Evidence-Based Infertility Treatment Approaches

Male Factor Infertility Management

The American Urological Association recommends that male contributions to infertility be properly evaluated and treated with evidence-based medical or surgical therapies, as they are prevalent in approximately half of all infertile couples 2
For men with azoospermia due to obstruction, sperm may be extracted from either the testis or the epididymis, according to the American Urological Association 2
The American Urological Association suggests that treatments for men with ejaculatory dysfunction may include penile vibratory stimulation, electroejaculation, surgical sperm retrieval, or sympathomimetic agents, depending on the cause 2
For men with infertility and low serum testosterone, the American Urological Association recommends treatments such as aromatase inhibitors, human chorionic gonadotropin, selective estrogen receptor modulators, or combinations thereof 3
The American Urological Association advises that testosterone monotherapy should not be prescribed for males interested in current or future fertility 3

The American Society for Reproductive Medicine recommends established treatments for women with infertility, including ovarian stimulation with gonadotropins, oocyte and embryo cryopreservation, and other assisted reproductive technologies (ART) 4, 5
For women with limited time before starting treatments like chemotherapy, the American Society for Reproductive Medicine suggests that ovarian tissue cryopreservation may be considered 5
The American Society for Reproductive Medicine notes that ovarian stimulation protocols can be started at any time of the menstrual cycle ('random start stimulation') and can be completed rapidly before initiating treatments like chemotherapy 5

The American Urological Association and American Society for Reproductive Medicine do not recommend acupuncture as a primary treatment for infertility, based on current high-quality medical guidelines 2, 3, 6
The World Health Organization found insufficient high-quality data to recommend the use of acupuncture for treating men with abnormal semen parameters and/or male infertility, with a strong recommendation against herbal therapies for male infertility treatment based on very low quality of evidence 1

The American Urological Association and American Society for Reproductive Medicine recommend that patients be directed to evidence-based medical and surgical interventions for infertility treatment, including assisted reproductive technologies (ART) such as intrauterine insemination (IUI), in vitro fertilization (IVF), and intracytoplasmic sperm injection (ICSI) 2, 3, 6
Treatment should be provided according to the needs and characteristics of the couple through a shared decision-making process, as recommended by the American Urological Association 3
If patients wish to explore complementary approaches like acupuncture, they should be informed that current medical evidence does not support its use as a primary treatment for infertility, according to the World Health Organization 1

Delaying evidence-based treatments in favor of unproven alternative therapies may reduce chances of successful conception, especially for women of advanced maternal age, as noted by the American Society for Reproductive Medicine 5
Using supplements or herbal remedies without medical supervision may interfere with conventional treatments or have unexpected side effects, according to the World Health Organization 1