Assisted reproductive techniques and male infertility.

For couples in whom improvement in spermatogenesis is not possible or is unsuccessful in producing conception, ARTs offer much promise. For mild to moderate male factor couples, IUI combined with superovulation is often the initial procedure employed. If unsuccessful, IVF or one of its variations should be considered. With severe male factor cases, couples should proceed directly to IVF or one of its variations in which specific techniques may be used to improve the chances of fertilization. Currently both specialized semen-processing techniques and micromanipulation are used either singly or in combination. More experience is needed to determine which couples will benefit from which techniques. Although the urologist may not actively participate in all the actual ART procedures, it is important that the urologist have a thorough understanding of the procedures and their indications. This allows for accurate counseling of the male factor couple.