Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Criteria for referring a male patient for specialist assessment in cases of infertility include:
- Men with abnormal semen analysis results, such as azoospermia or other significant semen abnormalities, should be referred for specialist assessment to determine underlying causes and appropriate management options.
- Men with hypogonadotrophic hypogonadism should be referred as they may benefit from gonadotrophin therapy to improve fertility.
- Men with obstructive azoospermia should be referred to centres with appropriate expertise for possible surgical correction of epididymal blockage as an alternative to surgical sperm recovery and IVF.
- Men with chronic viral infections such as hepatitis B, hepatitis C, or HIV should be referred to specialist centres with expertise in safe risk-reduction investigation and treatment before conception is considered.
- Men with ejaculatory failure or other specific male factor infertility issues should be referred for specialist evaluation and management.
Referral should also be considered earlier if there is a known clinical cause or history of predisposing factors for infertility, or if treatment that may impair fertility (e.g., cancer treatment) is planned.
Routine use of ineffective treatments such as anti-oestrogens, androgens, or surgery for varicoceles is not recommended without specialist assessment.
Overall, referral is indicated when initial assessment including semen analysis suggests male factor infertility or when clinical history indicates a need for specialist input to guide management and treatment options.
References: NICE CG156