Male Infertility
About Male Infertility
15% of couples experience infertility, with male factor contributing to 40-50% of cases. If you have risk factors such as prior abdominal surgery, spinal cord injury, cancer, chemo, or radiation, it may be a good idea to seek a consultation even sooner.
Causes of Male Infertility
Hormonal Dysregulation
Hormones play an important role in our sexual and reproductive systems. Frequently, hormonal imbalances result in infertility. When indicated, Dr. Pan will perform a full evaluation of your hormonal profile.
Blockage
A blockage in the reproductive tract is a common cause of infertility, whether it is from a prior surgery or injury. Rarely, certain inherited conditions may cause a malformation of the ducts necessary for transporting sperm. A careful evaluation is essential to proper diagnosis, but treatments are available!
Varicocele
Varicocele, a dilation of veins surrounding the testicle, is a common cause of reduced sperm count and infertility. Not only that, it can be a cause of chronic testicular pain. Luckily, this condition can be treated with a minimally invasive surgical procedure.
Genetics
Genetics play a large role in our reproductive health. In some instances, conditions causing infertility may be passed onto future generations. If a genetic cause for infertility is diagnosed, Dr. Pan will guide you through the treatment options as well as coordination of care with other clinical specialists.
Diagnostic Tools
Semen Analysis
An important tool in the evaluation of male fertility. Semen analyses evaluate for the physical characteristics of an ejaculated specimen as well as microscopic parameters, such as: concentration, motility, and morphology of the sperm.
Hormone Panel
Hormones that influence the reproductive system include testosterone, follicular stimulating hormone (FSH), luteinizing hormone (LH), and prolactin. Other tests may be run depending on the clinical presentation.
Genetic Testing
In cases of severely reduced sperm count, or no sperm found on semen analysis, genetic testing may be indicated. A karyotype provides an assessment of the number and structure of the chromosomes, which is usually performed in tandem with a Y-chromosome microdeletion assay.
Treatments for Male Infertility
Microsurgical Epididymal Sperm Aspiration (MESA)
In the setting of an obstruction, MESA is performed to harvest sperm directly from the epididymis. The specimen is then cryopreserved to be later used with in vitro fertilization.
Microsurgical Testis Sperm Extraction (mTESE):
mTESE is performed on male patients with significant dysfunction in sperm production, who have no sperm seen on semen analysis (azoospermia). Utilizing an operating microscope, Dr. Pan will meticulously search through the testis to isolate tissue that can be used with IVF.
Vasectomy Reversal
For men who have had a vasectomy but want to grow their family. A vasectomy reversal (microsurgical reconstruction) is an outpatient procedure during which the vasa deferentia are reconstructed. Please see the different treatment options to achieve fertility after vasectomy.