Genital tract obstruction

It has been reported that -50% of infertility problems are male in origin. However, male infertility often goes undetected, because low sperm count or abnormal sperm motility, combmed with normal female reproductive function, merely results in delayed conception. Most infertile men (80%) will not have a definable cause and are said to have so-called idiopathic impaired sperm function. In about 20% of cases, a cause can be determined. A study at Monash University Infertility Clinic in Australia indicated that primary testicular failure accounted for 11% of male patients seen 8.5% had genital tract obstruction, 0.5% had hypothalamic-pituitary disease, and less than 1% had coital disorders or abnormal sperm. A fist of the most common male infertility factors is given in Box 53-4. 

Several causal associations have been identified in the development of endometriosis despite the uncertainty regarding etiology. Eac-tors associated with endometriosis include obstruction of menstrual flow, frequent or heavy menstruation, genital tract abnormalities. 

Due to the close developmental relationship of the urinary and the genital tract, malformations frequently occur in both of these systems. Major renal anomalies are common in patients presenting with unilateral obstruction or agenesis of duplicated structures derived from the mullerian duct. 

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