[Clinical approach to male infertility]

The clinical approach to male infertility involves uncertainties, and various circumstances must be considered: 1. If no pregnancy occurs in the case of a couple whose sexual relations are "normal" and regular, and who have used no form of contraceptive for one year, the evaluation must systematically include both the woman and the man. 2. In the case of a man wishes to know his capacity for procreating, what are the possibilities for improvement? 3. Are there ways of predicting male infertility? If there are, the socioprofessional and iatrogenic risks should be more fully investigated. 4. What are the current possibilities for male contraception? In practical terms, the case of the infertile couple offers the widest field for clinical and paraclinical investigations. An exploratory strategy must guide this evaluation, assuring efficacy and taking account of current therapeutic possibilities, which are still unfortunately limited. The change in attitudes is clearly expressed by the number of couples who resort to adoption or artificial insemination rather than continue examinations and treatments when there is little chance of achieving pregnancy.