Updates to Male Infertility: AUA/ASRM Guideline 2024

August 2024 in “ The Journal of Urology ”

Robert E. Brannigan, Linnea Hermanson, Janice L Kaczmarek, Sennett K. Kim, M. Hassan Murad, Cigdem Tanrikut

male infertility genetic testing Y-chromosome microdeletion pelvic MRI sperm retrieval techniques testicular sperm nonazoospermic males varicocele correction lifestyle factors environmental factors sperm retrieval

TLDR The 2024 guideline updates recommendations for genetic testing, imaging, and sperm retrieval in male infertility.

The updated 2024 AUA/ASRM guidelines on male infertility stress the importance of evaluating the male partner, as male factors contribute to infertility in about 50% of cases. They recommend comprehensive assessments, including reproductive history and semen analysis, and highlight that some conditions can be treated medically or surgically, potentially reducing the need for invasive reproductive technologies. The guidelines address the impact of lifestyle factors like obesity and smoking on fertility, recommend specialized semen analysis, and suggest genetic testing for certain infertility cases. For non-obstructive azoospermia, micro-TESE is preferred for sperm retrieval. The guidelines advise against exogenous testosterone therapy for those seeking fertility and suggest human chorionic gonadotropin (hCG) for restoring fertility. Sperm banking is recommended before gonadotoxic therapies, and future directions include genomic advances and lifestyle impact studies to improve treatments.

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