Infertility affects approximately 15% of couples attempting to conceive. Male factor is a contributing cause in approximately 50% of infertile couples, and is the sole cause in about 20 to 30% of cases. Despite this, the male partner is often evaluated last — a delay that significantly extends the time to treatment.
Causes of Male Infertility
Varicocele — an abnormal enlargement of the veins within the scrotum — is the most common correctable cause, present in approximately 35% of men with primary infertility. By raising testicular temperature, varicoceles impair sperm production. Surgical repair often results in significant improvement. Obstruction of the vas deferens, hormonal imbalances, genetic abnormalities, and ejaculatory dysfunction are additional causes.
Evaluation
The evaluation begins with a semen analysis — measuring sperm count, motility, morphology, and volume. Abnormal results prompt further investigation: hormonal blood tests, scrotal ultrasound, genetic testing, and sometimes testicular biopsy. We work closely with reproductive endocrinologists to provide comprehensive, coordinated care.
Tratamiento
En la fase aguda, las inyecciones intralesionales de colagenasa de Clostridium histolyticum (Xiaflex, el único tratamiento inyectable aprobado por la FDA) actúan degradando el colágeno de la placa. La terapia de tracción peneana ayuda a limitar la progresión de la deformidad. En la fase crónica con deformidad estable, las opciones quirúrgicas ofrecen la corrección más definitiva: procedimientos de plicatura para curvaturas leves; incisión de la placa e injerto para deformidades más severas; e implante de prótesis de pene cuando coexiste una disfunción eréctil significativa, permitiendo tratar ambas condiciones de forma simultánea.