How long should we try before testing the male partner?
If you and your partner are trying for a baby, it is reasonable to ask when the male partner should have fertility testing.
As a general guide, fertility assessment is usually recommended after 12 months of regular unprotected intercourse if the female partner is under 35, and after about 6 months if she is 35 or older. Earlier assessment may be appropriate if she is over 40 or if either partner has a known fertility risk factor.[1–5]
Importantly, once fertility testing is indicated, both partners should usually be assessed at the same time.[1–4]
When should the male partner be tested?
A practical guide is:
Female partner under 35: consider assessment after 12 months.
Female partner 35 or older: consider assessment after 6 months.
Female partner over 40: earlier assessment may be appropriate.
Known fertility risk factors: consider testing sooner.[1–5]
Australian guidelines recommend concurrent assessment of the male and female partners rather than completing the female investigation first.[1]
Learn more about male infertility assessment.
When should testing happen earlier?
You do not necessarily need to wait 6–12 months if there is a recognised male fertility risk.
Earlier assessment may be reasonable with a history of:
undescended testis
testicular torsion or injury
chemotherapy or radiotherapy
previous testicular or reproductive surgery
vasectomy
testosterone or anabolic steroid use
known varicocele
erectile or ejaculation problems
previous abnormal semen analysis
azoospermia or very low sperm counts.[1–3]
Assessment may also be appropriate sooner if the female partner has reduced ovarian reserve or another fertility condition.
What is the first male fertility test?
For most men, the key initial test is a semen analysis.[1–3,6]
It assesses factors including sperm concentration, total sperm number, motility, morphology and semen volume.
However, semen analysis is not a simple "fertile versus infertile" test. Mildly abnormal results do not mean natural pregnancy is impossible, and results within reference ranges cannot guarantee pregnancy.[6]
If the first semen analysis is abnormal, repeat testing is often recommended because semen parameters can vary between samples.[1]
Read more about low sperm count.
What if the semen analysis is abnormal?
Further assessment may include:
reproductive and medical history
examination of the testes
hormone blood tests
selected genetic testing
additional investigations where clinically indicated.[1–3]
Not every man requires every test.
If no sperm are found in the ejaculate, known as azoospermia, further investigation is needed to determine whether the problem is due to reduced sperm production or an obstruction.[1–3]
What if I have used testosterone?
Testosterone replacement therapy and anabolic steroids can suppress sperm production.
In some men this causes a very low sperm count, while in others sperm may disappear from the ejaculate altogether.[1–3]
If you are taking prescribed testosterone, do not stop or change treatment without discussing this with your treating doctor.
Read more about fertility after testosterone.
Does testing mean we will need IVF?
No.
The purpose of assessment is to identify the cause of difficulty conceiving and understand the available options.
Depending on the findings, management may include continued natural conception, treatment of a relevant medical condition, selected surgical treatment, vasectomy reversal, sperm retrieval or assisted reproductive treatment such as IVF or ICSI.[1–3]
The best pathway depends on the circumstances of both partners.
What about interstate or international patients?
Men living outside Brisbane may be able to begin assessment remotely where clinically appropriate.
Existing semen analyses, hormone tests, fertility records and previous specialist reports can often be reviewed before travel. An in-person examination or additional testing may still be required before some treatment decisions.
International patients can review the International Patient Information and International Patient Planner before arranging travel.
Take home message
For most couples:
Under 35: consider fertility assessment after 12 months.
35 or older: consider assessment after about 6 months.
Over 40 or with recognised fertility risks: consider assessment sooner.[1–5]
Once fertility investigation begins, the male partner should generally be assessed at the same time as the female partner.
For men, semen analysis is usually the key first test. If it is abnormal or there are recognised risk factors, more detailed male fertility assessment may help clarify the cause and treatment options.
For further information, visit Male Fertility & Reproductive Urology or request an appointment.
Frequently Asked Questions
Should the woman be tested first?
Usually not. Current Australian and international guidelines support assessing both partners concurrently once fertility investigation is indicated.[1–4]
Is six months too early for a semen analysis?
Not necessarily. Earlier testing may be reasonable if there are fertility concerns or recognised risk factors.
Can a normal semen analysis prove I am fertile?
No. Semen analysis provides important information but cannot by itself confirm or exclude fertility.[6]
Does an abnormal semen analysis mean we need IVF?
No. The importance of the result depends on its severity, the underlying cause and the fertility circumstances of both partners.
References
Katz DJ, O'Donnell L, McLachlan RI, et al. The first Australian evidence-based guidelines on male infertility. Med J Aust. 2025;223(11):653-663.
American Urological Association; American Society for Reproductive Medicine. Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. 2020; amended 2024.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health: Male Infertility. 2026.
Practice Committee of the American Society for Reproductive Medicine. Fertility evaluation of infertile women: a committee opinion. Fertil Steril. 2021;116(5):1255-1265.
World Health Organization. Guideline for the prevention, diagnosis and treatment of infertility. Geneva: WHO; 2025.
World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: WHO; 2021.
Medical Disclaimer
This article provides general educational information only and does not replace individual medical advice, diagnosis or treatment. The appropriate timing and type of fertility assessment depend on the circumstances of both partners. Do not start, stop or change prescribed medication, including testosterone, without discussing this with your treating healthcare professional.
