A urologist is a medical doctor specializing in the genitourinary system, including the kidneys, bladder, urethra, and male reproductive organs like the prostate, testes, and penis. They manage issues related to sperm production and function.
When a Urologist is Consulted
Urologists assess sperm count and overall semen health. A primary reason to consult a urologist for this evaluation is male infertility. If a couple has been attempting to conceive for a year without success, or six months if the female partner is over 35, a male fertility evaluation is recommended.
Urologists investigate underlying causes of male infertility, such as hormonal imbalances, infections, physical conditions like varicoceles (enlarged veins in the scrotum), blockages, or genetic conditions. Sperm count assessment by a urologist is also common following a vasectomy. Semen analysis confirms the procedure’s success in preventing sperm from being present in the ejaculate, ensuring sterility. Beyond fertility and post-vasectomy checks, urologists assess sperm health as part of a broader male reproductive health assessment. Individuals with symptoms like reduced sexual desire, erectile dysfunction, testicular discomfort, or changes in semen characteristics may seek a urologist’s advice.
The Semen Analysis Procedure
Semen analysis is the standard test to evaluate sperm count and other parameters. Accurate results require specific preparation steps before providing a sample. Individuals should abstain from ejaculation for two to seven days prior to the test. Avoid alcohol, caffeine, recreational drugs, and certain medications as instructed. Maintain a normal body temperature and avoid hot environments like baths or saunas, as high temperatures can negatively influence sperm production.
The preferred method for collecting a semen sample is masturbation into a sterile container, often done in a private room at the clinic or laboratory. If masturbation is not feasible, a special non-lubricated condom can be used for collection during intercourse. After collection, keep the sample at body temperature and transport it to the laboratory promptly, ideally within 30 to 60 minutes, for reliable results.
In the laboratory, the sample undergoes detailed microscopic examination. Technicians evaluate semen volume, liquefaction time, viscosity, and pH level. They also assess sperm characteristics like motility (ability to move efficiently) and morphology (size and shape). The presence of other cells, such as white blood cells indicating infection, is also noted.
Understanding Test Results and Follow-Up
Healthcare providers review semen analysis results using guidelines from organizations like the World Health Organization (WHO) to determine typical parameters. A normal sperm count is 15 million or more sperm per milliliter of semen, or 39 million or more in the entire ejaculate. Other normal parameters include a semen volume of at least 1.5 milliliters, progressive motility of 30-32% or more, and at least 4% of sperm with normal shape.
An abnormal result means one or more parameters fall outside expected ranges. Oligospermia refers to a low sperm count (less than 15 million per milliliter). Azoospermia is the complete absence of sperm. Other abnormalities include poor sperm movement (asthenozoospermia) or an unusually high number of abnormally shaped sperm (teratozoospermia). An abnormal semen analysis does not automatically mean infertility, as sperm parameters fluctuate, and other factors contribute to fertility.
If abnormal results are found, a repeat semen analysis is often recommended to confirm findings due to natural variability. Further diagnostic tests may include blood tests for hormone levels, genetic testing, or imaging studies like a scrotal ultrasound. Treatment options are tailored to the cause. These may involve lifestyle adjustments (dietary changes, exercise, avoiding harmful substances), medications for hormonal imbalances or infections, or surgical interventions for conditions like varicoceles or blockages. Assisted reproductive technologies may also be discussed.