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Diagnosis The diagnosis of male fertility must focus on a number of prevalent disorders (Table 1). Simultaneous assessment of the female partner is preferable, even if abnormalities are found in the male since WHO data show that, in 1 out of 4 couples who consult with fertility problems, both male and female partners have pathological findings.

Table 1: Reasons for a reduction in male infertility

  • Congenital factors (cryptorchidism and testicular dys- genesis, congenital absence of the vas deferens);

  • Acquired urogenital abnormalities (obstructions, testicular torsion, testicular tumour, orchitis);

  • Urogenital tract infections;

  • Increased scrotal temperature (e.g. as a consequence of varicocele);

  • Endocrine disturbances;

  • Genetic abnormalities;

  • Immunological factors;

  • Systemic diseases;

  • Exogenous factors (medications, toxins, irradiation, life- style factors);

  • Idiopathic (40-50% of cases).

Semen analysis Semen analysis forms the basis of important decisions con- cerning appropriate treatment. Semen analysis should be per- formed in a laboratory adhering to national quality control standards (Table 2).

158 Male Infertility

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