Published online by Cambridge University Press: 24 May 2020
Male infertility is a common condition estimated to be a contributory factor in as many as 50% of couples experiencing problems with conception. It is also a key catalyst for the increasing uptake of assisted reproductive technologies (ART). Traditionally, andrological practice has relied on the use of ostensibly descriptive criteria; seeking to define a male’s fertility status based on the number of motile, morphologically normal spermatozoa present in their ejaculate. Notwithstanding the widespread adoption of such measures, over time we have come to appreciate their limitations and that fertility is more accurately predicted on the basis of sperm quality. This realisation poses the fundamental question of what constitutes a high-quality, fertilisation competent spermatozoon. Here, we consider recent advances in our understanding of the mechanistic basis of sperm function that are driving innovations in our ability to diagnose and treat male infertility, thus optimising outcomes for the management of male fertility.
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