A male factor contributes to infertility in approximately 50% of couples who fail to conceive, causing significant psychosocial and marital stress.
This article reviews the general practitioner’s (GP’s) evaluation of male infertility and indications for referral to a male infertility specialist, and gives an overview of the specialist management of male infertility.
Male infertility can result from anatomical or genetic abnormalities, systemic or neurological diseases, infections, trauma, iatrogenic injury, gonadotoxins and development of sperm antibodies. When a couple fails to achieve pregnancy after 12 months of regular, unprotected sexual intercourse, a screening evaluation of both partners is essential. For the male partner this includes history, physical examination, endocrine assessment and semen analysis. Several lifestyle and environmental factors can have a negative impact on male fertility, and the GP has a pivotal role in educating patients about modifiable factors.