The sterility of a couple is in thirty three percent of the cases because of the man. According to Doepfner, the notion of sterility refers to the conjugal pair, while infertility refers to a single partner. The infertility can be absolute in case of azoospermia or sub-fertility in case of oligoastenoteratospermia. Regarding the absolute infertility, this can be of a secretory origin or excretory. 
The azoospermia of secretory nature, from a pathogenic point of view can be ptimitive testicular (through various lesions of the testicular parenchyma) or secondary of hypophysiary origin, through deficit of gonadotropes FSH or/and LS, or hypothalamo-hypophisiary.
The azoospermia of excretory nature is due to an obstacle on the seminal paths of elimination of the spermatozoa. The secretory sterility, etiologically speaking (of the causing factors that produce it) can be classified in the following forms and completed by us;
Genetic
- The Klinefelter syndrome; the del Castillio syndrome;
- The immobile cilia;
- The absence of the spermatozoa’s acrosome syndrome;
Congenital anorchism;
Testicular atrophies or hypotrophies after unresolved bilateral criptorchidias or too tardy resolved;
Accidental bilateral castration or therapeutic or through irradiation;
Vascular-the compressive bilateral great varicocele;
Infectious;
- Acute bilateral orchitis or chronic.
- Acute or chronic epididimites.
Viral (bilateral urlian orchitis or with other viruses);
Metabolic-hyperglycemia clinically manifested;
Secondary from endocrine diseases and Treatment Premature Ejacuation:
- Primary panhipopithuitarism or secondary,
- Pure, idiopathic hypogonadism,
- Prolactinoma, iatrogenic hyperprolactinemia,
- Acromegaly,
- Primary mixedema,
- The Cushing syndrome,
- Precocious preudopuberty;
Psychic post-traumatisms;
Iatrogenic:
- Hormonal treatments: estrogens, androgens, anti-androgens;
- Hyperprolactinemies induced by: phenothiazine, sulpiride, DOPA alpha-methyl, metoclopramide etcetera;
- Cytostatics: vinblastine, bleomicine, ciclofosfamide;
- Furazolidone, difenilhidantonine;
- Chronic alcoholism, nicotine;
- Exposure at ionizing radiations or excessive heat for an extended period of time;
Autoimmune-by producing antispermatozoa antibodies at woman or at man;
Morphological congenital anomalies or dystrophic of the epididim:
- Are usually bilateral and generally symmetrical;
- Partial or total ageneses;
- Absence of cooptation of the epididim with the testicle or with the deferential;
- It is frequently associated with genital-urinary malformations.
Lesions at the level of the epididim’s head (the junction area with the efferent cones).
Generalized fibrosis of the epididim
Generalized fibrosis of the rete testis (difficult to diagnose).
The retraction of the epididimary lumen at the level of the body (with the presence of spermiofaces-azoospermia).
Epidimary bilateral stasis of traumatic origin.
Cysts of the epididim that are great or small and multiple-partial obstruction.
Solid tumors of the epididim, benign (mezotelioma) or malign.
Epodididimo-testicular metastases.
Agenesis or the obstruction of the deferential.