A couple is considered infertile if they have not conceived after one year of trying to conceive, without contraception. Andrologists focus on the treatment of male infertility, sexual dysfunction, benign prostate hyperplasia, and erectile dysfunction.
The first step in identifying and treating infertility is often rigorous testing for women. However, only 50 percent of infertility is attributable to the female partner alone, 50 percent of couples have a male factor, according to Nikhil Gupta, MD, assistant professor of surgery. In May 2018, Dr. Gupta became the first andrologist and male sexual function subspecialist appointed to the faculty of Rutgers Robert Wood Johnson Medical School. He focuses on the treatment of male infertility, sexual dysfunction, benign prostate hyperplasia (non-cancerous enlarged prostate) and erectile dysfunction.
In the world of modern medicine, andrology, is a relative newcomer. The field acquired its name only 70 years ago, bringing under one umbrella a variety of areas concerned with male reproductive health, including urology, endocrinology surgery and genetics. A couple is considered infertile if they have not conceived after one year of trying to conceive, without contraception. A couple will usually seek a consultation with a fertility specialist after trying to conceive for a year without success.
"Often, when no pregnancy occurs, the woman is the first to see an infertility specialist, believing that the problem must originate with her,"
says Dr. Gupta. If the woman's specialist finds no issues, she and her partner would most likely be referred to a specialist in male infertility. But in fact, the causes of infertility are equal between men and women.
As an andrologist, Dr. Gupta's role in helping a couple to conceive focuses on the man, but he always starts out by meeting with both partners. He devotes a lot of time to helping the couple to understand that infertility is neither partner's "fault,
" emphasizing instead what the diagnostic tests will show and how their results may help the couple start their family. Infertility creates a special kind of anxiety in men, says Dr. Gupta. "Boys are raised to believe that if you try hard enough, you can develop the strength to overcome challenges. Some of my patients fear there is something wrong with their manhood, because they haven't been able to father a child."
Evaluation starts with blood screening to determine the signaling ability of the patient's testosterone, the hormone that stimulates sperm production. Subsequent semen analysis may indicate the inability of ejaculated sperm to travel efficiently through the woman's reproductive system or a low sperm count or an absence of sperm, which could stem from earlier trauma, childhood illness, undescended testis or testes or chemotherapy.
In adition to testing sperm, the andrologist will also look for autoimmune factors in the reproductive systems of either partner, as they can be toxic to sperm. Genetics can also be a factor. A blood test can detect a missing gene in the Y chromosome, a fairly common cause that is responsible for approximately 13 percent of male infertility. In addition, a clinical examination can reveal other issues leading to male infertility like encountering obstruction in the male ducts, blocking them from their route out of the testes.
One of Dr. Gupta's great satisfactions as an andrologist is to be able to help his patients father a child. On why he decided to pursue andrology as a specialty, he found it to be "incredibly hopeful"
with much progress to be made and stigmas to overcome.
About Rutgers Robert Wood Johnson Medical School
As one of the nation's leading comprehensive medical schools, Robert Wood Johnson Medical School is dedicated to the pursuit of excellence in education, research, health care delivery, and the promotion of community health. Part of Rutgers, The State University of New Jersey, and Robert Wood Johnson Medical School encompasses 20 basic science and clinical departments, and hosts' centers and institutes including The Cardiovascular Institute, the Child Health Institute of New Jersey, and the Women's Health Institute. The medical school has been recognized by U.S. News & World Report
as among the top 100 medical schools in the nation for research and primary care.
Robert Wood Johnson Medical School and Robert Wood Johnson University Hospital, an RWJBarnabas Health facility and the medical schools principal affiliate; comprise one of the nation's premier academic medical centers. Clinical services are provided by more than 500 faculty physicians in 200+ specialties and subspecialties as part of Rutgers Health, the clinical arm of Rutgers University. Rutgers Health is the most comprehensive academic health care provider in New Jersey, offering a breadth of accessible clinical care throughout the state supported by the latest in medical research and education.
Robert Wood Johnson Medical School maintains educational programs at the undergraduate, graduate and postgraduate levels on its campuses in New Brunswick and Piscataway and provides continuing education courses for health care professionals and community education programs. With more than 5,500 alumni since the start of its first class in 1996, the medical school has expanded its comprehensive programming and educational opportunities and is at the forefront of innovative curriculum development and a visionary admissions program. To learn more about Rutgers Robert Wood Johnson Medical School, visit rwjms.rutgers.edu.