Chapter 4

Treatment of Male Infertility

Giovanna Franconi


The medical treatment of male infertility is possible when there is a specific etiological factor that is potentially susceptible to medical care. Hormonal replacement therapy is indicated in hypogonadism with different options depending on the purpose of the treatment. To induce or maintain androgenisation, testosterone should be used, while to induce or maintain spermatogenesis, gonadotropins or GnRH should be used. Hyperprolactinemia can be treated with dopamine agonists. Antibiotic therapy is indicated for symptomatic infections of the genital tract. In idiopathic forms, various empirical treatments have been tried with limited success. Surgical therapy is indicated for congenital or acquired obstruction of the seminal ducts, to extract sperm or testicular tissue, and in varicocele. Assisted reproductive technology, in particular Intracytoplasmic Sperm Injection (ICSI), has revolutionized the prognosis of male infertility, because it has allowed azoospermic men to procreate.

Total Pages: 54-60 (7)

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