Patient handout

Male Infertility Evaluation — chronic outpatient (azoospermia / oligospermia / asthenospermia / teratospermia / varicocele / HH / drug-induced / radiation)

PRODUCTION

1. Your condition

This handout is for male infertility evaluation — chronic outpatient (azoospermia / oligospermia / asthenospermia / teratospermia / varicocele / hh / drug-induced / radiation). Your care team identified this based on: couple with ≥12 mo unprotected intercourse without conception (≥6 mo if female partner >35y) — male partner evaluation (aua 2020; eau; nice cg156).

Other reasons your team may use this plan: abnormal semen analysis per who 5th ed thresholds (volume, count, motility, morphology) (who 2010 5th); planned gonadotoxic therapy → sperm cryopreservation counseling (aua 2020; asrm); known azoospermia on prior testing — phenotyping (obstructive vs non-obstructive).

2. Your medications

Take these medications exactly as prescribed. Do not stop or change a dose without talking to your provider.

Medication	Starting dose	How	When	What it does
Smoking cessation + alcohol moderation + marijuana cessation + heat avoidance + weight loss + anabolic steroid discontinuation	—	—	—	ASRM smoking + AUA 2020 + EAU; modifiable risk factors improve parameters in 3-6 mo

Plan: Male infertility — AUA 2020 ladder: lifestyle → empiric → varicocele → ART → sperm retrieval → HH gonadotropin therapy

3. When to call your provider

Contact your care team if any of the following happen:

New testicular mass on exam → STAT scrotal US + uro (GCT risk in infertile men) (AUA 2020)
Visual field defect + low T + low FSH → STAT pituitary MRI (AUA 2020)
Rapid progression / B symptoms → onc evaluation

4. When to seek emergency care

Call 911 or go to the nearest emergency room right away if you have:

Non-obstructive azoospermia — elevated FSH + reduced testicular volume; Klinefelter 47,XXY / Y-microdeletion / post-chemo / cryptorchidism (AUA 2020)
Severe oligospermia <5M/mL — usually genetic or anatomic; ART pathway (AUA 2020)
Hypogonadotropic hypogonadism — low FSH + LH + T; Kallmann syndrome / pituitary lesion / prior testosterone use (AUA 2020)
Prior gonadotoxic therapy → post-treatment infertility; counsel sperm cryopreservation BEFORE therapy if planned (AUA 2020; ASRM)

5. Follow-up

Coordinate with female partner workup; counseling for donor sperm / adoption if untreatable

6. Sources

Guideline: Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline — Part I evaluation (Schlegel PN et al, Fertil Steril/J Urol 2021 PMID 33309062) + Part II management (PMID 33309061). WHO laboratory semen-analysis reference values cited by name.