The role has a mixture of direct contact with patients and laboratory work. Andrologists primarily perform sperm tests to help determine the fertility potential of male patients attempting to conceive a child with their partner.
This involves looking at multiple parameters under the microscope including sperm concentration, sperm motility and sperm shape. The test helps to direct fertility specialists to best decide the next stage of investigation or treatment for the couple. This may be as simple as making small lifestyle changes or directing the couple to undergo assisted reproductive treatment with procedures such as in vitro fertilisation. Sperm tests are also done for patients who have undergone a vasectomy to confirm whether the procedure has been successful or not.
In addition to sperm testing, Andrologists perform sperm banking in which sperm is frozen and stored for use at later date using assisted reproductive technology. A patient may have their sperm frozen for:
- fertility preservation purposes – before undergoing treatment such as chemotherapy that has the potential to permanently stop or hugely reduce sperm production in the testicles
- transgender banking – prior to medication or reassignment surgery so their sperm can be used in the future to create a genetically related child without the use of donor sperm
- a low sperm count – for patients that have very low numbers of sperm so there is a back-up sample that can be used for treatment
- testicular biopsies – some patients may not have sperm present in their semen so will undergo testicular biopsies in which sperm is directly harvested from the testicles and subsequently frozen
For couples that undergo assisted reproductive treatment, an Andrologist will perform a process known as sperm washing. Sperm washing is the process in which individual sperms are separated from the semen. This is to remove any mucus, non-motile sperm and to extract certain disease-carrying material in the semen to improve the chances of successfully fertilising the female egg.
Andrologists also run and manage sperm donation banks. Sperm donation offers hope to same sex couples, single women and heterosexual couples who previously thought they could never have children. Individuals wishing to donate are screened and frozen by Andrologists, creating a bank in which couples can choose from to use in assisted reproduction.