Male Infertility

Presenting Issue: The patient, a 35-year-old male, presents with concerns about infertility after trying to conceive with his partner for over a year without success. Paternity Hx: The patient has no children and has never fathered a child. PMHx: The patient has a history of hypertension and mild asthma, both well-controlled with medication. Urological Hx: Undescended testis – No history of undescended testis. Testicular torsion/injury – No history of testicular torsion or injury. Orchitis – No history of orchitis. Vasectomy +/- reversal – No history of vasectomy or reversal. Ejaculatory problems – Reports occasional premature ejaculation. Erectile problems – No erectile dysfunction reported. Other conditions: No other significant medical conditions reported. PSHx: Appendectomy at age 12. Allergies: No known drug allergies. Medicines: Lisinopril 10 mg daily for hypertension. Albuterol inhaler as needed for asthma. FMHx: Maternal: Mother has a history of type 2 diabetes. Paternal: Father has a history of coronary artery disease. SHx: EtOH - Consumes alcohol socially, approximately 2-3 drinks per week. Smoking - Non-smoker. Rec drug use – Denies any recreational drug use.