IDIOPATHIC MALE INFERTILITY

The World Health Organization (WHO) estimates that 60–80 million couples worldwide currently suffer from infertility.2 Infertility varies across regions of the world and is estimated to affect 8–12% of couples worldwide.3,4 Infertility tends to be highest in countries with high fertility rates, an occurrence termed “barrenness amid plenty”.5 The WHO estimates the overall prevalence of primary infertility in India to be between 3.9% and 16.8%.2 Estimates of infertility vary widely among Indian states from 3.7% in Uttar Pradesh, Himachal Pradesh and Maharashtra,6 to 5% in Andhra Pradesh,7 and 15% in Kashmir.8 Moreover, the prevalence of primary infertility has also been shown to vary across tribes and castes within the same region in India.6,9 However, it should be noted that many of these estimates use different definitions of infertility and consider different time periods, which makes direct comparisons difficult between any studies. In a 1982–1985 WHO multicenter study, 20% of cases were attributed to male factors, 38% were attributed to female factors, 27% had causal factors identified in both partners, and 15% could not be satisfactorily attributed to either partner.10 In Indian couples seeking treatment, the male factor is the cause in approximately 23%.8

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