There are many infertile couples in whom the male is completely azoospermic (that is, no sperm at all in the ejaculate). For these cases, the urologist is actually needed, but again often his treatment is poorly performed.
There are two entirely different situations and causes for no sperm in the ejaculate (azoospermia): obstructive and non-obstructive. For obstructive azoospermia, aside from vasectomy, which is reversible with reconstructive microsurgery, there are men who were born with the absence of the vas. Most of them have a mutation on their CF (cystic fibrosis) gene or chromosome 7 but do not have cystic fibrosis. They just never developed a vas deferens in fetal life, and they do not discover they have this problem until they get married, try to have children, and discover they have no sperm in the ejaculate. There is no vas to reconstruct and so the only way they can have children is to microsurgically retrieve sperm from their epididymis and inject this sperm into the wife’s eggs via IVF. This procedure is virtually 100% successful.
Male infertility treatment, short of IVF and ICSI, should be limited to microsurgery for azoospermia, and careful thought has to go into making your choice of where to go for such treatment.