par Pening, David 
Référence Revue médicale de Bruxelles, 44, 4, page (351-355)
Publication Publié, 2023-09-01
Référence Revue médicale de Bruxelles, 44, 4, page (351-355)
Publication Publié, 2023-09-01
Article révisé par les pairs
| Résumé : | Infertility is defined as failure to conceive within a year of unprotected sexual intercourses. A male factor can be found in up to 50% of cases. The importance of the male factor has long been underestimated in our society. It has long been assumed that the age-related female fertility issue is responsible alone for the couple’s infertility. Any pathology that impairs transport or sperm production will lead to male infertility or “subfertility” interchangeably. An evaluation of the male patient along with the female partner, is essential to counsel infertile couples. A physical examination of the testis, thorough personal and fertility history, laboratory assessment (hormonal and genetics when indicated) along with a semen analysis (2021 World Health Organization criteria) are all part of this unique opportunity to assess male health and screen for concomitant diseases. In case of severe male factor infertility, a 3 to 10 times higher incidence of testicular cancer can be found compared to age-matched controls, emphasizing andrology workup and follow-up in this population. Advanced paternal age (over 40 years old) is associated with a decreased quality in sperm (which may be associated with a longer time to pregnancy) and adverse outcomes in pregnancies (increased risk of miscarriages and fetal malformations). Other factors such as obesity, lifestyle, and habits (smoking, drugs, and alcohol consumption) impair spermatogenesis. Recent studies have highlighted that reproductive healthcare providers should be trained in andrology assessment, as semen analysis may reflect a man’s general health overall. |
