Male infertility is present in 30% - 45% of infertile couples. This high frequency seems to be increasing in parallel with a possible overall decline of sperm numbers and function worldwide.
Today, moderate and severe cases of male infertility are efficiently treated by the use of assisted reproductive technology ( ART ). Among these modalities, in vitro fertilization ( IVF ) and embryo transfer, augmented by intracytoplasmic sperm injection ( ICSI ), constitute formidable and successful means to achieve viable pregnancies in these groups of patients. ICSI has become a revolutionary alternative that offers a high chance of conception to men presenting with previously intractable or irreversible infertility.
It is mandatory for the male partner of all infertile couples to undergo a thorough physical examination followed by repeated semen analyses. The semen analysis should always include a state - of - the - art determination of the basic semen parameters ( i.e., sperm concentration, motility, morphology, and viability ) and a microbiologica ( semen culture ) investigation.
Hormonal evaluation and urologic consultation may be indicated in many cases. Because of the ICSI "revolution," many cases can be approached through a combined effort of ART and urologic interventions. A testicular biopsy may be indicated in some cases to determine the potential use of testicular sperm for ICSI.