Expert Working Groups (EWG)

GFMER Global Consultation on WHO Infertility Guidelines
EWG: Male subfertility work-up

The EWG on diagnosis of male fertility focuses on the diagnosis of male infertility. It will address the investigation of the male including physical examination and history taking, role of the genetic basis of male infertility, role of occupation, environmental and lifestyle influences, the role of semen analysis and in particular advanced tests of sperm e.g. DNA assessment. We will take cultural, social, economical and religious issues into account.

Christopher LR Barratt
Chair, EWG Male subfertility work-up

Chair: Christopher LR Barratt (UK)

Members

• Herman Tournaye (Belgium)
• Rob McLachlan (Australia)
• Christopher De Jonge (USA)
• Lars Björndahl (Sweden)
• Robert B Oates (USA)

Participants

• Akmal El-Mazny - Department of Obstetrics and Gynecology, Faculty of Medicine, Cairo University, Egypt
• Amare Siraw - Counterpart International Ethiopia, Addis Ababa, Ethiopia
• Georgy Eralil - Sree Narayana Institute of Medical Sciences, North Kuthiyathodu, India
• Kenneth Kabali - Joint Medical Store, Kampala, Uganda
• Khaled Gadalla - Department of Urology, Al-Azhar Faculty of Medicine for Girls, Al-Azhar University Hospital, Cairo, Egypt
• Purushottam Sah - Nightingale Hospital, Calcutta, India
• Shambhu Dutta Joshi - National Academy of Medical Sciences, Kathmandu, Nepal
• Stephen Okeyo - Faculty of Health Sciences and Tropical Institute of Community Health and Development, Great Lakes University of Kisumu, Kenya
• Yitref Dinberu - CURE International Hospital, Addis Ababa, Ethiopia
• Ziaulhaq Mansoor Ahrari - Herat Institute of Health Sciences, Afghanistan

WHO DRAFT PICO Questions:

Population Intervention Comparator Outcome (PICO):
Being developed to find the evidence in order to determine if a Recommendation on best practice can be made by the World Health Organization concerning the following topic.

MALE SUB-FERTILITY WORK-UP

(P = men of reproductive age – questions may include exclusion or inclusion criteria)

Should WHO develop a recommendation concerning:

1. within which settings a rectal examination should be an essential part of a physical examination?
2. how varicocele should be assessed and its significance to fertility?
3. abnormalities of the epididymides and vasa are apparent on examination and their significance to fertility?
4. a) which serum evaluations would assist to identify subfertility?
   b) which serum evaluations are necessary to identify co-morbidities (such as testis cancer, androgen deficiency)?
5. the criteria required to suggest genetic evaluations (such as KS (47,XXY), Yq deletion)?
6. which genetic evaluations are necessary to address potential impact on offspring (BCAV-CFTR)?
7. key male lifestyle factors which impact on fertility (such as weight, alcohol intake, temperature, diet, stress, tobacco smoking, marijuana)?
8. the harm or benefit in the use of natural or complimentary therapies on fertility (such as vitamins, herbal therapies, zinc)?