Spermatogenesis and Assisted Fertility Treatment

  • Andrew A. DwyerEmail author
  • Elizabeth Williamson
  • Margaret G. Au
  • Channa Jayasena


Approximately 15% of couples are affected by infertility and it is estimated that male factors contribute to roughly half of cases. Careful history and clinical assessment is warranted in men presenting with infertility. Genetic defects such as Klinefelter syndrome and iatrogenic causes such as exogenous testosterone treatment are not uncommonly identified causes of infertility in men presenting for endocrine consultation. Importantly, neuroendocrine aetiologies of male infertility such as congenital hypogonadotrophic hypogonadism (CHH) are more amenable to treatment compared to gonadal defects causing hypergonadotrophic hypogonadism. Assessing predictors of outcomes is an important aspect of setting appropriate patient expectations prior to beginning fertility-inducing treatment. Tailored hormonal therapies can effectively develop sperm in approximately 75% of men with CHH. Additionally, assisted reproductive technologies can be a helpful complement in challenging cases. This chapter is intended to give the endocrine nurse context for the approach to male infertility and provides an overview of hormonal treatments and relevant assisted reproductive technologies. Emphasis is given to setting realistic patient expectations, delivering coordinated care including appropriate referral to fertility specialists and elements related to therapeutic education and psychosocial support relevant for this patient population.


Ethics Fertility agents, male Follicle stimulating hormone GnRH Gonadotrophins Infertility, male Spermatogenesis 



Assisted reproductive technologies


American Society of Reproductive Medicine


Body mass index


Congenital adrenal hyperplasia


Congenital bilateral absence of the vas deferens


Cystic fibrosis transmembrane regulator


Comparative genomic hybridization


Congenital hypogonadotrophic hypogonadism


Combined pituitary hormone deficiency


European Society of Human Reproduction and Embryology


Follicle stimulating hormone


Gonadotrophin-releasing hormone


Human chorionic gonadotrophin


Human immunodeficiency virus




Inhibin B


Intracytoplasmic sperm injection


Intra-uterine insemination


In vitro fertilization


Luteinizing hormone


Microsurgical epididymal sperm aspiration


Microsurgical testicular sperm extraction


Permeable cryoprotective agents


Percutaneous epididymal sperm aspiration


Pre-implantation genetic diagnosis/screening


Sex hormone binding globulin




Testicular adrenal rest tumours


Testicular volume


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Andrew A. Dwyer
    • 1
    • 2
    Email author
  • Elizabeth Williamson
    • 3
  • Margaret G. Au
    • 4
  • Channa Jayasena
    • 5
  1. 1.William F. Connell School of Nursing, Boston CollegeChestnut HillUSA
  2. 2.Boston CollegeChestnut HillUSA
  3. 3.Reproductive Medicine UnitUniversity College London HospitalsLondonUK
  4. 4.Department of PediatricsCedars-Sinai Medical CenterLos AngelesUSA
  5. 5.Reproductive Endocrinology and AndrologyImperial College and Hammersmith HospitalLondonUK

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