Differential Diagnosis for Male Infertility
Single Most Likely Diagnosis
- Idiopathic Oligoasthenoteratozoospermia (OAT): This condition, characterized by low sperm count, poor sperm motility, and abnormal sperm morphology, is a common cause of male infertility. Given the lack of specific symptoms or findings on physical examination, it is reasonable to consider this as a primary diagnosis until laboratory results are available.
Other Likely Diagnoses
- Hypogonadism: Abnormal levels of FSH, LH, and testosterone can indicate hypogonadism, which can be a cause of infertility. This could be primary (testicular failure) or secondary (hypothalamic or pituitary dysfunction).
- Varicocele: Although not identified on the initial physical exam, varicoceles are a common and treatable cause of male infertility. They can sometimes be subtle and require specialized examination techniques or imaging for diagnosis.
- Infectious or Inflammatory Conditions: Epididymitis, orchitis, or prostatitis can affect sperm quality and are relatively common.
Do Not Miss Diagnoses
- Klinefelter Syndrome: A genetic condition (47,XXY) that affects testicular function, leading to infertility. It's crucial to diagnose due to its implications for genetic counseling and potential associated health issues.
- Testicular Cancer: Though less common, testicular cancer can cause infertility and is critical to diagnose early due to its high cure rate with prompt treatment.
- Pituitary Tumors: Tumors affecting the pituitary gland can disrupt hormone production necessary for sperm production, leading to infertility.
Rare Diagnoses
- Young's Syndrome: A condition characterized by obstructive azoospermia, chronic sinopulmonary infections, and normal sweat chloride levels. It's a rare cause of male infertility.
- Cystic Fibrosis: Though primarily known for its respiratory symptoms, cystic fibrosis can cause congenital absence of the vas deferens, leading to infertility.
- Immune Infertility: Autoimmune reactions against sperm can cause infertility. This is a rare condition but should be considered in the appropriate clinical context.
- Genetic Disorders: Such as Y chromosome microdeletions, which can affect sperm production and are a rare but significant cause of male infertility.