Infertility is defined as the inability to conceive after one year of unprotected, adequately timed intercourse. Approximately 15% of all couples are infertile. Up to 50% of these infertile couples will have a male factor component and 20% of couples will not be able to conceive solely because of a male factor.
Traditionally, the initial evaluation of the male was performed only when the couple had been unable to conceive after one year of unprotected intercourse. However, because many couples are now postponing parenthood, and because the risk of a female’s infertility increases as she passes the age of 35, most male infertility evaluations are performed upon initial presentation.
There can be many causes of male infertility. Therefore, we advocate a systematic approach which begins with a detailed history and physical examination, followed by a thorough laboratory evaluation. The initial evaluation includes a semen analysis and hormonal testing. Depending upon these results, a more detailed evaluation may follow with:
- repeat semen analyses
- sperm function tests
- additional hormonal studies
- radiologic studies
- genetic evaluation
- testicular biopsy
Since up to 50% of infertile couples will have a male factor component, a thorough evaluation of the male partner is essential to a complete infertility workup..
