The male body, followed by male reproductive organs from which the sperm originates, is depicted from top to bottom at the left. Under the male reproductive organs is a diagram of a single sperm. To the right of the sperm diagram, the physiological and morphological changes a sperm undergoes to fertilize an egg are depicted from left to right. Each change is associated with a light pink rectangle background. Each light pink rectangle corresponds to the location of the sperm within the female reproductive organs, which is depicted above it.

In 2021, the World Health Organization, or WHO, published the sixth edition of their Laboratory Manual for the Examination and Processing of Human Semen, which provides standardized guidelines to physicians and other medical professionals performing semen analysis. Semen analysis is a technique that medical professionals use to analyze the characteristics of a male’s semen and sperm cells to identify possible causes of male infertility. A sperm cell is the male sex cell that fertilizes a female’s egg cell, while semen is the fluid containing sperm cells that men release during ejaculation. The WHO created the first laboratory manual for semen analysis in 1980, a time when there was no standardized way to analyze a male’s semen sample. The WHO laboratory manual was one of the first documents to standardize a procedure for evaluating human semen to look for sperm abnormalities, and it remains one of the most widespread methods of evaluating a male’s fertility potential and determining the causes of male infertility.

Gonorrhea is a sexually transmitted disease, or STD, caused by the bacterium Neisseria gonorrhoeae. Common symptoms of the disease include painful urination and genital discharge. There are records of historical discussions of gonorrhea in ancient civilizations and during the Middle Ages, but scientists did not begin investigating the scientific causes and treatments of the STD until the sixteenth century. In the 1700s, physicians attributed gonorrhea to the same cause as another STD, syphilis. Later, in the 1800s, researchers discovered the two diseases were not the same and identified the bacteria N. gonorrhoeae that causes gonorrhea. By the 1900s, researchers began using antibiotics to target the bacteria, but many drugs eventually developed antibiotic resistance. In 2020, the World Health Organization, or WHO, estimated that 82.4 million individuals contracted gonorrhea globally, and as of 2024, researchers continue to experiment with various antibiotic drugs to provide adequate treatment for the disease.

In December of 2016, Margus Punab and colleagues published “Causes of Male Infertility: A 9-year Prospective Monocentre Study on 1737 Patients with Reduced Total Sperm Counts,” hereafter “Male Infertility,” in the journal Human Reproduction. The study examines the main causes of severe male factor infertility, or SMF infertility, which occurs when a male’s semen has a very low number of healthy sperm cells or contains atypically low levels of sperm cells. In “Male Infertility,” the authors determine the primary cause of SMF infertility in forty percent of their participants, and among those participants, they found that the primary causes of SMF infertility were varicoceles, or enlarged veins within the loose bag of skin holding the testicles. The authors did not determine the cause of SMF infertility in the remaining sixty percent of the cases, noting a gap in the current understanding of the causes of SMF infertility. “Male Infertility” was one of the first large-scale studies to reveal certain underlying causes of SMF infertility, and its conclusions have allowed researchers to investigate fertility solutions for male patients who would otherwise not be able to reproduce.