Clinical summary guide

Male infertility

3 min

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The GP’s role


Brief assessment and pre-pregnancy advice.

Table: Brief assessment and pre-pregnancy advice.

Reproductive history

Table: Reproductive history

Physical examination

Table: Physical examination


Semen analysis is the primary investigation for male infertility.

Reference limits for semen analysis

Table: Reference limits for semen analysis


Treatment options

Protecting and preserving fertility

Mumps vaccination, sperm cryopreservation (prior to chemotherapy, vasectomy or androgen replacement), safe sex practices, and early surgical correction of undescended testes.

Options for improving natural fertility

It may be possible to improve fertility for a minority of infertile men, including those with clinically diagnosed varicocele and abnormal semen parameters, pituitary hormonal deficiency or hyperprolactinemia, genitourinary infection, erectile and psychosexual problems and through the withdrawal of drugs (especially androgenic hormones). 

Assisted reproductive technology (ART)

Donor insemination

For men with complete failure of sperm production.

Specialist referral and long-term management

Warning: Never institute testosterone replacement therapy in a newly recognised androgen deficient man who is seeking fertility. The fertility issue must be addressed first as testosterone therapy has a potent contraceptive action via suppression of pituitary gonadotrophins and sperm output.

When should I refer a patient?

GPs can refer couples immediately or after a few months during which baseline tests are performed.

Fertility clinics

A list of Australian ART Clinics, accredited by the Reproductive Technology Accreditation Committee are available via Fertility Society of Australia.

Supporting the couple

Clinical review

Dr Gideon Blecher, Alfred Health

Male infertility

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