Box 6.36Causes of male infertility*

Testicular disease (50% of total)

  • Unknown (~50%)
  • Maldescent (~20%)
  • Torsion/trauma (~5%)
  • Klinefelter's (~20%)
  • Orchitis (~5%)
  • Chemotherapy (~5%)

Duct obstruction (~15% of total) - may occur in rete testis or the result of too tight coiling of the seminiferous tubules: most commonly in the epididymal duct (as a result of infection, trauma, congenital abnormality). Obstruction of the vas deferens is usually surgical but may be congenital particularly in patients heterozygous for the ΔF508 mutation causing cystic fibrosis.

Endocrine (~2% of total) - any cause of hypopituitarism (see Box 7.9)

Autoimmune (5% of total)

Sperm abnormalities (~25% of total)

Ejaculatory problems (~5% of total)


It is difficult to establish the exact frequencies of the causes of infertility. The exact roles of, for example, varicocele or autoimmunity continue to be debated.

From: Chapter 6, The gonad

Cover of Endocrinology
Endocrinology: An Integrated Approach.
Nussey S, Whitehead S.
Copyright © 2001, BIOS Scientific Publishers Limited.

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