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Given the cost and burden ART puts in and prior to application of any invasive techniques, understanding precisely the etiology associated with male infertility is essential for the fertility specialist to circumvent inefficient or any unproductive steps in the fertilization process besides helping in counseling patients on their chance of success with the use of reproductive technology

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Quasi-experimental designs paired with longitudinal analysis, time series modeling, or generalized estimating equations (GEE) provide a higher degree of rigor in research, particularly when studying interventions or outcomes over time due to their capacity for causal inference and control of confounding factors compared to cross-sectional survey designs 18,19