Urology focuses on the urinary tract in all sexes and the male reproductive organs. The male urinary and reproductive systems share several organs and pathways, so urologists often take part in fertility evaluations. When a couple has trouble conceiving, a urologist may assess the male partner while a gynecologist evaluates the female partner. Here is some information about urology and its role in fertility issues:
Checks for Structural Abnormalities
During a fertility evaluation, a urologist usually begins with a medical history and a physical exam. The exam focuses on the testicles, epididymis, vas deferens, and surrounding tissue. Your urologist checks the size and firmness of each testicle, and they feel for lumps or swelling.
One common finding is a varicocele. This is an enlargement of the veins inside the scrotum, similar to a varicose vein in the leg. Varicoceles sometimes raise the temperature around the testicles, and this may impact sperm count and quality. A scrotal ultrasound helps confirm the diagnosis. Other structural issues include:
- Blockages in the vas deferens or ejaculatory ducts
- Congenital absence of the vas deferens
- Undescended testicles, past or present
- Scarring from prior infections, injuries, or surgeries
A semen analysis guides the next steps, and the results determine which treatments are appropriate. If no sperm appear in the sample, the urologist looks for a blockage or a production problem. Depending on the results, options may include varicocele repair, reconnection of blocked tubes, or sperm retrieval for assisted reproduction.
Supports Blood and Genetic Testing
Many male fertility workups at a urology clinic include a blood draw. Hormones control sperm production, and an imbalance may lower sperm count or stop production. A urologist typically orders tests for:
- Testosterone
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
- Prolactin
- Estradiol
High FSH levels sometimes point to a problem in the testicles, while low levels may suggest a pituitary gland issue. Low testosterone has many possible causes, including obesity, certain medications, and testosterone supplements. Tell your urologist about any hormone products you use, since outside testosterone may suppress sperm production.
Genetic testing is usually recommended when sperm counts are very low or absent. Common tests look for chromosomal conditions. Men with congenital absence of the vas deferens sometimes receive cystic fibrosis gene testing. These results help explain the likely cause, and they may lead to a referral for genetic counseling.
Manages Sexual Dysfunction
Sexual function and fertility are closely linked, and problems in one area often affect the other. Erectile dysfunction may make intercourse difficult during a partner’s fertile window. Ejaculation disorders create different obstacles. Premature, delayed, and retrograde ejaculation, where semen flows backward into the bladder, may each reduce the chance of sperm reaching the egg.
Speak openly about these symptoms, since urologists discuss them routinely. Your urologist reviews your medications and health history; this helps identify contributing factors such as diabetes, nerve damage, or certain prescriptions. Treatment may involve oral medications or procedures to collect sperm directly.
Visit a Urology Clinic
A male fertility evaluation involves several steps, from a physical exam to blood work. A urologist coordinates these tests and explains the results. The findings help distinguish sperm production problems from blockages, and they guide decisions about further testing or treatment. Schedule an appointment with a urology clinic today to begin a male fertility evaluation.
