Evaluation of the Male infertility Patient

When someone needs to be evaluated for problems with male fertility, they are often referred to a urologist.  What are urologists and why are they the doctor frequently recommended to see?    Who else is involved in fertility care?

Urology

Urology is a surgical subspecialty within medicine.  Urologists are physicians whose focus is the urinary and male genital system.     That means beyond an internship in general surgery, urologists spend several years in residency training acquiring knowledge and skills used in treatment of disorders of the genitourinary system. 

 The Urinary system includes whatever is involved in the production and transport of urine.  This includes the kidneys which filter the blood to actually produce the urine,  the ureters which carry the urine to the bladder, the bladder itself and the urethra.     With respect to  males, urologists also receive residency training in  disorders of the male genital system.    This includes the accessory sex organs such as the prostate, and seminal vesicles as well as the penis and testicles, all of which are involved with reproduction.  

 Male Reproductive Medicine

Some Urologists may undertake additional training known as a  Fellowship in Male Reproductive Medicine or Male infertility.   Fellowship training may give a urologist more exposure and experience with disorders related to male infertility as well as with surgical procedures often used in the treatment of men with fertility issues such as varicocelectomy, vasectomy reversal and surgical sperm retrieval.  Fellowships usually provide extensive microsurgical training and experience to maximize surgical skills in this area.

Obstetrician / Gynecologists

However, infertility is, in reality, a couple’s issue.   Obstetrician/Gynecologists have residency training in the female genital system and are often the first doctor the infertile couple will see in the evaluation process.   Reproductive endocrinologists are gynecologists who have undertaken fellowship training in female fertility  and have additional expertise including extensive training and experience with in vitro fertilization.    Nurses often play a large role in reproductive care, especially in the setting of a reproductive endocrinology practice.

Other Health Professionals

Still other health professionals may be involved with the treatment of individuals with fertility issues.  It is not uncommon for couples to seek nutritional counseling.   Acupuncturists sometimes also attend to couples with fertility issues.    Less commonly, genetic counselors may play a role.

At  the end of the day,  the patient should see the physician or health care professional who is best trained and best able to address their particular problem.   For male infertility issues, particularly surgically treated problems, Urologists, may be the most appropriate physician to see, especially those with additional training and or an interest in male infertility. 

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