Approximately 15% of couples are unable to conceive after one year of unprotected intercourse. A male factor is solely responsible in about 20% of infertile couples and contributory in another 30-40%. If a male infertility factor is present, it is almost always defined by the finding of an abnormal semen analysis, although other male factors may play a role even when the semen analysis is normal.
This statement, which updates earlier guidance of 2007, offers recommendations for the optimal diagnostic evaluation of the male partner of an infertile couple. Male infertility can be due to a variety of conditions. Some are identifiable and reversible, such as ductal obstruction and hypogonadotropic hypogonadism. Other conditions are identifiable but not reversible, such as bilateral testicular atrophy secondary to viral orchitis.