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  • Review Article
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Physical deformities relevant to male infertility

Nature Reviews Urology volume 9, pages 156–174 (2012)Cite this article

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Abstract

Infertile men are frequently affected by physical abnormalities that might be detected on routine general and genital examinations. These structural abnormalities might damage or block the testes, epididymis, seminal ducts or other reproductive structures and can ultimately decrease fertility. Physical deformities are variable in their pathological impact on male reproductive function; some render men totally sterile, such as bilateral absence of the vasa deferentia, while others cause only mild alterations in semen parameters. Concise and up-to-date information regarding the contemporary epidemiological characteristics, clinical features and pathophysiological impacts of these common abnormalities on male fertility is crucial for the practicing urologist to identify the best treatment option.

Key Points

  • Physical deformities of the male reproductive tract are physically evident structural abnormalities that can damage or block the testes, epididymis, seminal ducts and other reproductive structures

  • Paternity rates in men with a unilateral undescended testicle are similar to those of healthy men, whereas those who have undergone bilateral orchiopexy for cryptorchidism have a paternity rate of 46–65%

  • Clinical presentations of infertile men with previous testicular torsion include unilateral or bilateral anorchia, unilateral testicular atrophy, oligozoospermia, oligoasthenoteratospermia and nonobstructive azoospermia

  • Unilateral or bilateral clinical varicocele is associated with defective endocrine and exocrine testicular and epididymal functions as well as sperm dysfunction

  • Incidence of hydrocele in infertile men is 3.2%, constituting the third most common ultrasonographically-detected scrotal abnormality after varicocele and epididymal cyst

  • Infertility among men with autosomal polycystic kidney disease is common and has multiple pathologies

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Article 14 September 2023

Michael L. Eisenberg, Sandro C. Esteves, … Yu-Sheng Cheng

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Authors and Affiliations

  1. Central Drug Research Institute, Lucknow, 226001, India

    Rajender Singh

  2. Center for Reproductive Medicine, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, 44195, OH, USA

    Alaa J. Hamada, Laura Bukavina & Ashok Agarwal

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  1. Rajender Singh
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  2. Alaa J. Hamada
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  3. Laura Bukavina
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R. Singh, A. Hamada and L. Bukavina researched data for the article. R. Singh, A. Hamada and A. Agarwal contributed to the discussion of content. A. Hamada, L. Bukavina and A. Agarwal wrote the article. A. Hamada and A. Agarwal reviewed the manuscript before submission.

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Correspondence to Ashok Agarwal.

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Singh, R., Hamada, A., Bukavina, L. et al. Physical deformities relevant to male infertility. Nat Rev Urol 9, 156–174 (2012). https://doi.org/10.1038/nrurol.2012.11

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