Male infertility may be caused by varicocele (abnormal enlargement of veins in the scrotum), urogenital infections, immunologic factors (antisperm antibodies), sexual/ejaculatory inadequacy, congenital disorders (Kallmann’s and Klinefelter’s syndrome, etc.), acquired urogenital abnormalities, and endocrine disorders.
In varicocele, removal of veins by surgery is recommended only for large veins, however, the improvement of fertility is not always observed. Congenital disorders, sexual/ejaculatory dysfunction and urogenital abnormalities are mostly treated by counseling and sperm harvesting followed by in vitro fertilization.
Once the exact culprit for endocrine disorder is identified, hormone replacement therapy (HRT) is initiated; treatment may last for 6 months to 3 years, since production of new sperm takes between 9-10 weeks, and depending on the disorder it may take time until normal sperm production.