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Male infertility is a neglected reproductive health problem, yet it contributes to at least half of all cases of subfertility worldwide. Consanguinity, or the intermarriage of two individuals who have at least one ancestor in common, may increase the risk for recessively inherited disorders, including genetic forms of male infertility. This chapter investigates the influence of consanguineous marriage on male infertility in Lebanon, where rates of consanguineous marriage remain high (26.9% among Muslims, 16.5% among Christians). Using a mixed-methods, ethnographic-epidemiological, and case-study design, it demonstrates a significant association between consanguinity and family clustering of male infertility cases, suggesting a strong genetic component to this reproductive health problem in Lebanon. Because consanguineous marriage is a socially supported institution throughout the Muslim world, culturally sensitive public health education programs, which support genetic counseling and risk management without condemning consanguineous marriage practices per se, are highly recommended.

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