Report on optimal evaluation of the infertile male.

the Practice Committee of the American Society for Reproductive Medicine (ASRM). The two organizations agreed to collaborate to prepare documents of importance in the field of male infertility. The Male Infertility Best Practice Policy Committee was created in 1999 by the Board of Directors of the American Urological Association, Inc. ® The Committee co-chairmen and members were selected by the Practice Parameters, Guidelines and Standards Committee (PPGSC) of the AUA. The membership of the Committee included nine urologists, one reproductive endocrinologist, one family physician and one research andrologist. The mission of the Committee was to develop recommendations , based on expert opinion, for optimal clinical practices in the diagnosis and treatment of male infertility. It was not the intention of the committee to produce a comprehensive treatise on male infertility. This document was submitted for peer review by 125 physicians and researchers from the disciplines of urology, gynecology, reproductive endocrinology, primary care and family medicine, andrology and reproductive laboratory medicine. Modifications were made by the Practice Committee of the ASRM. After the final revisions were made based upon the peer review process and the Practice Committee of the ASRM, the documents were submitted to, and approved by the Board of Directors of the AUA and the Board of Directors of the ASRM. These " Best Practice Policies " are intended to assist urologists, gynecologists, reproductive endocrinologists, primary care practitioners and reproductive researchers. Funding of the Committee was provided by the AUA. Committee members received no remuneration for their work. Each member of the Committee provided a conflict of interest disclosure to the AUA. Required evaluation components for every patient Medical history Physical examination Semen analysis Other procedures and tests for assessing male fertility Endocrine evaluation Post ejaculatory urinalysis Ultrasonography Transrectal ultrasonography Scrotal ultrasonography Specialized clinical tests on semen and sperm Quantitation of leukocytes in semen Tests for antisperm antibodies Sperm viability tests Tests of sperm-cervical mucus interaction Zona free hamster oocyte test Computer-aided sperm analysis Less commonly used specialized tests Genetic screening Cystic fibrosis gene mutations Karyotypic chromosomal abnormalities Y-chromosome microdeletions Approximately 15% of couples are unable to conceive after one year of unprotected intercourse. A male factor is solely responsible in about 20% of infertile couples and contributory in another 30-40% (1). If a male infertility factor is present, it is almost always defined by the finding of an abnormal semen analysis, although other male factors may play a …