ, Bernat R, Navarro MA, Rodriguez Tolra J, Guspi R, Bosch R. Leydig cell in idiopathic varicocele. Eur Urol. 1990;17:257–61.

    Article  CAS  PubMed  Google Scholar 

  42. Dabaja AA, Goldstein M. When is a varicocele repair indicated: the dilemma of hypogonadism and erectile dysfunction? Asian J Androl. 2016;18:213–6.

    Article  PubMed  Google Scholar 

  43. Hayden RP, Tanrikut C. Testosterone and Varicocele. Urol Clin North Am. 2016;43:223–32.

    Article  PubMed  Google Scholar 

  44. Li F, Yue H, Yamaguchi K, et al. Effect of surgical repair on testosterone production in infertile men with varicocele: a meta-analysis. Int J Urol. 2012;19:149–54.

    Article  CAS  PubMed  Google Scholar 

  45. Shabana W, Teleb M, Dawod T, et al. Predictors of improvement in semen parameters after varicocelectomy for male subfertility: a prospective study. Can Urol Assoc J. 2015;9:E579–82.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Abdel-Meguid TA, Farsi HM, Al-Sayyad A, Tayib A, Mosli HA, Halawani AH. Effects of varicocele on serum testosterone and changes of testosterone after varicocelectomy: a prospective controlled study. Urology. 2014;84:1081–7.

    Article  PubMed  Google Scholar 

  47. Ahmed AF, Abdel-Aziz AS, Maarouf AM, Ali M, Emara AA, Gomaa A. Impact of varicocelectomy on premature ejaculation in varicocele patients. Andrologia. 2015;47:276–81.

    Article  PubMed  Google Scholar 

  48. Trsinar B, Muravec UR. Fertility potential after unilateral and bilateral orchidopexy for cryptorchidism. World J Urol. 2009;27:513–9.

    Article  PubMed  Google Scholar 

  49. Gracia J, Sanchez Zalabardo J, Sanchez Garcia J, Garcia C, Ferrandez A. Clinical, physical, sperm and hormonal data in 251 adults operated on for cryptorchidism in childhood. BJU Int. 2000;85:1100–3.

    Article  CAS  PubMed  Google Scholar 

  50. Lee PA, O'Leary LA, Songer NJ, Coughlin MT, Bellinger MF, LaPorte RE. Paternity after unilateral cryptorchidism: a controlled study. Pediatrics. 1996;98:676–9.

    CAS  PubMed  Google Scholar 

  51. Lee PA, O'Leary LA, Songer NJ, Coughlin MT, Bellinger MF, LaPorte RE. Paternity after bilateral cryptorchidism. A controlled study. Arch Pediatr Adolesc Med. 1997;151:260–3.

    Article  CAS  PubMed  Google Scholar 

  52. Canavese F, Mussa A, Manenti M, et al. Sperm count of young men surgically treated for cryptorchidism in the first and second year of life: fertility is better in children treated at a younger age. Eur J Pediatr Surg. 2009;19:388–91.

    Article  CAS  PubMed  Google Scholar 

  53. Wiser A, Raviv G, Weissenberg R, et al. Does age at orchidopexy impact on the results of testicular sperm extraction? Reprod Biomed Online. 2009;19:778–83.

    Article  CAS  PubMed  Google Scholar 

  54. Cooper ER. The histology of the retained testis in the human subject at different ages, and its comparison with the scrotal testis. J Anat. 1929;64:5–27.

    CAS  PubMed  PubMed Central  Google Scholar 

  55. Murphy F, Paran TS, Puri P. Orchidopexy and its impact on fertility. Pediatr Surg Int. 2007;23:625–32.

    Article  PubMed  Google Scholar 

  56. Setchell BP. The Parkes lecture. Heat and the testis. J Reprod Fertil. 1998;114:179–94.

    Article  CAS  PubMed  Google Scholar 

  57. Leissner J, Filipas D, Wolf HK, Fisch M. The undescended testis: considerations and impact on fertility. BJU Int. 1999;83:885–91; quiz 91–2.

    Google Scholar 

  58. Hadziselimovic F, Zivkovic D, Bica DT, Emmons LR. The importance of mini-puberty for fertility in cryptorchidism. J Urol. 2005;174:1536–9; discussion 8–9.

    Google Scholar 

  59. Kurpisz M, Havryluk A, Nakonechnyj A, Chopyak V, Kamieniczna M. Cryptorchidism and long-term consequences. Reprod Biol. 2010;10:19–35.

    Article  PubMed  Google Scholar 

  60. Jorgensen N, Rajpert-De Meyts E, Main KM, Skakkebaek NE. Testicular dysgenesis syndrome comprises some but not all cases of hypospadias and impaired spermatogenesis. Int J Androl. 2010;33:298–303.

    Article  CAS  PubMed  Google Scholar 

  61. Abe T, Takaha N, Tsujimura A, et al. Leydig cell tumor of the testis presenting male infertility: a case report. Hinyokika Kiyo. 2003;49:39–42.

    PubMed  Google Scholar 

  62. Shiraishi Y, Nishiyama H, Okubo K, et al. Testicular Leydig cell tumor presenting as male infertility: a case report. Hinyokika Kiyo. 2009;55:777–81.

    PubMed  Google Scholar 

  63. Chovelidze Sh G, Kochiashvili DK, Gogeshvili GG, Getta T, Lababidi A. Cases of Leydig cell tumor in male infertility. Georgian Med News. 2007:76–9.

    Google Scholar 

  64. Hayashi T, Arai G, Hyochi N, et al. Suppression of spermatogenesis in ipsilateral and contralateral testicular tissues in patients with seminoma by human chorionic gonadotropin beta subunit. Urology. 2001;58:251–7.

    Article  CAS  PubMed  Google Scholar 

  65. Ho GT, Gardner H, DeWolf WC, Loughlin KR, Morgentaler A. Influence of testicular carcinoma on ipsilateral spermatogenesis. J Urol. 1992;148:821–5.

    Article  CAS  PubMed  Google Scholar 

  66. Carmignani L, Gadda F, Paffoni A, et al. Azoospermia and severe oligospermia in testicular cancer. Arch Ital Urol Androl. 2009;81:21–3.

    PubMed  Google Scholar 

  67. Rowley MJ, Leach DR, Warner GA, Heller CG. Effect of graded doses of ionizing radiation on the human testis. Radiat Res. 1974;59:665–78.

    Article  CAS  PubMed  Google Scholar 

  68. Paulsen CA. The study of radiation effects on the human testis: including histologic, chromosomal and hormonal aspects. Final Progress Report of AEC contract AT(45-1)-2225, Tas Agreement 6. RLO-225-2. 1973.

    Google Scholar 

  69. Speiser B, Rubin P, Casarett G. Aspermia following lower truncal irradiation in Hodgkin's disease. Cancer. 1973;32:692–8.

    Article  CAS  PubMed  Google Scholar 

  70. Ash P. The influence of radiation on fertility in man. Br J Radiol. 1980;53:271–8.

    Article  CAS  PubMed  Google Scholar 

  71. Spitz S. The histological effects of nitrogen mustards on human tumors and tissues. Cancer. 1948;1:383–98.

    Article  CAS  PubMed  Google Scholar 

  72. Watson AR, Rance CP, Bain J. Long term effects of cyclophosphamide on testicular function. Br Med J (Clin Res Ed). 1985;291:1457–60.

    Article  CAS  Google Scholar 

  73. Pryzant RM, Meistrich ML, Wilson G, Brown B, McLaughlin P. Long-term reduction in sperm count after chemotherapy with and without radiation therapy for non-Hodgkin's lymphomas. J Clin Oncol. 1993;11:239–47.

    Article  CAS  PubMed  Google Scholar 

  74. da Cunha MF, Meistrich ML, Fuller LM, et al. Recovery of spermatogenesis after treatment for Hodgkin's disease: limiting dose of MOPP chemotherapy. J Clin Oncol. 1984;2:571–7.

    Article  PubMed  Google Scholar 

  75. Meistrich ML, Chawla SP, Da Cunha MF, et al. Recovery of sperm production after chemotherapy for osteosarcoma. Cancer. 1989;63:2115–23.

    Article  CAS  PubMed  Google Scholar 

  76. Katz DJ, Kolon TF, Feldman DR, Mulhall JP. Fertility preservation strategies for male patients with cancer. Nat Rev Urol. 2013;10:463–72.

    Article  PubMed  Google Scholar 

  77. Meistrich ML. Effects of chemotherapy and radiotherapy on spermatogenesis in humans. Fertil Steril. 2013;100:1180–6.

    Article  CAS  PubMed  Google Scholar 

  78. Ferlin A, Raicu F, Gatta V, Zuccarello D, Palka G, Foresta C. Male infertility: role of genetic background. Reprod Biomed Online. 2007;14:734–45.

    Article  CAS  PubMed  Google Scholar 

  79. Berookhim BM, Schlegel PN. Azoospermia due to spermatogenic failure. Urol Clin North Am. 2014;41:97–113.

    Article  PubMed  Google Scholar 

  80. Vogt PH. Azoospermia factor (AZF) in Yq11: towards a molecular understanding of its function for human male fertility and spermatogenesis. Reprod Biomed Online. 2005;10:81–93.

    Article  CAS  PubMed  Google Scholar 

  81. Stahl PJ, Masson P, Mielnik A, Marean MB, Schlegel PN, Paduch DA. A decade of experience emphasizes that testing for Y microdeletions is essential in American men with azoospermia and severe oligozoospermia. Fertil Steril. 2010;94:1753–6.

    Article  CAS  PubMed  Google Scholar 

  82. Sabbaghian M, Mohseni Meybodi A, Rafaee A, Saba S, Zamanian M, Sadighi Gilani MA. Sperm retrieval rate and reproductive outcome of infertile men with azoospermia factor c deletion. Andrologia. 2018:e13052.

    Google Scholar 

  83. Oates RD, Silber S, Brown LG, Page DC. Clinical characterization of 42 oligospermic or azoospermic men with microdeletion of the AZFc region of the Y chromosome, and of 18 children conceived via ICSI. Hum Reprod. 2002;17:2813–24.

    Article  CAS  PubMed  Google Scholar 

  84. Dabaja AA, Schlegel PN. Microdissection testicular sperm extraction: an update. Asian J Androl. 2013;15:35–9.

    Article  PubMed  Google Scholar 

  85. Kamischke A, Baumgardt A, Horst J, Nieschlag E. Clinical and diagnostic features of patients with suspected Klinefelter syndrome. J Androl. 2003;24:41–8.

    Article  PubMed  Google Scholar 

  86. Bojesen A, Gravholt CH. Klinefelter syndrome in clinical practice. Nat Clin Pract Urol. 2007;4:192–204.

    Article  PubMed  Google Scholar 

  87. Ferlin A, Garolla A, Foresta C. Chromosome abnormalities in sperm of individuals with constitutional sex chromosomal abnormalities. Cytogenet Genome Res. 2005;111:310–6.

    Article  CAS  PubMed  Google Scholar 

  88. Ghorbel M, Gargouri Baklouti S, Ben Abdallah F, et al. Chromosomal defects in infertile men with poor semen quality. J Assist Reprod Genet. 2012;29:451–6.

    Article  PubMed  PubMed Central  Google Scholar 

  89. Blanco J, Egozcue J, Vidal F. Meiotic behaviour of the sex chromosomes in three patients with sex chromosome anomalies (47,XXY, mosaic 46,XY/47,XXY and 47,XYY) assessed by fluorescence in-situ hybridization. Hum Reprod. 2001;16:887–92.

    Article  CAS  PubMed  Google Scholar 

  90. Bergere M, Wainer R, Nataf V, et al. Biopsied testis cells of four 47,XXY patients: fluorescence in-situ hybridization and ICSI results. Hum Reprod. 2002;17:32–7.

    Article  PubMed  Google Scholar 

  91. Wikstrom AM, Dunkel L. Testicular function in Klinefelter syndrome. Horm Res. 2008;69:317–26.

    CAS  PubMed  Google Scholar 

  92. Fullerton G, Hamilton M, Maheshwari A. Should non-mosaic Klinefelter syndrome men be labelled as infertile in 2009? Hum Reprod. 2010;25:588–97.

    Article  CAS  PubMed  Google Scholar 

  93. O'Flynn O'Brien KL, Varghese AC, Agarwal A. The genetic causes of male factor infertility: a review. Fertil Steril. 2010;93:1–12.

    Article  CAS  PubMed  Google Scholar 

  94. Shafik A. Contraceptive efficacy of polyester-induced azoospermia in normal men. Contraception. 1992;45:439–51.

    Article  CAS  PubMed  Google Scholar 

  95. Munkelwitz R, Gilbert BR. Are boxer shorts really better? A critical analysis of the role of underwear type in male subfertility. J Urol. 1998;160:1329–33.

    Article  CAS  PubMed  Google Scholar 

  96. Bonde JP, Ernst E. Sex hormones and semen quality in welders exposed to hexavalent chromium. Hum Exp Toxicol. 1992;11:259–63.

    Article  CAS  PubMed  Google Scholar 

  97. Jung A, Schuppe HC. Influence of genital heat stress on semen quality in humans. Andrologia. 2007;39:203–15.

    Article  CAS  PubMed  Google Scholar 

  98. Agarwal A, Deepinder F, Sharma RK, Ranga G, Li J. Effect of cell phone usage on semen analysis in men attending infertility clinic: an observational study. Fertil Steril. 2008;89:124–8.

    Article  PubMed  Google Scholar 

  99. Agarwal A, Desai NR, Makker K, et al. Effects of radiofrequency electromagnetic waves (RF-EMW) from cellular phones on human ejaculated semen: an in vitro pilot study. Fertil Steril. 2009;92:1318–25.

    Article  PubMed  Google Scholar 

  100. Collodel G, Capitani S, Pammolli A, Giannerini V, Geminiani M, Moretti E. Semen quality of male idiopathic infertile smokers and nonsmokers: an ultrastructural study. J Androl. 2010;31:108–13.

    Article  CAS  PubMed  Google Scholar 

  101. Calogero A, Polosa R, Perdichizzi A, et al. Cigarette smoke extract immobilizes human spermatozoa and induces sperm apoptosis. Reprod Biomed Online. 2009;19:564–71.

    Article  PubMed  Google Scholar 

  102. Gaur DS, Talekar MS, Pathak VP. Alcohol intake and cigarette smoking: impact of two major lifestyle factors on male fertility. Indian J Pathol Microbiol. 2010;53:35–40.

    Article  PubMed  Google Scholar 

  103. Kunzle R, Mueller MD, Hanggi W, Birkhauser MH, Drescher H, Bersinger NA. Semen quality of male smokers and nonsmokers in infertile couples. Fertil Steril. 2003;79:287–91.

    Article  PubMed  Google Scholar 

  104. Sallmen M, Sandler DP, Hoppin JA, Blair A, Baird DD. Reduced fertility among overweight and obese men. Epidemiology. 2006;17:520–3.

    Article  PubMed  Google Scholar 

  105. Hammoud AO, Gibson M, Peterson CM, Meikle AW, Carrell DT. Impact of male obesity on infertility: a critical review of the current literature. Fertil Steril. 2008;90:897–904.

    Article  PubMed  Google Scholar 

  106. Alshahrani S, Ahmed AF, Gabr AH, Abalhassan M, Ahmad G. The impact of body mass index on semen parameters in infertile men. Andrologia. 2016;48:1125–9.

    Article  CAS  PubMed  Google Scholar 

  107. Craig JR, Jenkins TG, Carrell DT, Hotaling JM. Obesity, male infertility, and the sperm epigenome. Fertil Steril. 2017;107:848–59.

    Article  PubMed  Google Scholar 

  108. Dupont C, Faure C, Sermondade N, et al. Obesity leads to higher risk of sperm DNA damage in infertile patients. Asian J Androl. 2013;15:622–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  109. Vermeulen A, Kaufman JM, Deslypere JP, Thomas G. Attenuated luteinizing hormone (LH) pulse amplitude but normal LH pulse frequency, and its relation to plasma androgens in hypogonadism of obese men. J Clin Endocrinol Metab. 1993;76:1140–6.

    CAS  PubMed  Google Scholar 

  110. Lamm S, Chidakel A, Bansal R. Obesity and hypogonadism. Urol Clin North Am. 2016;43:239–45.

    Article  PubMed  Google Scholar 

  111. Twig G, Yaniv G, Levine H, et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016;374:2430–40.

    Article  PubMed  Google Scholar 

  112. Brandes SB, Buckman RF, Chelsky MJ, Hanno PM. External genitalia gunshot wounds: a ten-year experience with fifty-six cases. J Trauma. 1995;39:266–71; discussion 71–2.

    Google Scholar 

  113. Cass AS, Ferrara L, Wolpert J, Lee J. Bilateral testicular injury from external trauma. J Urol. 1988;140:1435–6.

    Article  CAS  PubMed  Google Scholar 

  114. Kuhlmann J, Bohme H, Tauber R. Bilateral testicular gunshot injuries. Urologe A. 2005;44:918–20.

    Article  CAS  PubMed  Google Scholar 

  115. Tomomasa H, Oshio S, Amemiya H, et al. Testicular injury: late results of semen analyses after uniorchiectomy. Arch Androl. 1992;29:59–63.

    Article  CAS  PubMed  Google Scholar 

  116. Lin WW, Kim ED, Quesada ET, Lipshultz LI, Coburn M. Unilateral testicular injury from external trauma: evaluation of semen quality and endocrine parameters. J Urol. 1998;159:841–3.

    Article  CAS  PubMed  Google Scholar 

  117. Kukadia AN, Ercole CJ, Gleich P, Hensleigh H, Pryor JL. Testicular trauma: potential impact on reproductive function. J Urol. 1996;156:1643–6.

    Article  CAS  PubMed  Google Scholar 

  118. Masarani M, Wazait H, Dinneen M. Mumps orchitis. J R Soc Med. 2006;99:573–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Philip J, Selvan D, Desmond AD. Mumps orchitis in the non-immune postpubertal male: a resurgent threat to male fertility? BJU Int. 2006;97:138–41.

    Article  PubMed  Google Scholar 

  120. Osegbe DN. Testicular function after unilateral bacterial epididymo-orchitis. Eur Urol. 1991;19:204–8.

    Article  CAS  PubMed  Google Scholar 

  121. Schuppe HC, Meinhardt A, Allam JP, Bergmann M, Weidner W, Haidl G. Chronic orchitis: a neglected cause of male infertility? Andrologia. 2008;40:84–91.

    Article  PubMed  Google Scholar 

  122. Zariwala MA, Knowles MR, Omran H. Genetic defects in ciliary structure and function. Annu Rev Physiol. 2007;69:423–50.

    Article  CAS  PubMed  Google Scholar 

  123. Leigh MW, Pittman JE, Carson JL, et al. Clinical and genetic aspects of primary ciliary dyskinesia/Kartagener syndrome. Genet Med. 2009;11:473–87.

    Article  PubMed  PubMed Central  Google Scholar 

  124. Collins JA, Burrows EA, Yeo J, YoungLai EV. Frequency and predictive value of antisperm antibodies among infertile couples. Hum Reprod. 1993;8:592–8.

    Article  CAS  PubMed  Google Scholar 

  125. Menge AC, Medley NE, Mangione CM, Dietrich JW. The incidence and influence of antisperm antibodies in infertile human couples on sperm-cervical mucus interactions and subsequent fertility. Fertil Steril. 1982;38:439–46.

    Article  CAS  PubMed  Google Scholar 

  126. Sinisi AA, Di Finizio B, Pasquali D, Scurini C, D'Apuzzo A, Bellastella A. Prevalence of antisperm antibodies by SpermMARtest in subjects undergoing a routine sperm analysis for infertility. Int J Androl. 1993;16:311–4.

    Article  CAS  PubMed  Google Scholar 

  127. Heidenreich A, Bonfig R, Wilbert DM, Strohmaier WL, Engelmann UH. Risk factors for antisperm antibodies in infertile men. Am J Reprod Immunol. 1994;31:69–76.

    Article  CAS  PubMed  Google Scholar 

  128. Walsh TTP, Infertility I. In: Lipschultz L, Howards SS, Niederberger CS, editors. Infertility in the male. New York, NY: Cambridge University; 2009.

    Google Scholar 

  129. Lissens W, Mercier B, Tournaye H, et al. Cystic fibrosis and infertility caused by congenital bilateral absence of the vas deferens and related clinical entities. Hum Reprod. 1996;11(Suppl 4):55–78; (discussion 9-80).

    Article  PubMed  Google Scholar 

  130. Donat R, McNeill AS, Fitzpatrick DR, Hargreave TB. The incidence of cystic fibrosis gene mutations in patients with congenital bilateral absence of the vas deferens in Scotland. Br J Urol. 1997;79:74–7.

    Article  CAS  PubMed  Google Scholar 

  131. Sokol RZ. Infertility in men with cystic fibrosis. Curr Opin Pulm Med. 2001;7:421–6.

    Article  CAS  PubMed  Google Scholar 

  132. Dork T, Dworniczak B, Aulehla-Scholz C, et al. Distinct spectrum of CFTR gene mutations in congenital absence of vas deferens. Hum Genet. 1997;100:365–77.

    Article  CAS  PubMed  Google Scholar 

  133. Gaillard DA, Carre-Pigeon F, Lallemand A. Normal vas deferens in fetuses with cystic fibrosis. J Urol. 1997;158:1549–52.

    Article  CAS  PubMed  Google Scholar 

  134. Radpour R, Gourabi H, Dizaj AV, Holzgreve W, Zhong XY. Genetic investigations of CFTR mutations in congenital absence of vas deferens, uterus, and vagina as a cause of infertility. J Androl. 2008;29:506–13.

    Article  CAS  PubMed  Google Scholar 

  135. Donohue RE, Fauver HE. Unilateral absence of the vas deferens. A useful clinical sign. JAMA. 1989;261:1180–2.

    Article  CAS  PubMed  Google Scholar 

  136. Shapiro E, Goldfarb DA, Ritchey ML. The congenital and acquired solitary kidney. Rev Urol. 2003;5:2–8.

    PubMed  PubMed Central  Google Scholar 

  137. Handelsman DJ, Conway AJ, Boylan LM, Turtle JR. Young's syndrome. Obstructive azoospermia and chronic sinopulmonary infections. N Engl J Med. 1984;310:3–9.

    Article  CAS  PubMed  Google Scholar 

  138. Domingo C, Mirapeix RM, Encabo B, Roig J, Lopez D, Ruiz J. Clinical features and ultrastructure of primary ciliary dyskinesia and young syndrome. Rev Clin Esp. 1997;197:100–3.

    CAS  PubMed  Google Scholar 

  139. Goeminne PC, Dupont LJ. The sinusitis-infertility syndrome: Young’s saint, old devil. Eur Respir J. 2010;35:698.

    Google Scholar 

  140. Arya AK, Beer HL, Benton J, Lewis-Jones I, Swift AC. Does Young’s syndrome exist? J Laryngol Otol. 2009;123:477–81.

    Google Scholar 

  141. Smith JF, Walsh TJ, Turek PJ. Ejaculatory duct obstruction. Urol Clin North Am. 2008;35:221–7, viii.

    Article  PubMed  Google Scholar 

  142. Paick J, Kim SH, Kim SW. Ejaculatory duct obstruction in infertile men. BJU Int. 2000;85:720–4.

    Article  CAS  PubMed  Google Scholar 

  143. Carson CC. Transurethral resection for ejaculatory duct stenosis and oligospermia. Fertil Steril. 1984;41:482–4.

    Article  CAS  PubMed  Google Scholar 

  144. Talbot HS. The sexual function in paraplegia. J Urol. 1955;73:91–100.

    Article  CAS  PubMed  Google Scholar 

  145. Utida C, Truzzi JC, Bruschini H, et al. Male infertility in spinal cord trauma. Int Braz J Urol. 2005;31:375–83.

    Article  PubMed  Google Scholar 

  146. Ibrahim E, Brackett NL, Lynne CM. Advances in the management of infertility in men with spinal cord injury. Asian J Androl. 2016;18:382–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  147. Patki P, Woodhouse J, Hamid R, Craggs M, Shah J. Effects of spinal cord injury on semen parameters. J Spinal Cord Med. 2008;31:27–32.

    Article  PubMed  PubMed Central  Google Scholar 

  148. Restelli AE, Bertolla RP, Spaine DM, Miotto A Jr, Borrelli M Jr, Cedenho AP. Quality and functional aspects of sperm retrieved through assisted ejaculation in men with spinal cord injury. Fertil Steril. 2009;91:819–25.

    Article  PubMed  Google Scholar 

  149. Ibrahim E, Lynne CM, Brackett NL. Male fertility following spinal cord injury: an update. Andrology. 2016;4:13–26.

    Article  CAS  PubMed  Google Scholar 

  150. Wieder JA, Lynne CM, Ferrell SM, Aballa TC, Brackett NL. Brown-colored semen in men with spinal cord injury. J Androl. 1999;20:594–600.

    CAS  PubMed  Google Scholar 

  151. Narayan P, Lange PH, Fraley EE. Ejaculation and fertility after extended retroperitoneal lymph node dissection for testicular cancer. J Urol. 1982;127:685–8.

    Article  CAS  PubMed  Google Scholar 

  152. Lange PH, Narayan P, Vogelzang NJ, Shafer RB, Kennedy BJ, Fraley EE. Return of fertility after treatment for nonseminomatous testicular cancer: changing concepts. J Urol. 1983;129:1131–5.

    Article  CAS  PubMed  Google Scholar 

  153. Pizzocaro G, Salvioni R, Zanoni F. Unilateral lymphadenectomy in intraoperative stage I nonseminomatous germinal testis cancer. J Urol. 1985;134:485–9.

    Article  CAS  PubMed  Google Scholar 

  154. Richie JP. Clinical stage 1 testicular cancer: the role of modified retroperitoneal lymphadenectomy. J Urol. 1990;144:1160–3.

    Article  CAS  PubMed  Google Scholar 

  155. Donohue JP, Foster RS, Rowland RG, Bihrle R, Jones J, Geier G. Nerve-sparing retroperitoneal lymphadenectomy with preservation of ejaculation. J Urol. 1990;144:287–91; discussion 91–2.

    Google Scholar 

  156. Heidenreich A, Albers P, Hartmann M, et al. Complications of primary nerve sparing retroperitoneal lymph node dissection for clinical stage I nonseminomatous germ cell tumors of the testis: experience of the German testicular cancer study group. J Urol. 2003;169:1710–4.

    Article  PubMed  Google Scholar 

  157. Pettus JA, Carver BS, Masterson T, Stasi J, Sheinfeld J. Preservation of ejaculation in patients undergoing nerve-sparing postchemotherapy retroperitoneal lymph node dissection for metastatic testicular cancer. Urology. 2009;73:328–31; discussion 31–2.

    Google Scholar 

  158. Hellstrom WJ, Sikka SC. Effects of acute treatment with tamsulosin versus alfuzosin on ejaculatory function in normal volunteers. J Urol. 2006;176:1529–33.

    Article  CAS  PubMed  Google Scholar 

  159. Marks LS, Gittelman MC, Hill LA, Volinn W, Hoel G. Silodosin in the treatment of the signs and symptoms of benign prostatic hyperplasia: a 9-month, open-label extension study. Urology. 2009;74:1318–22.

    Article  PubMed  Google Scholar 

  160. Hisasue S, Furuya R, Itoh N, Kobayashi K, Furuya S, Tsukamoto T. Ejaculatory disorder caused by alpha-1 adrenoceptor antagonists is not retrograde ejaculation but a loss of seminal emission. Int J Urol. 2006;13:1311–6.

    Article  CAS  PubMed  Google Scholar 

  161. Kobayashi K, Masumori N, Hisasue S, et al. Inhibition of seminal emission is the main cause of anejaculation induced by a new highly selective alpha1A-blocker in normal volunteers. J Sex Med. 2008;5:2185–90.

    Article  PubMed  Google Scholar 

  162. Smith SM, O'Keane V, Murray R. Sexual dysfunction in patients taking conventional antipsychotic medication. Br J Psychiatry. 2002;181:49–55.

    Article  CAS  PubMed  Google Scholar 

  163. Loh C, Leckband SG, Meyer JM, Turner E. Risperidone-induced retrograde ejaculation: case report and review of the literature. Int Clin Psychopharmacol. 2004;19:111–2.

    Article  PubMed  Google Scholar 

  164. Haefliger T, Bonsack C. Atypical antipsychotics and sexual dysfunction: five case-reports associated with risperidone. Encéphale. 2006;32:97–105.

    Article  CAS  PubMed  Google Scholar 

  165. Agarwal A, Deepinder F, Cocuzza M, Short RA, Evenson DP. Effect of vaginal lubricants on sperm motility and chromatin integrity: a prospective comparative study. Fertil Steril. 2008;89:375–9.

    Article  PubMed  Google Scholar 

  166. Kutteh WH, Chao CH, Ritter JO, Byrd W. Vaginal lubricants for the infertile couple: effect on sperm activity. Int J Fertil Menopausal Stud. 1996;41:400–4.

    CAS  PubMed  Google Scholar 

  167. Anderson L, Lewis SE, McClure N. The effects of coital lubricants on sperm motility in vitro. Hum Reprod. 1998;13:3351–6.

    Article  CAS  PubMed  Google Scholar 

Notable Suggested Readings from the Last 5 Years

  • Abdel-Meguid TA, Farsi HM, Al-Sayyad A, Tayib A, Mosli HA, Halawani AH. Effects of varicocele on serum testosterone and changes of testosterone after varicocelectomy: a prospective controlled study. Urology. 2014;84:1081–7.

    Article  PubMed  Google Scholar 

  • Craig JR, Jenkins TG, Carrell DT, Hotaling JM. Obesity, male infertility, and the sperm epigenome. Fertil Steril. 2017;107:848–59.

    Article  PubMed  Google Scholar 

  • Ibrahim E, Lynne CM, Brackett NL. Male fertility following spinal cord injury: an update. Andrology. 2016;4:13–26.

    Article  CAS  PubMed  Google Scholar 

  • Punab M, Poolamets O, Paju P, Vihljajev V, Pomm K, Ladva R, Korrovits P, Laan M. Causes of male infertility: a 9-year prospective monocentre study on 1737 patients with reduced total sperm counts. Hum Reprod. 2017;32:18–31.

    CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Urology, Medical College of Wisconsin, Milwaukee, WI, USA

    Graham Luke Machen & Jay I. Sandlow

Authors
  1. Graham Luke Machen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jay I. Sandlow
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jay I. Sandlow .

Editor information

Editors and Affiliations

  1. PUR Clinic, University of Central Florida (UCF), Clermont, FL, USA

    Sijo J. Parekattil

  2. ANDROFERT and State University of Campinas (UNICAMP), Campinas, Brazil

    Sandro C. Esteves

  3. Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA

    Ashok Agarwal

Rights and permissions

Reprints and permissions

Copyright information

© 2020 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Machen, G.L., Sandlow, J.I. (2020). Causes of Male Infertility. In: Parekattil, S., Esteves, S., Agarwal, A. (eds) Male Infertility. Springer, Cham. https://doi.org/10.1007/978-3-030-32300-4_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-32300-4_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-32299-1

  • Online ISBN: 978-3-030-32300-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation