MANday: What Doctor Should You See for Male Infertility?
Sperm is produced by the testicle. The testicle is not only part of the male genitourinary system but also a part of the endocrine system, the system that produces hormones. When a male has an abnormal semen analysis, which doctor should he see? According to Farber et. al (2019), “Obstetricians and gynecologists, and in particular reproductive endocrinologists (REIs), are typically the gatekeepers and first-line providers for couples initially seeking an infertility evaluation. A timely referral to a reproductive urologist may improve pregnancy outcomes in certain clinical scenarios.” In addition, data reveals that nearly one-third of IFV centers visits are concerning a male fertility problem and the decision to refer patients to a reproductive urologist is wanting (Farber et. al, 2019). There is a lack of timely referral of male patients who specialize in reproductive urology which can improve pregnancy outcomes.
In 2020, a collaboration between the American Urological Association (AUA) and American Society of Reproductive Medicine (ASRM) was released and issued more than 50 guideline statements which included guideline number 3. “Men with one or more abnormal semen parameters or presumed male infertility should be evaluated by a male reproductive expert for complete history and physical examination as well as other directed tests when indicated. (Expert Opinion)” (Schlegel et al., 2020). ASRM is an organization that makes best practices recommendations for assistive reproductive experts and these guidelines were approved by their influencing counsel.
In a retrospective study performed by Pham et al. (2022), the researchers evaluated abnormal semen analysis at their institution in which “2,283 men had abnormal SAs [semen analysis] ordered by non urologists, among whom 20.5% underwent RU [reproductive urology] consultation”. Only one fifth of the men that had abnormal semen analysis that were performed by physicians other than reproductive urologist received referrals to reproductive urologist. This begs to question where the deficit is. We at The Y Factor, want to empower our patients with knowledge. As a reminder, 50% of infertility is due to a male problem. Obtain your male fertility evaluation today.
Women have OB-GYNs | Men Have The Y Factor!
Farber, N. J., Madhusoodanan, V. K., Gerkowicz, S. A., Patel, P., & Ramasamy, R. (2019). Reasons that should prompt a referral to a reproductive urologist: guidelines for the gynecologist and reproductive endocrinologist. Gynecology and pelvic medicine, 2, 20. https://doi.org/10.21037/gpm.2019.09.04
Pham, M. N., Ambulkar, S. S., Fantus, R. J., Joshi, T., Hudnall, M. T., Lai, J. D., Wren, J. M., Bennett, N. E., Jungheim, E. S., Brannigan, R. E., & Halpern, J. A. (2022). Reproductive urologic consultation in subfertile men: predictors of establishing care and patient perceptions after abnormal semen testing. Fertility and sterility, 117(3), 489–496. https://doi.org/10.1016/j.fertnstert.2021.11.021
Schlegel et al. (2020). Diagnosis and Treatment of Infertility in Men: AUA/ASRM Guideline. Diagnosis and treatment of infertility in men: Aua/asrm guideline – american urological association. https://www.auanet.org/guidelines/guidelines/male-infertility.
Mike Manis is a board-certified nurse practitioner with a master’s of science in nursing.Mike brings 8 years of nursing experience to The Y Factor. He graduated with honors in 2012, cum laude, with a bachelor of science in nursing. He was also inducted into the national honor society and also received the honorary Dean’s Award. He worked in the area of emergency medicine at Houston Methodist, a Magnet Hospital. While there, he pioneered advanced educational nursing programs, received honorary rewards, and became a certified emergency nurse.
In 2020, Mike earned his master’s degree as a family nurse practitioner to advance his career. Mike was also class president of his graduating class of 2020.
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