Male infertility is divided into three groups – pretesticular, testicular and post-testicular.
Pretesticular factors can be both congenital and obtained hypothalamic, pituitary and peripheral organ dysfunction – hypogonadotropic idiopathic hypogonadism, prolactinoma, gonadotrophin synthesis deficiency, or Cushing’s syndrome.
Testicular factors may be congenital or obtained. Klinefelter syndrome is a genetically inherited male chromosome aberration, which is characterized by additional X chromosome in all cells (47, XXY) or, more rarely, in some of the cells in case of cell mosaicism (mos 47, XXY/ 46, XY), and is characterized by the lack of male hormone production from the testicles. Factors that are not attributable to heredity may be associated with medication use, infections, trauma, and varicocele.
Post-testicular factors are those related to impaired sperm transport through the tubular system. Post-testicular factors may be congenital or obtained. Congenital bilateral vas deference shortfall may occur in men who suffer from cystic fibrosis. Also, infections, surgery, and trauma can cause tubular closure.