Male infertility contributes to one in four cases of assisted reproductive treatment in Australia, but could be a factor in up to 50% of all infertile couples. Until now, there hasn’t been a consistent, standardised approach to assessing, diagnosing and managing male infertility.
That’s why Healthy Male is proud to release Australia’s first-ever clinical guidelines for the management of male infertility to set a national standard of evidence-based fertility care. Here’s what you need to know about the guidelines.
Why did we create the guidelines?
For too long, the management of male infertility in Australia has been inconsistent, fragmented and often overlooked,” says Healthy Male’s Medical Director, Professor Robert McLachlan AM, who was a Chief Investigator on the project.
Previously, no Australian-based clinical guidelines existed for the management of male infertility. That meant the many different health practitioners involved in assessing, diagnosing and managing male infertility — from GPs to urologists, endocrinologists, obstetricians/gynaecologists — acted based on guidelines from Europe and the US.
“Clearly, men are the same around the world, but there are differences in practice, in culture, in the health system,” says Prof McLachlan. “Without clear national guidance, different specialties have been approaching infertility in their own way, sometimes without a strong evidence base.”
Who made the guidelines?
This milestone is the result of years of work and collaboration.
A panel of experts was assembled in 2022, including clinicians, researchers and subject matter experts with specialised knowledge in male reproductive health.
The experts looked closely at the European and American guidelines, drew on their own extensive clinical experience and the latest scientific evidence to create 80 clear recommendations to support health professionals in delivering consistent, high-quality care for men experiencing infertility.
Each recommendation was given a rating to show how important it is:
They also gave each recommendation a rating to show how strong the supporting evidence is, from high quality down to very low quality.
What are the key issues these guidelines address?
“The guidelines reinforce a message we’ve been advocating for decades: you must see the man,” says Prof McLachlan. “Too often, men are left out of fertility investigations, reduced to a semen test while attention focuses on their partner.”
Bypassing but not treating male infertility, often the treatment burden is placed on women. This can mean healthy women need to undergo invasive procedures — like hormone treatment and egg collection — that risk their own wellbeing.
“A thorough history, examination and appropriate testing of the man is essential — not only to support the couple’s fertility goals, but to address the man’s own health needs.”
– Prof McLachlan
Infertility may be a sign of treatable illness or genetic conditions that compromise male health and are often undiagnosed, even though there are identifiable signs and symptoms, and effective treatments.
“In my extensive experience in male infertility I have seen time and again men who have been told they have no hope of becoming a biological dad — but after treatment — their dream of becoming a father is realised,” says A/Prof Darren Katz, a renowned urological surgeon who worked on the guidelines.
What you can do with the guidelines
These guidelines are designed for health practitioners, but the information can help you understand what your treatment journey may look like and advocate for yourself if you’re not receiving the best care possible.
“If you’re going through fertility care, these guidelines should empower you to ask the right questions: Has my partner been examined? Are the right tests being done? Is this evidence-based care?” says Prof McLachlan. “Educated consumers can help drive change by expecting and asking for best practice.”
