Can Male Fertility Be Improved Prior to Assisted Reproduction through The Control of Uncommonly Considered Factors?

Male factor infertility or subfertility is responsible for up to 50% of infertility cases. A considerablebody of recent studies indicates that lifestyle as well as environmental and psychological factorscan negatively affect male fertility, more than previously thought. These negative effects have beenshown in many cases to be reversible. This review aims to provide a rationale for early clinicalattention to these factors and presents a non-exhaustive evidence-based collection of primaryrelevant conditions and recommendations, specifically with a view to making first line diagnosticsand recommendations. The presently available evidence suggests that considering the high cost,success rates, and possible side effects of assisted reproduction techniques (ART), such as in vitrofertilization (IVF) and intracytoplasmic sperm injection (ICSI), early efforts to improve malefertility appear to be an attainable and worthwhile primary goal.A series of searches was conducted of Medline, Cochrane and related databases from November14th, 2010 to January 26th, 2012 with the following keywords: male, fertility, infertility, spermdefects, IVF, ICSI, healthy habits, and lifestyle. Subsequent follow-up searches were performed forupcoming links. The total number of studies contemplated were 1265; of these, 296 studies werereviewed with criteria of relevance; the date of study or review; study sample size and study type;and publishing journal impact status. Data were abstracted based upon probable general clinicalrelevancy and use. Only a selection of the references has been reflected here because of spacelimitations. The main results obtained were evidence-supported indications as to the other causes ofmale infertility, their early detection, and treatment.