Our insight into the mechanisms of the physiology of reproduction has
experienced a swift and constant development these last few years. The
advent of more sophisticated diagnostic methods and their relatively
easy clinical application allow for the incorporation of that knowledge
into the evaluation of the infertile couple. These facts, together with
an obvious change in social psychology, have facilitated the development
of different specialities dealing with the problems of infertility. It
is now possible in medical centers all around the world to undertake a
better disposition of the infertile husband to look for advice, to be
studied, and treated. Confronted with this situation we are still unable
to offer specific therapy in most cases; however, empirically based
therapy abounds. Advances in therapy have not kept pace with our
increased physio- logical knowledge and improved diagnostic techniques.
Patho- physiological mechanisms and etiological factors in male
infertility are largely unknown. This has significantly hampered both
clinical evaluation and advances in treatment allowing for frequent non-
scientific therapeutic incursions into the armamentarium of the an-
drologist. Several factors have given birth to therapeutic "fashions",
which are bound to survive as long as this state of lack of knowledge
con- tinues. For example, we may ask whether the treatment of varicocele
constitutes a fashion? Though we accept the treatment of varicocele as
the best available treatment of male infertility, we do not know its
mechanism of action and so we cannot predict a therapeutic result.
