Which factor is NOT associated with male infertility during physical examination?

In the context of male infertility, understanding the physical examination findings is crucial for identifying potential underlying causes. Elevated body mass index (BMI), gynecomastia, and small testes are all factors that can indicate issues related to male reproductive health.

Elevated BMI is associated with hormonal imbalances that can negatively affect sperm production and overall fertility. Excess body weight can lead to alterations in testosterone and estrogen levels, impacting the spermatogenic process.

Gynecomastia, or the enlargement of breast tissue in males, often reflects hormonal imbalances, particularly an increased estrogen-to-testosterone ratio. This condition can also be linked to various medical conditions and medications that could further impair fertility.

Small testes are a direct indicator of testicular function and health. They may indicate conditions such as testicular atrophy or hormonal deficiencies that can result in impaired spermatogenesis, leading to infertility.

Ovarian cysts, on the other hand, are associated with female reproductive health and have no relevance to male infertility factors. The presence of ovarian cysts does not affect male reproductive capacity and is not a finding that one would assess during the physical examination of a male patient. Thus, it is distinct from the other options that summarize factors directly linked to male infertility.