Why Bother about Male Infertility? Implications forThe Male, Female and The Children

The management of infertility is traditionally in the hands ofgynecologis ts with special interes t in reproductive medicine. Inmajority of cases, assis ted reproductive techniques (ART) as invitro fertilization (IVF ) and In intracytoplasmic sperm injection(ICSI) are used to help the childless couple with becomingparents and the inves tigation of the male is limited to searchingfor spermatozoa in seminal fluid, epididymis or tes tis. However,in ۵۰% of cases, impairment of male reproductive function is acontributing factor to the infertility problem. Furthermore, only۲۵-۳۰% of all ART treatments result in a child birth. Therefore,there is a need for finding alternative, male-related methods ofinfertility management, aiming to improve the efficiency of currenttherapies but also saving the female partner from potentiallydangerous hormonal s timulation in cases where the majorproblem is poor semen quality.Furthermore, recent research has clearly shown that men withimpaired fertility are at higher risk of early mortality and morbiditydue to non-communicable diseases as diabetes, metabolicsyndrome, os teoporosis, cardiovascular conditions andsome cancers. This is an additional reason to offering the malein an infertile couple a more detailed examination, which canhelp identifying men to whom preventive measures should beoffered due to highly increased risk of morbidity and mortality.Las t but not leas t, pathological conditions which are over-representedin subfertile men, e.g. sperm DNA damage, may havenegative impact on risk of pregnancy-related pathologies aswell as on perinatal characteris tics of children conceived usingART. Therefore, more focus on the male partner is not onlyneeded for improvement of outcome of infertility managementbut also to secure health of fathers, mothers and their children.