What is Andrology?
The term ‘andrology’ comes from the Greek word ‘Andros’, which means male. As its name implies, the field of andrology focuses on helping men with a number of male-related medical issues.
When should you see an Andrologist?
If you are having an issue with reproduction, hormone issues or your penis, you may be referred to an Andrologist. Andrologists are able to manage a range of conditions relating to men’s health. These include:
- Erectile dysfunction
- Male fertility issues
- Sexual dysfunction
- Prostate disease including prostatitis (inflammation of the prostate)
- Penile and testicular cancers
- Premature ejaculation.
What are some of the more common diagnostic tests in Andrology?
There are a range of tests that may be recommended by an Andrologist, or a specialist who manages reproductive health issues. These include:
1. Semen analysis
Semen is the name of the male reproductive fluid that contains spermatozoa (also known as ‘sperm’). A semen analysis is an andrology test that’s done to check on different parameters, including the:
- Volume and consistency of the semen
- Number of sperm present in the semen
- Ability of the sperm to move (known as their ‘motility’)
- Size and shape of sperm (known as their ‘morphology’).
A semen analysis is considered the most important andrology test for male infertility. In order to perform a semen analysis, you need to produce a semen sample (often referred to as a ‘sperm sample’). Providing this sample requires ejaculating directly into a clean specimen jar that your health practitioner will provide.
Semen samples need to be analysed soon after they are collected. That is why you will either need to bring your sample to your clinic soon after producing it, or collect the semen sample at a clinic in the first place. For more information about this andrology test, please talk to your doctor.
2. Sperm processing for Assisted Reproductive Technology (ART)
Before embarking on a reproductive therapy such as Assisted Reproductive Technology (ART), your fertility specialist will require a sperm sample. The sperm is collected in the same way as a semen analysis (see above). Once the semen has been collected, the scientist can process the sample.
Part of processing the semen involves separating the sperm from the surrounding seminal fluid. After the sperm has been separated, it is washed and examined. The sperm can then be used as part of a therapy to help conception, such as in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI).
3. Post-vasectomy semen analysis
After having a vasectomy, it’s important to have a semen analysis to check that your semen no longer contains sperm. Once your semen no longer contains sperm, you cannot impregnate a female partner. It takes some time after a vasectomy for semen to no longer contain sperm. That is why a post-vasectomy semen analysis should be performed at least three months after a vasectomy, or after at least 20 ejaculations.
If you are sexually active during that time, you should wear a condom to prevent pregnancy in a female partner. The post-vasectomy semen analysis should occur after you have abstained from ejaculating for at least 48 hours, but not longer than seven days. The sample is collected in the same way as a semen analysis (as per above). Once the test comes back showing there is ‘complete azoospermia’ (meaning no sperm were present in the sample collected), no further tests are needed.
4. Testicular biopsy evaluations
Your fertility specialist may organise a testicular biopsy to check whether there are issues with sperm production caused by a blockage. A testicular biopsy can also help determine the cause of other andrology issues, such as a lump in the testicles, or to diagnose testicular cancer. This andrology procedure is usually performed as an outpatient, either in your doctor’s rooms or at a hospital. Your doctor may recommend performing a testicular biopsy while you are awake, using anaesthesia and/or a sedative.
Alternatively, your doctor may recommend being asleep for the procedure (under a general anaesthetic). During the procedure, your doctor will make an incision and take a small sample of testicular tissue. The biopsy itself typically takes around 15 — 20 minutes. After this procedure, your doctor may advise refraining from sexual activity for one to two weeks.
Please talk to your specialist about any further concerns or questions relating to this procedure.
Treatments for male infertility
There are a number of causes for male infertility. These include:
- Obstruction to the passage of sperm (meaning sperm can’t pass easily from the testicles through to the ejaculate)
- Hormonal issues (relating to male hormones such as testosterone)
- Issues with sperm (such as low sperm count, or low motility)
- Functional problems (such as an inability to sustain an erection).
Depending on the issue, your doctor may recommend a number of treatments. These can include:
1. Hormone therapy
In order to produce sperm, the brain needs to release hormones that stimulate their production. If your hormone levels are insufficient, hormone therapy can help boost sperm production.
2. Fertility treatments
There are a number of fertility treatments that require the collection of sperm. These include in-vitro fertilisation (IVF), artificial insemination and intra-cytoplasmic sperm injection (ICSI).
For IVF, eggs are removed from the woman’s ovaries. Sperm is then mixed with the woman’s eggs in a laboratory.
For ICSI, a woman’s eggs are removed from her ovaries and then injected with sperm.
For artificial insemination, the sperm is inserted into your partner’s uterus through her cervix.
Less commonly, your fertility specialist may recommend a surgical procedure for male infertility. For example, your doctor may recommend surgical correction of a blockage in the tubes. Alternatively, your andrology doctor may recommend surgery to treat a varicocele (an enlargement of veins in the scrotum that can impair fertility).
ANZSREI offers access to the most advanced specialists in fertility in both gynaecology and andrology throughout Australia and New Zealand. These specialists have up-to-date knowledge in all fertility treatments, including andrology. They are happy to answer your fertility and andrology related questions. Find a CREI qualified specialist near you.