Male infertility

According to the World Health Organization (WHO), infertility is the failure of a couple to achieve pregnancy after one year of consistent unprotected sex. Male factors contribute to about 50 percent of all infertility cases. Male infertility is a multifactorial disease that can stem from multiple etiologies which can be congenital or acquired. Due to the complex nature of male infertility, a multifaceted approach is crucial for the diagnosis and treatment of the condition. But, in most cases, the cause of infertility is idiopathic. The diagnosis and management of male infertility is a comprehensive and stepwise process that involves history, physical examinations, and semen analyses which is the gold standard for evaluating male fertility in the clinic. The outcomes of semen analyses will determine the next step of investigation which may include hormone profiling, imaging, and genetic testing to identify the mechanism of infertility. Through advances in fertility research, Assisted Reproductive Technology has revolutionized the treatment approach for male infertility. ARTs like IVF and Intracytoplasmic sperm Injection have been useful in helping couples achieve pregnancy when all other treatment options have failed. Despite advances in fertility research, there are still challenges to be overcome such as improved access to fertility care, optimization of ART to achieve 100 percent clinical pregnancy, deeper understanding of etiologies of male infertility with emphasis on idiopathic male infertility. This review summarizes current knowledge on the etiologies, diagnosis, and therapeutic interventions as well as recent advances in basic and clinical research on male infertility.