When should I consider referring a male patient for specialist fertility assessment?

Consider referring a male patient for specialist fertility assessment if:

• He has been trying to conceive with his partner for 1 year or more without success, and there is no known cause of infertility.
• There is a known clinical cause of infertility or a history of predisposing factors for infertility.
• The male patient has chronic viral infections such as hepatitis B, hepatitis C, or HIV, requiring specialist expertise for safe risk-reduction investigation and treatment.
• There is evidence of abnormal semen analysis results, such as azoospermia or severe oligozoospermia, especially if confirmed on repeat testing.
• He has hypogonadotrophic hypogonadism, which may benefit from specialist medical management.
• He has obstructive azoospermia, where surgical correction might be considered by specialists.
• Early referral is warranted if fertility-threatening treatments (e.g., cancer treatment) are planned.

Referral should be made to a specialist fertility team to improve the effectiveness and efficiency of treatment and to provide appropriate counselling and support.

¹