The role of the urologist in barren marriages

This paper is addressed to the gynecologist, who is generally the first to be consulted by the patient because of her failure to conceive. Early in the study there arises the problem of assigning individual factors. Is the patient involved solely, or is there also a male factor? Excluding the female's role to bear and nurture the fertilized cell until maturity, the frequency of subfertility in the male is just as great as it is in the female. Evaluation of the male should be done early in the study of the childless couple because it is less complex and less time consuming. Assignment of the relative fertility of husband and wife depends on the correlation of the findings in each. For that reason, also, treatment of the subfertile husband should not be undertaken until it is definitely determined that his wife is either reproductively normal or has remediable abnormalities. On the other hand, improvement of the fertility of one partner may be sufficient to induce pregnancy. Frequent communication between gynecologist and urologist is of utmost importance. An attempt is made to clarify for the gynecologist the abnormalities that may be encountered, the treatment to be employed and the prognosis. The mere fact that hormone administration is generally not effective in the male should not lead to the conclusion that treatment of the male is useless and that nothing can be done to improve his semen quality.