Infertile Males with Muscle Weakness: Keep Your Eyes Open for Myotonic Dystrophy.

Male factor infertility affects approximately 1 in 20 men and is the responsible factor in almost half of the couples undergoing assisted reproductive treatments (ARTs). The most common presentation is oligozoospermia, as defined by a sperm concentration less than 15 million/ml [1]. Though idiopathic spermatogenetic disorders are the underlying cause of oligozoospermia in majority, it may occur in a variety of reproductive or systemic diseases. A detailed history and thorough clinical examination may at times identify treatable causes of oligozoospermia. In case effective treatment is unavailable for a particular disorder, a precise diagnosis can identify associated systemic comorbidities, which may have profound implications for general health. Last but not the least, underlying genetic disorders may potentially influence treatment of the reproductive disorder and transmission of the disease to the offspring. In this article, we discuss two patients of myotonic dystrophy (MD), in whom a careful questioning and appropriate clinical examination revealed the diagnosis.