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Chapter 12 - Endocrine Causes of Male Infertility – Diagnosis and Treatment

from Section 2 - Clinical Evaluation of the Infertile Male

Published online by Cambridge University Press:  08 July 2023

By
Fiona Yuen ,
Ronald S. Swerdloff  and
Christina C. L. Wang
Edited by
Larry I. Lipshultz ,
Stuart S. Howards ,
Craig S. Niederberger  and
Dolores J. Lamb
Larry I. Lipshultz
Affiliation:
Baylor College of Medicine, Texas
Stuart S. Howards
Affiliation:
University of Virginia
Craig S. Niederberger
Affiliation:
University of Illinois, Chicago
Dolores J. Lamb
Affiliation:
Weill Cornell Medical College, New York
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Summary

Infertility is generally defined as the inability to achieve conception after 12 months of regular unprotected sexual intercourse (World Health Organization (WHO)) [1]. It is estimated that approximately one-third of infertility cases are due to male factor infertility, another one-third due to female factor infertility, and the remainder due to combined male and female factors or unexplained cause(s). A recent large cross-sectional study suggests that about 10.1 percent of men experience infertility [2], and in a birth cohort study, in men aged 38 years, male infertility ranged from 14.4 to 21.8 percent [3]. Endocrine causes of male infertility are surprisingly infrequent, given that fertility is dependent on an intact hypothalamic–pituitary–testicular (HPT) axis (see Chapter 4) for adequate spermatogenesis. Systemic endocrine diseases and disturbances of the HPT axis comprise approximately 2 to 5 percent of causes of male infertility [4, 5]. Though uncommon, endocrine causes of infertility are important to diagnose, as specific treatment is available in most cases to ameliorate the clinical symptoms of hypogonadism and, in some instances, for treatment of infertility. Understanding the underlying endocrine etiology of infertility allows for shared decision-making in the management of a couple with infertility; furthermore, certain conditions may have serious health consequences if left untreated. Evaluation of endocrine causes is essential when investigating male factor infertility.

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Infertility in the Male , pp. 197 - 217
Publisher: Cambridge University Press
Print publication year: 2023

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References

Further Reading

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Stamou, MI, Georgopoulos, NA. Kallmann syndrome: phenotype and genotype of hypogonadotropic hypogonadism. Metabolism 2018;86:124–34.Google Scholar

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