Causes of male infertility. The contribution of endocrine factors

Background: Male infertility is responsible for 35% of infertile endocrine factors. Patients and methods: Patients referred to an andrology clinic due to an abnormal spermiogram were studied. A testicular examination, spermio gram and determination of FSH, LH, testosterone and prolactin were done to all. Testicular biopsy was done to patients with severe oligospermia or azo ospermia. Causes of infertility were defined and classified as pretesticula r, testicular, posttesticular or unclassified. Results: Two hundred fifty s even males were studied. In 3.5% of them, the cause of infertility was defi ned as pretesticular (that included hypothalamic and pituitary endocrine ca uses), in 66.9% it was classified as testicular, in 15.6% as posttesticular and in 14% as unclassified. Thirty percent of infertility cases were idiop athic, 17.9% were associated to varicocele, 12.8% were associated to crypto rchidism, 8.9% to Klinefelter syndrome and 6.6% to exposure to toxic substa nces. In 50% of patients with cryptochidism, this abnormality was found dur ing the specialized andrological examination and referrals for surgical cor rection were made late. Two thirds of patients with Klinefelter syndrome we re hypoandrogenic. Conclusions: Causes for male infertility should be inves tigated and diagnosed accurately. Primary hypoandrogenic testicular failure s must be treated with hormone replacement therapy.