ART and Male Infertility

Abstract

The management of male infertility has advanced dramatically over the past few decades. Significant developments in diagnostic techniques and assisted reproductive technologies (ART) have revolutionised the treatment of the infertile male. The introduction of intracytoplasmic sperm injection (ICSI) has made it possible for couples with severe male factor infertility to have their own genetic children and has become established as a key treatment strategy for male factor infertility. A thorough evaluation of the male partner is essential to identify conditions that can be corrected as well as conditions for which ART will be required. Deciding when ART is indicated for male factor infertility and which ART technique to choose are key issues in the management of male factor infertility. Refinements in sperm retrieval techniques and the widespread use of ICSI have made it possible for men with obstructive and non-obstructive azoospermia to have a successful pregnancy using surgically retrieved spermatozoa. Novel methods of selecting sperm for use in ART have been introduced with the aim of improving pregnancy outcomes. This chapter outlines current approaches to evaluation of the infertile male and provides a comprehensive review of current treatment options and recent advances in the use of ART for male factor infertility.