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Table 1 Possible acquired causes of male reproductive impairment

From: Smoke, alcohol and drug addiction and male fertility

Hypothalamic-pituitary axis  
 Compressive effect (Pituitary or brain tumors)  
 Ablative effect (CNS surgery or radiotherapy)  
 Infiltrative effect (fungal infections, sarcoidosis, hemochromatosis)  
 Suppressive effect (exogenous AAS)  
Quantitative alterations of spermatogenesis  
 Varicocele  
 Previous chemotherapy or radiotherapy  
 Testicular failure (torsion, orchitis, orchiectomy)  
 Comorbidities (liver and kidney disease)  
Qualitative alterations of spermatogenesis  
 Oxidative stress  
 DNA damage  
Ductal obstructions  
 Surgery (vasectomy, hernia repair, pelvic surgery)  
 Neurological disorders (Multiple Sclerosis, Spinal Cord Injury, neural tube defects)  
 Erectile or ejaculatory dysfunction  
  1. Abbreviations: CNS central nervous system, AAS anabolic-androgenic steroid. Edited from H Tournaye, C Krausz and RD Oates [10]