Male factor infertility — MCCQE Part 1 MCQ

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ModerateInfertilityMale factor infertilityMCCQE Part 1

A couple has tried to conceive for 14 months; the woman has regular cycles and the male partner had mumps orchitis as a teenager. Which of the following is the most appropriate next step?

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Correct answer: B — Order semen analysis as part of initial infertility evaluation

Order semen analysis as part of initial infertility evaluation is the single best answer because the age, timing, examination findings and investigations in the vignette fit Male factor infertility better than the alternatives. The most tempting distractor is less appropriate because it either treats a neighbouring presentation, delays a time-critical intervention, or ignores a key discriminator in the stem. The remaining options are suboptimal because they would miss the diagnosis, use an investigation or treatment in the wrong sequence, or fail to address safety and follow-up. Canadian practice should be anchored to Canadian Fertility and Andrology Society guidance, with attention to acuity, safety-netting and local provincial pathways.

Reference: Canadian Fertility and Andrology Society guidance