The conventional management of male infertility

Although the male reproductive function is impaired in about half of infertile couples, the evaluation of male infertility is underrated or neglected even today. In addition to a physical examination and imaging techniques, semen analysis as well as endocrine and genetic analyses should be part of the routine investigation. Few disorders have become subjects of rational treatment of the infertile male, even though, as examples, hypogonadotropic hypogonadism is treatable by gonadotropins and obstructive azoospermia by reconstructive surgery. Early treatment of maldescended testes and sexually transmitted diseases can prevent infertility. Similar pregnancy rates from patients with varicocele following surgery or counseling demonstrate the important role of the physician in the treatment of infertility. In the age of evidence-based medicine, most empirical treatments have been demonstrated to be ineffective. Instead, symptomatic treatment by assisted reproductive techniques has become a central tool to overcome otherwise untreatable male infertility. (C) 2013 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.