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Major causes include endocrinopathies, heat stress, chronic diseases like diabetes and hypertension, genetic and immunological disorders, testicular pathologies, obstructive reproductive tract disorders and genitourinary tract infections, environmental factors such as alcohol consumption, cigarette smoking, exposure to heavy metals and environmental pollutants, drug abuse, ageing, and iatrogenic and idiopathic causes

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10.3168/jds.S0022-0302(75)84646-7