Challenges in Diagnosing Male Infertility and the Impact on IVF

The government is slowly becoming aware of the issue and last year introduced the first national guidelines for the management of male fertility, requiring GPs and specialists to assess both man and woman from the outset.

If those guidelines had been implemented earlier, Reece Conca, 34, might have been diagnosed much sooner.

After more than 12 months of trying and only cursory questions like “do you smoke?” from doctors, Conca was urged by an acupuncturist to get a semen analysis. It revealed he had azoospermia.

An AFL player at the time, Conca was in peak physical fitness and felt devastated: “I spent most of that night crying with my wife, Belle. Just starting to feel really hopeless and overwhelmed and guilty.”

Through surgical sperm retrieval and IVF, the couple conceived their son, Giovanni, born in December 2024.

Now retired from AFL, Conca has become a passionate advocate for male infertility awareness.

“It’s important for men to hear they’re not alone,” he says.

“I wrestled a lot with how it impacts your feelings of masculinity as well, and that’s a big part of it: you’re no less of a man because you’re going through infertility.”

Our lack of information surrounding male infertility also has serious implications for men’s overall health, with Dunleavy explaining male infertility is a “canary in the coal mine” for a man’s general health.

“Infertile men as a cohort have an increased risk of other health problems like cancer and metabolic diseases, and they also have a shorter average lifespan,” she says.

“So if we can give them a precise diagnosis of their infertility causes, it means we could better predict potential additional health risks.”

Meaningful diagnosis might also prevent some couples from unnecessarily draining thousands of dollars and being put through the ringer of IVF when they don’t need to, says Moss.

“If there is a male infertility problem that is due to something anatomical that can be fixed by surgery, or [something] metabolic that can be fixed by medication or changes in behaviours, then you could restore fertility in that man and avoid the need for assisted reproduction.”

One of the silver linings of male fertility is that for many men, they’ll be able to actively improve it through lifestyle interventions, says Dr Shadi Khashaba, a fertility specialist at IVFAustralia.

“We know smoking affects sperm,” he says. “Excessive alcohol will cause hormonal imbalances and of course, healthy diet will improve their weight, the insulin sensitivity, and also their reproductive health.”

Other things like avoiding prolonged and excessive heat on testicles, minimising contact with endocrine-disrupting chemicals (don’t microwave food in plastic), and ceasing any testosterone use (it halts sperm production) will also help.

Conca’s advice for aspiring fathers is simple: “Be as proactive as you can with the conceiving process. Make sure you’re putting everything you can in place, including your physical, mental, emotional health. Obviously make sure you’re supporting your partner through it all.

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