Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline PART II

J Urol. 2021 Jan;205(1):44-51. doi: 10.1097/JU.0000000000001520. Epub 2020 Dec 9.

Abstract

Purpose: The summary presented herein represents Part II of the two-part series dedicated to the Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Part II outlines the appropriate management of the male in an infertile couple. Medical therapies, surgical techniques, as well as use of intrauterine insemination (IUI)/in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) are covered to allow for optimal patient management. Please refer to Part I for discussion on evaluation of the infertile male and discussion of relevant health conditions that are associated with male infertility.

Materials/methods: The Emergency Care Research Institute Evidence-based Practice Center team searched PubMed®, Embase®, and Medline from January 2000 through May 2019. When sufficient evidence existed, the body of evidence was assigned a strength rating of A (high), B (moderate), or C (low) for support of Strong, Moderate, or Conditional Recommendations. In the absence of sufficient evidence, additional information is provided as Clinical Principles and Expert Opinions (table[Table: see text]). This summary is being simultaneously published in Fertility and Sterility and The Journal of Urology.

Results: This Guideline provides updated, evidence-based recommendations regarding management of male infertility. Such recommendations are summarized in the associated algorithm (figure[Figure: see text]).

Conclusion: Male contributions to infertility are prevalent, and specific treatment as well as assisted reproductive techniques are effective at managing male infertility. This document will undergo additional literature reviews and updating as the knowledge regarding current treatments and future treatment options continues to expand.

Keywords: chemotherapy; evaluation; health; male infertility; surgery.

Publication types

  • Practice Guideline

MeSH terms

  • Counseling / standards
  • Dietary Supplements
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / standards
  • Fertilization in Vitro / methods
  • Fertilization in Vitro / standards
  • Humans
  • Infertility, Male / diagnosis
  • Infertility, Male / etiology
  • Infertility, Male / therapy*
  • Male
  • Reproductive Medicine / methods
  • Reproductive Medicine / standards*
  • Scrotum / diagnostic imaging
  • Selective Estrogen Receptor Modulators / therapeutic use
  • Semen Analysis
  • Societies, Medical / standards
  • Sperm Retrieval / standards
  • Treatment Outcome
  • United States
  • Urology / methods
  • Urology / standards*
  • Varicocele / complications
  • Varicocele / diagnosis
  • Varicocele / therapy*

Substances

  • Selective Estrogen Receptor Modulators