Male Infertility


“Infertility is the inability of a sexual active, non-contracepting couple to achieve pregnancy in one year” (WHO). About 25% of couples do not achieve pregnancy within 1 year, of whom 15% seek medical treatment for infertility and less 5% remain unwillingly childless. Infertility affects both men and women : Male causes for infertility are found in 50% of involuntarily childless couples. Below you can see the main aetiological causes of male subfertility:

- Varicocele

- Sexual factors

- Prostatitis and genito urinary infections

- Congenital Anomalies

- Testicular Trauma

- Cryptorchidism

- Testicular Torsion

- Endocrine Disturbances

- Immunological Factors

- Radiation or chemical exposure

- Idiopathic causes


Semen analysis is fundamental in male infertility diagnosis. Semen analysis reveals a decreased number of spermatozoa (oligozoospermia), decreased motility (asthenozoospermia) and many abnormal forms on morphological examination (teratozoospermia). Usually, these abnormalities come together and are described as the oligo-astheno-teratozoospermia (OAT) syndrome.


There are medical and surgical therapies for many male infertility causes, but in cases of absence of spermatozoa in semen analysis (azoospermia), this situation cannot be resolved with neither surgery or medical treatment, and in these cases in the past we spoke of male sterility (failure of male to procreate). Today, however, in these cases we can attempt to retrieve the spermatozoa directly from the testicle by non-invasive percutaneous techniques (TEFNA) or by means of sophisticated microsurgical techniques of epididymal and testicular sperm retrieval (MESA, TESE, Micro-TESE), and if spermatozoa are detected in the testicle, programs of Assisted Fertilization (IVF/ICSI) with cryopreserved spermatozoa can be proposed to the couple.


TEFNA : TEsticular Fine Needle Aspiration

MESA: Microsurgical Epididymal Sperm Aspiration

TESE: TEsticular Sperm Extraction.

Micro-TESE: Microdissection-TEsticular Sperm Extraction by operating microscope 

IVFET: In Vitro Fertilization and Embryo Transfer.

ICSI: Intra Cytoplasmic Sperm Injection

Male Infertility ( Handbook by ISU)

Clinical management of HPV positive couple

Semen cryopreservation Guidelines 2005

Semen analysis Guidelines 2003

Male infertility : eau guidelines 2010

Study of chromosomes in sperm and egg cells

ART. The role of the Andrologist

Couple Infertility: when the man is the problem

Sperm recovery surgical tecniques:state of the art

Cancer therapy and male fertility

Andrological prevention in young men

Couple Infertility: Handbook

Cytogenetic abnormalities in human sperm

What is male infertility ?

Cytogenetic diagnosis in infertile couple

Urogenital flogosis and infertility:EAU Guidelines 2007

DNA fragmentation and male infertility

Vasectomy: medical, social and legal aspects

WHO laboratory manual for the examination and processing of human semen - V ed. 2010

Male reproductive system ( explanatory video)

Spermatogenesis ( explanatory video animation)

Spermatogenesis (explanatory video)

Male Infertility. Androlife campaign

TEFNA procedure

TESE Procedure

Micro-TESE (surgical tecnique video)

What you need to know about testicular mapping (by Prof. P. Turek San Francisco California USA)

What is vasectomy

Vasectomy reversal

Liberalization of heterologous Artificial Reproductive Tecniques (ART) in Italy. 2014

Wednesday 27 May 2015 •  Prof. A. Natali •  1

Italian Guidelines on Gamete Donation

Wednesday 27 May 2015 •  Prof. A. Natali •  1

Sperm test review 2011

Sunday 02 January 2011 •  Prof. A. Natali •  1

Obesity: modern man’s fertility nemesis - review 2010

Wednesday 03 February 2010 •  Prof. A. Natali •  1

The genetic causes of male factor infertility: A review 2010

Friday 01 January 2010 •  Prof. A. Natali •  1