Practical recommendations for the management of the infertile couple for clinical practice from the perspective of andrologist/urologist approved by the Slovak Urological Society and the Slovak Sexological Society

Final recommendations

• A clinical examination of the man is the first examination of the man to reveal the causes of infertility
• The SPG examination shall be in accordance with the criteria and manual of the SPG examination by the WHO
• Men with severe oligozoospermia or azoospermia (< 5 million spermatozoa/ml) should be subjected to a genetic examination
• Varicocele surgery should be considered in the case of clinical manifestation of varicocele, or pathological spermiogram
• No evidence indicates the benefit of treatment of varicocele for men who have a normal SPG
• Testosterone replacement therapy is strictly contraindicated for the treatment of male infertility
• Medicamental therapy of male infertility is recommended for cases of hypogonadotropic  hypogonadism
• Erectile dysfunction and premature ejaculation can greatly exacerbate the fertilization potential of the man
• In the pathological spermiograms in men with idiopathic infertility it is possible to consider supplementation by antioxidants supplements