Andrology is a medical discipline that deals with the male reproductive and urological systems.
The term ‘andrology’ derives from the Greek ‘Andros’, which means ‘male’. It is a fairly new area of specialist medical science, which has only been studied since the late 1960s.
Whilst it can be considered the male equivalent of gynaecology, andrology has not gained as much attention until more recent times, when the subject of male fertility and prostate issues have come under the spotlight a lot more.
What is an andrologist what does an andrologist do?
Medical professionals who specialise in diagnosing and treating male reproductive-related issues are known as andrologists.
Andrologists will often be clinical scientists, urologists (specialists who treat patients with kidney, bladder, prostate or male reproductive organ problems), or endocrinologists (specialists who treat conditions related to the endocrine glands and hormones, such as diabetes and thyroid problems).
Andrology covers a variety of conditions and functions. These may include male fertility, penile problems, male hormone deficiency, and genitourinary disorders.
What is andrology in the context of male fertility?
In terms of male fertility, andrology seeks to identify the issues that are preventing a couple successfully conceiving.
Around 50% of infertility cases are due to male factor infertility.
The main symptom of male infertility is the inability to conceive, and in many cases there will be no other obvious signs.
However, underlying issues such as hormonal imbalances, genetic disorders, dilated veins around the testes, or a condition or injury that has resulted in the passage of sperm being blocked, can display symptoms.
These may include erection or ejaculation problems, low sex drive, pain or swelling in the testicle area, abnormal breast growth (gynecomastia), decreased body or facial hair and a lower than normal sperm count.
What are the most common causes of male infertility investigated in an andrology clinic?
The most common causes of male infertility that are investigated in an andrology clinic include:
Sperm disorders
Issues with the production of healthy sperm, such as low sperm production, abnormal sperm function and mobility or blockages that prevent the delivery of sperm.
Varicocele
A varicocele is an enlarged vein in the scrotum that can lead to low sperm production and quality. It is one of the most common reversible causes of male infertility.
Hormone imbalances
Hormone imbalances can result in low sperm production or the absence of sperm altogether. Hormones include testosterone, LH and FSH.
Genetic factors, medical conditions and lifestyle
Inherited conditions can contribute to male infertility, as can infections, inflammatory conditions, diabetes, some autoimmune disorders and cystic fibrosis.
Cancer treatments such as radiation or chemotherapy may affect fertility, as can trauma or injury to the testes.
Lifestyle factors such as alcohol consumption, smoking and drug usage can also lead to fertility problems.
What fertility treatment will an andrologist usually recommend?
An andrologist will devise a treatment plan that is specifically tailored to the patient. Depending on the results of the tests carried out and the patient’s individual circumstances and medical history, treatments may include:
Medication
Andrologists may manage male infertility with medications that improve hormone levels and in turn improve sperm count and semen quality.
Assisted Reproductive Techniques (ART)
An andrologist may recommend assisted reproduction to couples who are having trouble conceiving naturally, and where the male partner has a low sperm concentration, characterised either by a reduced number of sperm, or low sperm motility. It may also be recommended when the source of infertility cannot be determined, and there is a normal sperm count.
IVF (in vitro fertilisation) is a form of ART, where eggs and sperm are mixed in a laboratory and fertilised outside of the body. This treatment will usually be recommended when the female partner has blocked, damaged or missing fallopian tubes, or ovulatory or hormonal issues alongside the male partner having a normal semen sample.
In male factor infertility cases where sperm count or motility is low, a different form of ART is used. This is known as intracytoplasmic sperm injection (ICSI), during which a sperm is injected into an egg by an embryologist.
Where it is not possible to obtain a quality sperm sample for IVF or ICSI, an andrologist may recommend surgical sperm retrieval, also known as sperm extraction. This technique is commonly used when the male partner has blockages that prevent the sperm from travelling to the urethra and out of the body.
Surgery
In some cases, following investigations, surgical procedures may be recommended by andrologists in order to correct conditions that are causing a blockage, or problems with sperm production.
Procedures may include:
Varicocelectomy – the process of sealing off affected veins to correct a varicocele by redirecting blood flow to healthy veins and improving sperm production.
Varicocele embolization – a minimally invasive procedure that moves blood away from an enlarged varicocele, relieving pressure and allowing blood to be directed through alternative pathways.
Transurethral ejaculatory duct resection – this procedure may be recommended in cases where the ejaculatory duct is blocked, or where there is an obstruction preventing ejaculation.
Vasectomy reversal – various techniques can be used to reverse a vasectomy, helping to restore fertility by reinstating the flow of sperm.
Are females referred to andrology clinics?
As andrology deals with male reproductive health, females are not typically referred to andrology clinics.
However, when treating a couple’s fertility, it is very important to look at the whole picture. This is why it is important for couples to undergo a collaborative treatment plan, supported by a fertility clinic that provides access to a variety of specialists who will work together with both the male and female partner to achieve the best possible outcome.
The Hull Andrology Unit – Specialist Male Fertility Testing Services
The Hull Andrology Unit is a specialist laboratory within Hull and East Riding Fertility. We offer preliminary investigations for male subfertility problems. These investigations may range from diagnostic semen evaluation, through to more specialised tests, including anti-sperm antibody and vitality testing.
We also carry out post-vasectomy semen analysis to confirm the success of vasectomy procedures, as well as offering private consultations with our specialist fertility consultants.
We offer a high standard of care and work in compliance with guidelines set out by the National Institute for Health and Clinical Excellence (NICE), the British Andrology Society (BAS), the World Health Organisation (WHO) and the British Fertility Society (BFS). In addition, we take part in regular internal and external quality control schemes to guarantee a standardised, high quality service.
Please read the dedicated andrology pages of our website to learn more about our services and how to make an appointment. Please note that most tests are usually requested by a GP or consultant, however patients are welcome to book a private consultation or fertility check-up directly with the clinic.