Designed and created by Guideline Central in participation with the American Society for Reproductive Medicine and American Urological Association
Infertility in Men
Patient Guideline Summary
Publication Date: October 1, 2020
Objective
Objective
This patient summary means to summarize key recommendations from the American Urological Association (AUA) and the American Society for Reproductive Medicine (ASRM) for Diagnosis and Treatment of Infertility in Men. This patient summary is limited to adults 18 years of age and older and should not be used as a reference for children.
Overview
Overview
- Infertility is defined as failure to conceive within 12 months of attempted conception.
- Neither sex is more likely to be responsible for infertility than the other.
- Identifying the responsible partner is key to pursuing treatment options.
- This patient summary focuses on evaluating and treating male infertility.
Diagnosis
Diagnosis
- Both partners must be initially screened by medical history, especially previous failed attempts at conception.
- Prior cancer treatment, other treatments that deal with the hormonal or reproductive system in any way and certain surgical procedures can cause infertility.
- Men begin with a physical examination and analysis of semen specimens.
- Subsequent testing depends on the results of this initial evaluation. Possible subsequent tests could include:
- Blood testing for hormones
- Genetic testing for chromosomal damage or mutations
- Search for low-grade infections in the involved organs
- Ultrasound imaging
- Subsequent testing depends on the results of this initial evaluation. Possible subsequent tests could include:
Treatment
Treatment
Each treatment option is specific for a cause discovered during evaluation. Some treatments address conditions causing infertility that also threaten the health of the patient.
Alternate Possibilities
Additional Information
- Hormonal treatments of several kinds may address both infertility and other consequences of hormonal imbalance.
- An overgrowth of veins in the scrotum may suggest surgical removal.
- Sperm can be obtained by stimulated ejaculation.
- Sperm can be extracted surgically from the testes and used to fertilize a partner or her eggs.
- Microsurgery can restore the integrity of tubes that carry sperm.
Alternate Possibilities
- Assisted reproductive technologies (ART) describes a number of methods to generate a pregnancy. These include using donor sperm, donor eggs, donor embryos and in vitro fertilization (IVF).
- Adoption is always a consideration.
Additional Information
- Men (and women) anticipating surgery or medical treatment that might impair fertility should consider storing eggs or sperm before the treatment.
- Such treatments should dictate suspension of attempts at conception for at least 12 months.
Abbreviations
- ART: Assisted Reproductive Technologies
- ASRM: American Society For Reproductive Medicine
- AUA: American Urologic Association
- IVF: In Vitro Fertilization
Source Citation
Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ, Mulhall JP, Niederberger C, Sandlow JI, Sokol RZ, Spandorfer SD, Tanrikut C, Treadwell JR, Oristaglio JT, Zini A. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. Fertil Steril. 2021 Jan;115(1):54-61. doi: 10.1016/j.fertnstert.2020.11.015. Epub 2020 Dec 9. PMID: 33309062. AND Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ, Mulhall JP, Niederberger C, Sandlow JI, Sokol RZ, Spandorfer SD, Tanrikut C, Treadwell JR, Oristaglio JT, Zini A. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline PART II. J Urol. 2021 Jan;205(1):44-51. doi: 10.1097/JU.0000000000001520. Epub 2020 Dec 9. PMID: 33295258.
Disclaimer
The information in this patient summary should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.