andrology and male infertility

Andrology & Male Infertility

As per the WHO, Andrology is engaged in all aspects of male Reproductive Health.
(Greek word ‘Andros’, means : that which deals with the male).

Primary focus of the branch is based on the physiology and pathophysiology of male reproductive functions, Erectile dysfunction, disturbed sexual dysfunctions and life style problems of aging males.

Conditions Treated Under Andrology Include:

Impotence is the difficulty in getting a proper erection enough to enjoy intercourse. The reasons for not getting a proper erection may be:

  • Vasculogenic: The blood supply is compromised as in case of a diabetic patient.
  • Neurogenic: The nerve supply to the penis is compromised.
  • Psychogenic: eg: secondary to stress OR
  • Combination of all of the above.

Assessment involves detailed history and proper examination. Nowadays we also do a Viagra test (The patient is examined after one hour of taking Viagra orally).When necessary Intrapenile injection test and Colour Doppler test are done.

80% of these problems can be handled with counseling and medication. If these fail, then a penile implant surgery can be carried out.

Male causes for infertility are various :

  • Oligospermia (less number of sperms)
  • Azoospermia (No sperms seen in semen): Azoospermia is of two types – Un obstructive Or Obstructive
  • Low motility sperms.

Diabetic patients present with either erectile dysfunction, or Peyronie’s disease (bending of erect penis to one side or painful erection) or Retrograde Ejaculation. Diabetic patients are likely to get these problems more often than the general population. A detailed history, examination and Doppler test or intrapenile injection test are carried out to assess these patients. Treatment for these problems may vary from medical to surgical treatment.

Treatment in Andrology


  • Surgical Treatment consist of:

  • Microsurgical procedure to overcome the obstruction eg. Vaso-Epididymal Anastomosis or Vaso-Vaso Anastamosis (in cases of post vasectomy) or Endoscopic de-roofing of a cystic obstruction of ejaculatory duct.

  • Microsurgical ligation of Varicocoele (Varicocelectomy) as a treatment for low motility sperm or even low or no sperm count in semen.

  • Retrieval of sperms for assisted pregnancy in ICSI in the form of – PESA (Percutaneous Epididymal Sperm Aspiration), TESA (Testicular Sperm), Micro –TESA ( under Microscope the testes is bivalved and sperm pick up is done.)

  • Medical Treatment: in the form of Antioxidants and drugs like cartine/clomiphene citrate to enhance the sperm counts.

Erectile Dysfunction

Treatment of erectile dysfunction is mainly medical. If medical treatment fails, intra penile injection can be used. If this is unsuccessful, penile implant surgery can be done.

If Peyronie’s disease is the cause, and is not in active /painful stage, then treatment consists of excision of Peyronie’s plaque or plication to correct the curvature of the penis with or without an implant.

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