Medical and surgical treatment of male infertility

Although modern assisted reproduction techniques is helping to overcome severe male factor infertility, conventional treatment modalities are still the first approach to male fertility disorders. The critical step in treating male infertility is to evaluate properly every male partner of an infertile couple and to generate the suitable treatment strategy. Specific medical management of infertility is based on identifying reversible causes of infertility and treating them with appropriate medications to achieve a pregnancy. In addition, andrologists have an extensive arsenal of surgical options that are available including varicocele repair, reconstruction of obstructed reproductive system, or retrieve sperm for assisted reproduction. In the absence of a correctable etiology, patients can be managed with either empirical medical therapy or assisted reproduction. Although empiric medical therapy continues as a viable option, patients must understand that the success rates remain suboptimal.