Reproductive Endocrinologists & Urologists

In modern fertility medicine, success depends on seamless collaboration between two specialists: Reproductive Endocrinologists (REIs) and Reproductive Urologists (RUs).
Each brings a unique clinical perspective to the evaluation and management of infertility. Understanding their respective roles, knowing when to involve each, and aligning their expertise are essential to optimizing treatment outcomes — particularly in cases involving male factor infertility or combined reproductive challenges.

This course provides fertility professionals with an expert-level understanding of each specialist’s role, referral triggers, coordination models, and best practices that ensure high-quality, efficient, and evidence-based patient care.

Course Objectives

By the end of this course, participants will be able to:

• Clearly define the scope of practice and expertise of Reproductive Endocrinologists and Reproductive Urologists.

• Determine when and why each specialist should take the lead in specific fertility scenarios.

• Create effective referral and collaboration protocols between REI and RU teams.

• Recognize key diagnostic and procedural overlaps and avoid redundant testing.

• Apply “Pro Tips” to enhance workflow, communication, and cycle success rates in ART programs.

What Each Specialist Does

Reproductive Endocrinologists (REIs)

Training & Expertise:
REIs are OB/GYN physicians with subspecialty training in reproductive endocrinology and infertility. They manage the female reproductive system, endocrine function, and the full range of assisted reproductive technologies (ART) such as IVF, ICSI, and egg donation.

Core Responsibilities:

• Evaluate and manage ovulatory, hormonal, uterine, and tubal causes of infertility.

• Design and supervise controlled ovarian stimulation and IVF cycles.

• Oversee oocyte retrieval, embryo culture, and embryo transfer procedures.

• Coordinate third-party reproduction, including egg donors, gestational carriers, and surrogates.

• Manage complex reproductive endocrine disorders (e.g., PCOS, premature ovarian insufficiency, endometriosis).

• Counsel intended parents and coordinate multidisciplinary fertility care.

Role in Male Factor Cases:
While their focus is the female partner or gestational carrier, REIs are often the first point of entry for couples. They initiate baseline male testing (semen analysis) and collaborate closely with urologists once abnormalities are identified.
REIs manage the overall fertility treatment plan — synchronizing egg retrieval with sperm collection, optimizing laboratory workflow, and integrating results into ART cycles.

Reproductive Urologists (RUs)

Training & Expertise:
RUs are urologists with advanced fellowship training in male reproductive medicine and microsurgery. Their expertise centers on identifying, treating, and surgically correcting the underlying causes of male infertility.

Core Responsibilities:

• Perform detailed semen evaluations and advanced sperm function tests (e.g., DNA fragmentation, oxidative stress).

• Diagnose and manage azoospermia, oligospermia, varicocele, and ejaculatory dysfunctions.

• Perform microsurgical procedures such as micro-TESE, PESA, MESA, or vasectomy reversal.

• Evaluate and treat hormonal imbalances affecting spermatogenesis.

• Provide genetic counseling and testing (karyotype, Y-chromosome microdeletions, CFTR mutations).

• Optimize sperm retrieval and preservation prior to ART cycles.

Role in Collaborative Care:
The RU works in tandem with the REI to ensure optimal sperm quality and availability for fertilization. Their goal is to correct reversible male factors and support the reproductive strategy designed by the REI.
They play an essential role in counseling, surgical planning, and ensuring that sperm retrieval aligns perfectly with the oocyte retrieval timeline.

When You Need Each Specialist

Reproductive Endocrinologist

Involve or lead with an REI when:

• The primary issue involves female factors (ovulatory, uterine, or endocrine).

• Managing IVF, IUI, or donor/surrogacy programs.

• Coordinating ART laboratory activities — oocyte retrieval, fertilization, embryo culture, and transfer.

• Addressing combined infertility with primary ART management responsibilities.

• Providing preconception and genetic counseling for intended parents.

Reproductive Urologist

Involve or lead with a RU when:

• Semen analysis shows low count, motility, or morphology abnormalities.

• Azoospermia or ejaculatory disorders are detected.

• Varicocele or testicular pathologies are suspected.

• Male hormonal imbalance, hypogonadism, or prior vasectomy is present.

• The couple is considering sperm retrieval for IVF/ICSI.

• There’s need for fertility preservation prior to medical treatment (e.g., chemotherapy).

How They Work Together

Fertility care functions best when both specialists operate as part of a synchronized multidisciplinary team.

Optimal Collaboration Framework:

1. Initial Consultation (REI): Both partners evaluated. Baseline labs and semen analysis ordered.

2. Abnormal Semen Result: REI refers male partner to RU for advanced testing or treatment.

3. RU Evaluation: Identifies correctable issues or plans for sperm retrieval.

4. Treatment Synchronization: REI manages ovarian stimulation; RU coordinates sperm retrieval or cryopreservation timing.

5. Embryology Coordination: Lab team ensures sperm sample is available for fertilization.

6. Follow-Up: Both specialists review fertilization outcomes and plan future cycles jointly.

Shared Communication Points:

• Unified patient records and laboratory tracking.

• Regular joint case meetings (especially for complex infertility).

• Shared access to cycle progress data and embryology reports.

• Clear, standardized referral documentation.