ABSTRACT
Approximately 10% of all couples will seek fertility assessment (1), and of these, a male factor will be found in up to two-thirds (2-5). Fertility assessment may be the first presentation of adult gonadotropin deficiency due to adult-onset or neglected pubertal delay (5,6). Missed diagnosis at this stage may have adverse longterm general health consequences (e.g., osteoporosis, sarcopenia, reduced quality of life), and may also immediately expose both the male and female partners, as well as any progeny, to the unnecessary risks of assisted reproduction (7).
