Male Infertility
Semen analysis parameters, Kruger strict morphology criteria, DNA fragmentation testing, varicocele grading, lifestyle factors, and treatment options.
Semen Analysis Parameters (WHO 6th Edition)
| Parameter | Normal | Concern | Notes |
|---|---|---|---|
| Volume | ≥1.5 mL | <1.5 mL | Low volume may indicate obstruction or retrograde ejaculation |
| Concentration | ≥15 million/mL | <15 million/mL | Oligozoospermia; severe if <5M/mL |
| Total count | ≥39 million | <39 million | Total motile count (TMC) most predictive |
| Motility (total) | ≥40% | <40% | Asthenozoospermia if low |
| Progressive motility | ≥32% | <32% | Grade A+B combined |
| Morphology (Kruger) | ≥4% normal | <4% | Teratozoospermia; ICSI may help |
| DNA fragmentation (DFI) | <15% | >30% | >30% = 3.5x miscarriage risk |
Lifestyle Factors
| Factor | Impact | Evidence |
|---|---|---|
| Heat exposure | High | Strong |
| Obesity (BMI >30) | High | Strong |
| Smoking | Moderate-High | Strong |
| Anabolic steroids | Very High | Very strong |
| BPA/phthalates | Moderate | Growing |
Varicocele
Varicocele is the most common correctable cause of male infertility, found in ~40% of infertile men. Surgical repair (varicocelectomy) improves semen parameters in ~60-70% of men.