Which Doctor Should I See for Male Infertility?
If you are having difficulty conceiving, it is not always obvious which doctor to see. Should you start with your GP, an IVF clinic, a urologist or an endocrinologist?
For suspected male infertility, a good starting point is often your GP. However, if a semen analysis is abnormal or there is another reason to suspect a male fertility problem, current Australian guidelines recommend further assessment by a specialist in male reproduction.[1]
For men, this is commonly a urologist with subspecialty training in male reproductive medicine or andrology.
What does a male fertility specialist do?
Male infertility is not simply a question of whether sperm numbers are high or low.
A male reproductive urologist assesses why fertility may be reduced. This may include:[1-4]
reviewing one or more semen analyses
examining the testicles and reproductive tract
looking for a varicocele
checking reproductive hormones
assessing previous testicular surgery, infection or injury
reviewing testosterone or anabolic steroid exposure
investigating obstruction or previous vasectomy
arranging genetic testing when appropriate
assessing erection or ejaculation problems
considering whether treatment of an underlying problem may be possible.
If you already have a semen analysis, the Semen Analysis Interpreter can provide a plain-English explanation of the measurements before your appointment.
Should I see my GP first?
A GP is an excellent place to start.
Your GP can review your medical history, arrange an initial semen analysis and identify health or medication issues that may affect fertility. They can also refer you for specialist assessment when required.
Australian guidelines recommend an initial male fertility assessment that includes a medical and reproductive history, physical examination and semen analysis.[1]
If the semen analysis is abnormal, it will often need to be repeated because sperm measurements naturally vary between samples.[1,5]
You can also use the Male Fertility Assessment Checklist to see what information may be useful to prepare.
Should I see an IVF specialist instead?
An IVF or fertility specialist plays an important role, particularly when assisted reproductive treatment such as IUI, IVF or ICSI may be required.
However, IVF treatment and assessment of the male partner are not the same thing.
Male infertility can occasionally be caused by conditions that may be treatable or that have implications for a man's broader health. Current guidelines therefore recommend assessing both partners in parallel, rather than investigating only the female partner or proceeding automatically to assisted reproduction.[1-3]
In many cases, the most effective approach is collaboration between the male reproductive specialist and the couple's fertility specialist.
When is seeing a male reproductive urologist particularly important?
Specialist male assessment should be considered particularly when there is:
no sperm in the semen (azoospermia)
a persistently low sperm count
very poor sperm movement or other significant semen abnormalities
a clinical varicocele
previous undescended testicles
previous testicular injury or surgery
a previous vasectomy
difficulty ejaculating
testosterone or anabolic steroid use
previous chemotherapy or radiotherapy
recurrent pregnancy loss
repeated unsuccessful fertility treatment.[1-4]
If your semen analysis reports no sperm, read more about azoospermia or use the Azoospermia Pathway Finder.
For selected men with non-obstructive azoospermia, specialist assessment may eventually include discussion of microTESE, although sperm-retrieval surgery is not appropriate for every man.
What about an endocrinologist?
An endocrinologist may be important when infertility is caused by a specific hormonal disorder.
For example, some men have inadequate hormonal stimulation of the testicles from the pituitary or hypothalamus. These conditions require different management from infertility caused by primary testicular sperm-production problems.[1]
A reproductive urologist may work with an endocrinologist when needed.
Importantly, testosterone treatment can suppress sperm production. Men who are trying to conceive should not start, stop or change testosterone or other hormonal medication without discussing this with an appropriately qualified doctor.[1-3]
What if I have a varicocele?
A varicocele is a group of enlarged veins around the testicle. Many men with a varicocele remain completely fertile.
Treatment is therefore not automatically required simply because a varicocele is seen on an ultrasound.
Current guidelines support considering treatment in selected infertile men with a clinically detectable varicocele and relevant fertility findings.[1-3]
Read more about varicocele and male fertility.
What if I have had a vasectomy?
After vasectomy, there are usually two broad fertility pathways:
microsurgical vasectomy reversal, or
sperm retrieval followed by IVF/ICSI.
Which option is more appropriate depends on factors involving both partners, including reproductive timeframe and the female partner's fertility.
The Vasectomy Reversal vs IVF/ICSI tool can help you understand the questions commonly considered when comparing these pathways.
When should I seek help?
Traditionally, infertility assessment is recommended after 12 months of regular unprotected intercourse without pregnancy. Earlier assessment may be appropriate when the female partner is 35 or older or when there is a known fertility concern.[1-3]
You do not necessarily need to wait 12 months if you already know that you have:
an abnormal semen analysis
azoospermia
previous testicular problems
a varicocele
previous vasectomy
testosterone or anabolic steroid exposure
difficulties with erections or ejaculation
previous cancer treatment.
Male fertility assessment in Brisbane, interstate or overseas
For patients in Brisbane and South-East Queensland, male reproductive assessment can include examination, review of semen analyses and targeted investigation where clinically indicated.
If you live interstate, previous semen analyses, hormone results and fertility records may be useful to review when planning your assessment.
Patients travelling from overseas can review the International Patient Information pathway before arranging travel. Where clinically appropriate and permitted, some initial discussion and record review may be possible before travelling, although physical examination or further investigation may still be required.
If you would like an individual male fertility assessment, you can request an appointment.
References
Katz DJ, O'Donnell L, McLachlan RI, Moss TJ, Boothroyd CV, Jayadev V, et al. The first Australian evidence-based guidelines on male infertility. Med J Aust. 2025;223(11):653-663. doi:10.5694/mja2.70080.
European Association of Urology. EAU Guidelines on Sexual and Reproductive Health. Arnhem, The Netherlands: EAU Guidelines Office; 2026.
Schlegel PN, Sigman M, Collura B, De Jonge CJ, Eisenberg ML, Lamb DJ, et al. Diagnosis and treatment of infertility in men: AUA/ASRM guideline part I. J Urol. 2021;205(1):36-43. doi:10.1097/JU.0000000000001521.
Brannigan RE, Hermanson L, Kaczmarek J, Kim SK, Kirkby E, Tanrikut C. Updates to male infertility: AUA/ASRM guideline (2024). J Urol. 2024;212(6):789-799. doi:10.1097/JU.0000000000004180.
World Health Organization. WHO laboratory manual for the examination and processing of human semen. 6th ed. Geneva: World Health Organization; 2021.
Medical disclaimer
This information is provided for general education only and does not replace individual medical advice, diagnosis or treatment. The appropriate investigation and management of infertility depends on the circumstances of both partners. Do not start, stop or change prescribed medicines or fertility treatment based on this article. Seek assessment from an appropriately qualified healthcare professional for advice specific to your situation.
