Australia has released its first evidence-based clinical guidelines for managing male infertility, offering 80 recommendations on assessment, diagnosis and treatment.
Developed by a multidisciplinary expert panel, the guidelines outline the key steps GPs should take during initial evaluation, including medical history, physical and scrotal examinations, and semen analysis. They also advise that fertility assessment of the female partner occur in parallel.
The full guidelines are available on the Healthy Male website, a government-funded organisation focused on men’s health education.
‘By assessing both partners at the same time, male fertility issues can be detected earlier, which may alter the couple’s treatment pathway,’ said Dr Liza O’Donnell, senior research scientist at Griffith University and a co-author of the guidelines. She added that early identification of male factors could help women avoid unnecessary testing and emotional distress.
The guidelines are endorsed by the Urological Society of Australia and New Zealand, the Endocrine Society of Australia, and the Fertility Society of Australia and New Zealand.
Some recommendations address specialised evaluations—such as genetic testing and imaging—when clinically indicated. Others focus on treating confirmed causes of infertility, ranging from hormone therapy to surgical and non-surgical approaches for azoospermia, the absence of sperm in semen.
Male factors account for 20–30% of infertility cases and contribute to half of all cases overall, the authors noted in a summary published in the Medical Journal of Australia. They stressed that the guidelines aim to support the wide range of clinicians involved in male infertility care.
The recommendations draw on guidelines from the European Association of Urology and the American Urological Association. The panel reviewed each statement, assessed its relevance to Australia, and graded the supporting scientific evidence from very low to high. Based on evidence strength and expert consensus, each recommendation is classified as suggested, recommended or mandatory.
‘My hope is simple: that these guidelines bring men into the fertility conversation where they belong and give clinicians the clarity and confidence they need to deliver equitable, effective care,’ said Professor Robert McLachlan of Monash University, medical director at Healthy Male.
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