RESTORING FERTILITY: MALE REPRODUCTIVE ENDOCRINOLOGY AND MICROSURGERY

The desire to have a child is one of life’s most important decisions for couples. Yet, there tends to be more focus on women who are having difficulty conceiving. There is a wealth of information on advanced assisted reproductive technologies (ART) for women but far less attention is given to male infertility causes and treatments. Dr. Robert Pugach, Medical Director of Pacific Coast Urology Medical Center, advises his patients that it is a commonly held view that male fertility isn’t a complex process. But, in reality, male fertility is extremely complex as there are a number of factors and conditions that must be present for a man to achieve a pregnancy with his partner. One third of the time, it is fertility issues with men that are the only cause of an inability for a couple to conceive.

WHAT ARE THE FACTORS MUST BE PRESENT FOR MALE FERTILITY?

In order for a couple to achieve a pregnancy, healthy sperm must be present from the male partner. There are numerous factors that can affect this. These include:

Varicoceles – Dilated veins in the scrotum, called varicoceles, raise the temperature of the testicles by 1.5⁰ Centigrade. That defeats the purpose of a man’s scrotum, which is to keep testicles slightly cooler than body temperature for healthy sperm production. It’s the most common cause of male factor infertility – it is the problem in 40% of cases.

Abnormal sperm propagation – There are numerous causes for this, including congenital blockage of the delicate tubules and tubes that carry sperm, STDs that can cause scarring, congenital absence of the vas deferens, physical trauma and retrograde ejaculation (where sperm go into the bladder instead of through the urethra).

Hormonal abnormalities – The pituitary gland and thyroid gland can be responsible when hormone production is not normal.

Congenital conditions – Conditions ranging from abnormal testicular architecture to chromosomal abnormalities may be the problem.

In many cases, it’s not just a problem with male factor infertility. It’s a couples’ problem. So, we work closely with gynecologists and reproductive endocrinologists to identify infertility factors that we can solve together.

HOW ARE MEN EVALUATED?

It starts with a careful medical history that evaluates numerous factors such as:

• Childhood development and puberty history
• Childhood illnesses and infections such as mumps (that can affect testicles)
• Testicular trauma or surgery
• History of STDs
• History of undescended testicles
• A sexual history

Then we do a careful examination looking for physical factors that may be a factor. Finally, Dr. Pugach will likely order some basic laboratory tests including:

• At least two semen analyses, using strict Kruger criteria
• Hormone studies
• Urine tests

HOW IS MALE INFERTILITY TREATED?

Some of these conditions can be treated with medications and hormone therapy. Other conditions require male reconstructive surgery and training in fertility procedures, such as:

• Vasectomy reversal
• Testicular Sperm Aspiration (TESA)
• Testicular Sperm Extraction (TESE)
• Varicocele surgical correction
• Therapy with vitamins and zinc
• Coordination with a reproductive endocrinologist

To learn more about Pacific Coast Urology Medical Center’s unique money back guarantee, as well as other advanced treatments for male infertility, call, 888.735.4336 or email us via our Contact Us Form.