Episode 166: Reproductive Urologists and Endocrinologists: What’s the Difference?

Dr. Janet Choi: Let’s start with Reproductive Endocrinologists. Anyone who becomes a medical doctor must go through not only four years of college and pre-med courses, but also four years of medical school training and graduation.

For people to become Reproductive Endocrinologist and infertility specialists there are an additional four years of Obstetrics and Gynecology residency training. For individuals who want to sub specialize in the area of REI, there’s an additional three years of subspecialty fellowship training and that involves clinical care of patients who have reproductive, endocrine and infertility needs as well as typically, a year of research during that three-year training. Once you finish all that and then pass all the specialty boards, you can call yourself a Reproductive Endocrinologist and infertility specialist.

The Reproductive Urology and infertility fellowship isn’t officially recognized yet. But the RUs that are in our network are typically fellowship trained. And that means they’ve done (and this is a lot of work after their four years of med school), five to six years of general urology residency training. Then they do an additional one to two years of fellowship training in the area of male infertility and Andrology.

Dan Bulger: Okay, so it’s no easy task to become an REI or an RU. And perhaps that’s why there are limited number of these sub-specialists in the U.S. About 1,300 Reproductive Endocrinologist and only about 300 to 350 or so, Reproductive Urologists.

Dan Bulger: REIs and RUs tend to work hand-in-hand for their patients when there is male infertility present.  Couples who have a problem with sperm sample results utilize ICSI, a game changing resource whereby a single sperm can be injected directly into an egg. And with ICSI, success rates for those with male-factor infertility are extremely good. So, if ICSI and IVF are great tools for those with male-factor. Then why would one need to see and RU?

Dr. Janet Choi: I’m pretty quick to send a male patient to Reproductive Urologist. So, if I see low sperm counts, like I said earlier, any kind of analysis, I will tell the patient I think it’s prudent and hopefully in your best interest to go. There is a real benefit to men in seeing an RU when trying to conceive. And there’s a real case to be made that these men should probably get themselves evaluated by an RU, while a female partner is being evaluated by an REI. Any couple where there’s a male fertility issues — those males would benefit from getting at least a quick evaluation with a Reproductive Urologist. And lo and behold sometimes they will evaluate the male patient and find something that’s treatable and fixable. Something that improves the sperm quality or helps improve the odds of a pregnancy resulting, because that’s what you want. And along the way, find some health issues that could have been a major problem, like, let’s say a small testicular nodule that they pick up early on and is then more treatable. Another shout out in terms of the services that they provide outside of fertility.