Male fertility and infertility in 2011 and beyond

In 30–50% of sub-fertile couples the male partner has poor semen quality, either because of low sperm count, poorly motile sperm or sperm with abnormal size and shape (morphology). This may result from inherent genetic factors, poor pre-natal testicular development or adult exposure to gonadotoxic agents. There are few proven therapies to improve semen quality. Therefore, the number and quality of sperm that can be recovered from the ejaculate, or obtained by surgical sperm recovery, determines the available options for assisted conception. In recent years, the reliance upon donor sperm has reduced markedly as intracytoplasmic sperm injection can be attempted. Reproductive technologies are considered relatively safe, with healthy babies born; however, there are some concerns about potential reproductive problems in males conceived in this way. These may be related to the techniques used, or the underlying infertility of the parents, and are currently the subject of follow-up studies.