Key points
- Male factors alone are responsible for up to 30% of cases of infertility and contribute to an additional 30% to 40%
- Varicoceles are relevant in the context of a subfertility presentation
- Factors known to affect male fertility and/or semen quality include smoking, alcohol, recreational or performance enhancing drug use, obesity, stress and advancing age
- An azoospermic sperm sample should be repeated immediately; a suboptimal test should be repeated one to three months after the original test
- Results outside of the normal reference ranges may reduce the chances of conceiving, but do not preclude it
- Medical treatment for male infertility is a specialist area and NICE advises that all fertility referrals should be made as joint referrals
Dr David Coleman is a GP partner and trainer in Doncaster
Q. How is male subfertility defined and to what extent is it a factor in couples having problems conceiving?
The terms ‘subfertility’ and ‘infertility’ are often used interchangeably in articles concerning reproductive medicine. NICE recommend defining infertility as the period of time people have been trying to conceive without success, after which formal investigation is justified. In practice, further investigation is usually offered after one year. Subfertility is defined as any form of reduced fertility that results in a prolonged duration of unwanted lack of conception.
The World Health Organization (WHO) definition of male infertility is the presence of one or more abnormal parameters on semen analysis (a first suboptimal test should be repeated) or inadequate sexual or ejaculatory function.
Male factors alone are responsible for up to 30% of cases of infertility and contribute to an additional 30% to 40% in combination with other factors.
Click here to read the full article and download your certificate logging 2 CPD hours towards revalidation
