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Published: November 28, 2025
Last reviewed: November 28, 2025
Reviewed by: Dr Nicole McPherson - Director of Research, Education and Diagnostic Laboratories
Genea

For too long, male infertility has been the forgotten factor in the fertility conversation. While women have been subjected to extensive testing and interventions, their male partners have often been an afterthought, despite contributing to half of all infertility cases. This month marks a turning point: Australia has released its first evidence-based clinical guidelines for male infertility, and the implications for how we approach fertility care are profound.

Shifting the narrative: Infertility is not just a "women's issue"

The statistics are stark. One in six Australian couples experience infertility, and male factors are involved in approximately 50% of cases. Yet until now, we've had no Australian-specific guidelines to ensure men receive the same quality of evidence-based care as their partners. I've spent my career researching male reproductive biology and the factors that influence sperm health, from obesity and lifestyle factors to the intergenerational effects of paternal health on embryo formation, pregnancy and child health. What has become increasingly clear is that we cannot continue to sideline men in the fertility journey.

These new Guidelines for the management of male infertility, developed by a multidisciplinary panel of experts and endorsed by the Urological Society of Australia and New Zealand, the Endocrinological Society of Australia and New Zealand, the Fertility Society of Australia and New Zealand, and Healthy Male, represent a fundamental shift in how we think about and deliver male fertility care.

What the guidelines recommend

The 80 expert-backed recommendations provide a comprehensive framework for assessment and management of male infertility. Key principles include:
  • Early and simultaneous evaluation of both partners. The guidelines emphasise that assessment should occur without delay for both members of a couple experiencing fertility concerns. This addresses a common scenario where months and sometimes years pass with the female partner undergoing extensive investigation while the male partner remains untested.
  • Comprehensive initial assessment. Every male evaluation should include a detailed reproductive and medical history, a physical examination (including scrotal examination), and semen analysis. This sounds basic, but in practice, many men never receive this fundamental workup.
  • Expert involvement for abnormal findings. Men with suspected infertility should have further evaluation guided by an expert in male reproduction, including hormonal assessment and testicular volume estimation. Additional investigations such as sperm DNA testing, genetic testing, and imaging should be performed based on clinical indication.
  • Counselling on modifiable risk factors. Perhaps most importantly for long-term outcomes, the guidelines emphasise counselling men about lifestyle factors, associated health conditions, and the implications for their future health and that of their children.

Why this matters: Semen analysis as a window to men's health

In our recently published work in Nature Reviews Urology, my colleagues and I argued that semen analysis holds untapped potential as a tool not just for assessing fertility, but for promoting men's overall health and preventing chronic disease. Spermatogenesis is exquisitely sensitive to environmental and lifestyle factors. Disruptions in sperm production can signal underlying systemic issues and predict long-term health risks, including cardiovascular disease and metabolic disorders.

This creates a unique opportunity. Many men who would otherwise never engage with the healthcare system are motivated to seek care when trying to conceive. We can leverage this moment, using their desire for fatherhood as an entry point and discuss broader health concerns like nutrition, physical activity, weight management, and mental wellbeing.

The research is compelling. Men with abnormal semen parameters have increased risks of chronic disease, mortality, and certain cancers. Male infertility isn't just a reproductive issue; it's a biomarker for overall health. These guidelines recognise this connection and encourage practitioners to consider the bigger picture.

What this means for Genea and our patients

At Genea, we've always believed in treating the whole patient, not just the presenting problem. These guidelines validate and reinforce what we've been building for years: a comprehensive, multidisciplinary approach to male fertility care that puts men at the centre of their own treatment journey.

A dedicated andrology service. Unlike general pathology labs that process sperm samples alongside countless other tests, Genea Andrology is staffed by scientists who specialise exclusively in male fertility. Our andrology laboratories conduct the full spectrum of male infertility diagnostic testing, from standard semen analysis performed to WHO standards, through to advanced sperm function tests. This specialisation matters as the quality and consistency of semen analysis directly impacts diagnosis and treatment decisions.

Specialists with expertise in male factor infertility. Across our network of clinics: from Sydney to Melbourne, Adelaide to Newcastle, our fertility specialists bring dedicated expertise in diagnosing and treating male infertility. For example: In South Australia, Dr Bruno Radesic, Medical Director of FertilitySA, is the only specialist in the state who can perform microsurgical testicular sperm extraction (microTESE) - the gold-standard procedure for men with non-obstructive azoospermia. This advanced microsurgical technique uses high-powered magnification to identify and extract sperm from the testes, offering hope to men who were previously told they had no options for biological fatherhood. Dr Genia Rozen in Melbourne brings sub-specialised training in andrology alongside her fertility expertise, performing procedures including testicular sperm aspiration (TESA) and extraction (TESE) for men with azoospermia. Dr Anthony Marren in Sydney partners with us to provide comprehensive male infertility assessment and treatment, with a particular focus on identifying and correcting the underlying factors that prevent couples from conceiving.

Advanced surgical options when needed. For men with no sperm in their ejaculate whether due to obstruction or impaired production we offer surgical sperm retrieval procedures including TESE and microTESE. These microsurgical techniques, performed by experienced specialists, can retrieve viable sperm directly from the testes for use with intracytoplasmic sperm injection, giving men with azoospermia a pathway to biological fatherhood that simply wasn't possible a generation ago.
A commitment to the whole picture. The new guidelines emphasise that male infertility management should include counselling on modifiable risk factors and implications for long-term health. This aligns perfectly with our philosophy. We don't just treat fertility in isolation, we consider lifestyle factors, metabolic health, and the psychosocial wellbeing of our patients. Our team includes fertility counsellors and nurses who understand that a diagnosis of male infertility can be deeply impactful, and we provide the emotional support men need alongside their medical care.

Looking forward: From guidelines to practice

Guidelines are only as valuable as their implementation. The real work begins now with translating these 80 recommendations into clinical practice across Australia. This requires education for primary care providers, streamlined referral pathways, and a cultural shift in how we communicate with men about their reproductive health.

For men reading this: if you and your partner are trying to conceive, don't wait to be tested. A semen analysis is a simple, non-invasive first step. If abnormalities are found, seek evaluation from a specialist in male reproduction. And regardless of your fertility goals, consider what your reproductive health might be telling you about your overall wellbeing.

For healthcare providers: familiarise yourself with these guidelines. They represent the collective wisdom of Australia's leading experts in male reproductive health and provide a clear roadmap for delivering best-practice care.

The release of these guidelines is a landmark moment. But more than that, it's a recognition that fertility truly takes two and that both partners deserve the highest standard of evidence-based care.
Ready to take the next step? Contact our Fertility Concierge team today to book a semen analysis or to speak with one of our male fertility specialists.

Disclaimer: Please note that this is a Genea Group blog and as such information may not be relevant for all clinics. We advise that you consult clinics directly for further information. 

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