Male infertility

Infertility is estimated to affect 1-in-7 couples living in the UK. An estimated 84% of couples will conceive naturally within a year if they have regular unprotected sex; but those who have been trying to conceive for greater than 3 years without success are less than 25% likely to conceive naturally within the course of the following year. Investigation of infertility in primary care is often focused on the female patient and neglectful of their male partner. However, male factors alone are responsible for 20–30% of couples’ infertility, and in an additional 30–40% of cases a male factor is present in combination with other female factors. An estimated 7% of men are affected by infertility, and the incidence of infertility appears to be increasing in the developed world. This article will address potential causes and how to investigate for them. The article will consider investigation in primary care and secondary care management strategies.