Male infertility affects 10% of couples and is treatable in many cases. The evaluation of infertility is initiated typically after 1 year of failure to conceive. Clinical evaluation of the infertile man requires a complete medical history, physical examination, and laboratory studies in order to identify and treat correctable causes of subfertility and recognize those who are candidates for assisted reproductive technologies, those who are sterile and should consider adoption or artificial insemination using donor sperm, and those who should undergo genetic screening. Although pregnancies can be achieved without any evaluation other than a semen analysis, this test alone is insufficient to adequately evaluate the male patient. Treatment of correctable male-factor pathology is cost effective, does not increase the risk of multiple births, and can spare the woman invasive procedures and potential complications associated with assisted reproductive technologies.
