What type of specialist performs fertility testing and management for couples having issues conceiving?

Fertility Testing and Management Specialists for Couples with Conception Issues

Couples having issues conceiving should be evaluated by both a reproductive endocrinologist (for the female partner) and a urologist specializing in male reproductive medicine (for the male partner), as infertility affects both partners in approximately 50% of cases. 1

Initial Evaluation Timeline

• Fertility evaluation should be initiated after 12 months of regular unprotected intercourse without conception for couples with women under 35 years 1
• Earlier evaluation (after 6 months) is recommended when the female partner is over 35 years 2, 3
• Immediate evaluation is warranted for couples with known risk factors such as:
  • History of male infertility risk factors (e.g., bilateral cryptorchidism) 1
  • Female factors including irregular menstrual cycles or suspected reproductive disorders 2
  • When either partner questions their fertility potential 1

Specialist Roles in Fertility Management

For Female Partners:

• Reproductive Endocrinologists (OB/GYN specialists with fellowship training in reproductive endocrinology and infertility) evaluate and treat:
  • Ovulatory dysfunction 2, 4
  • Uterine abnormalities 2, 4
  • Tubal obstruction 2, 4
  • Hormonal imbalances 3
  • Perform advanced reproductive technologies including IVF and ICSI 1

For Male Partners:

• Urologists specializing in male reproductive medicine evaluate and treat:
  • Abnormal semen parameters 1
  • Anatomical abnormalities 1
  • Hormonal issues affecting sperm production 1
  • Genetic causes of male infertility 1
  • Perform surgical sperm retrieval when needed 1

Collaborative Approach to Fertility Testing

• Both partners should be evaluated simultaneously to expedite diagnosis and treatment 1
• A multidisciplinary team approach is recommended, especially for complex cases 1
• Genetic counseling should be provided when genetic factors are suspected 1

Testing Components

Female Evaluation:

• Comprehensive medical and reproductive history 2
• Physical examination with focus on reproductive organs 2
• Ovarian reserve testing (FSH, estradiol, AMH) 2, 3
• Ovulation assessment (serum progesterone levels) 2, 5
• Imaging of reproductive organs (transvaginal ultrasound, hysterosalpingography) 2, 4

Male Evaluation:

• Reproductive history 1
• Physical examination with focus on genitalia 1
• At least two semen analyses performed one month apart 1
• Hormonal evaluation if indicated by abnormal semen parameters 1
• Genetic testing when appropriate 1

Common Pitfalls to Avoid

• Evaluating only one partner initially, which delays diagnosis in up to 50% of cases where male factors contribute 1, 4
• Failing to refer male partners to specialists with expertise in male reproductive medicine 4
• Delaying evaluation in women over 35 years 2, 3
• Not considering lifestyle factors that may impact fertility 2

When to Consider Advanced Reproductive Technologies

• After failed initial treatments appropriate for the diagnosed condition 6
• Immediately in women over 38-40 years due to declining fertility 6
• In cases of severe male factor infertility 6
• For bilateral tubal factor infertility 6
• After 3-4 cycles of ovarian stimulation in unexplained infertility 6