However, the advent of sophisticated reproductive techniques has not obviated the evaluation and treatment of the infertile male. The clinical evaluation of the infertile male requires a thorough understanding of reproductive physiology, including the influence of the endocrine system and testicular function. Urology residents are exposed to basic clinical evaluation of the infertile male. The clinical assessment includes a reproductive and sexual history, physical exam, and laboratory analysis of hormone and seminal factors.
Treatment is tailored to the individual patient and varies between medical and operative therapy.
Operative techniques include varix ligation, microsurgical and endoscopic procedures, and testicular sperm aspiration. To prepare the Urologic trainee, a laboratory for instruction in microsurgical technique, including inanimate and animal models, has been established. Supervised instruction in the laboratory setting permits development of microsurgical skills which are then refined in the clinical application for patients with ductal obstruction. Ongoing research at the basic science level is available for residents interested in expanding their knowledge of andrology and male infertility.