[Assessment of the man in the infertile couple].

Abstract

BACKGROUND:

Among couples consulting for infertility, there is a male component, either alone or associated with a female aetiology in around one in 2 cases.

MATERIAL AND METHODS:

Bibliographic search in PubMed using the keywords "male infertility", "diagnosis", "management" and "evaluation" limited to clinical articles in English and French prior to 1/01/2023.

RESULTS:

The AFU recommends: (1) a complete medical history including: family history, patient history affecting fertility, lifestyle habits (toxicity), treatments, symptoms, sexual dysfunctions; (2) a physical examination including: BMI, signs of hypogonadism, secondary sexual characteristics, scrotal examination (volume and consistency of testes, vas deferens, epididymal or testicular nodules, presence of varicocele); (3) two spermograms, if abnormal on the first; (4) a systematic scrotal ultrasound,± an endorectal ultrasound depending on the clinic; (5) a hormonal work-up (testosterone, FSH; if testosterone is low: LH assay to differentiate between central or peripheral hypogonadism); (6) karyotype if sperm concentration≤10 million/mL; (7) evaluation of Y chromosome microdeletions if concentration≤1 million/mL; (8) evaluation of the CFTR gene in cases of suspected bilateral or unilateral agenesis of the vas deferens and seminal vesicles. The role and usefulness of direct and indirect tests to assess the effects of oxidative stress on sperm DNA will also be explained.

CONCLUSION:

This review complements and updates the AFU/SALF 2021 recommendations.

• Authors: A Faix, C Methorst, F Lamazou, F Vialard, E Huyghe
• Journal: Progres en urologie : journal de l'Association francaise d'urologie et de la Societe francaise d'urologie (Prog Urol) Vol. 33 Issue 13 Pg. 588-612 (Nov 2023) ISSN: 1166-7087 [Print] France
• Vernacular Title: Évaluation de l’homme du couple infertile.
• PMID: 38012906 (Publication Type: Review, English Abstract, Journal Article)
• Copyright: Copyright © 2023. Published by Elsevier Masson SAS.

Chemical References

• Testosterone

Topics

• Male
• Humans
• Female
• Semen
• Infertility, Male (diagnosis, etiology)
• Testis
• Testosterone
• Hypogonadism (diagnosis, complications)