Your fertility is important.
And we can help you achieve your goals.
One in six couples are affected by infertility. Male factor plays a role in at least half of couples with trouble conceiving.
Testing.
Initial testing begins with a semen analysis (we generally recommend two tests at a reputable testing center) and basic hormone labs such as testosterone, FSH and LH. Based on those tests, you may require additional labs, a biopsy, an ultrasound or possibly nothing at all.
Semen Analysis
Sperm is the functional element of male fertility and semen is the vehicle for sperm transportation. Semen volume, how many sperm there are (concentration), the ability of sperm to swim (motility) and how the sperm are shaped (morphology) are all critical to the success of pregnancy. We highly recommend you have your analysis performed at a center specializing in fertility. We are happy to recommend centers of excellence for analysis via the contact form below.
Hormone Labs
Sperm production is regulated by the hypothalamic-pituitary-gonadal axis, a hormone regulation system involving the brain and your testes. Signals from the brain such as FSH and LH signal the testes to produce sperm and testosterone. Abnormalities of these labs can tell us why you may have fertility trouble and if medications can help.
Testicular Biopsy
A unique feature of Central Coast Men’s Health is our ability to perform biopsy mapping of the testes in men with no sperm on semen analysis, allowing us to avoid invasive and costly surgical procedures in most men with azoospermia (complete lack of sperm in the ejaculate).
Causes of male infertility.
There are many reasons men may have difficulty with causing pregnancy including hormonal causes, physical causes such as blockage, problems with the testicles themselves or surrounding anatomy or even genetic causes.
Hormone Factors
Hormone signals from your brain to your testes are critical for the production of sperm and some men need medication to boost sperm production. Additionally, the use of testosterone supplementation shuts down sperm production; many men on supplemental T can regain their fertility with medical management.
Blockage
Transportation of sperm from the testes to the ejaculate can be blocked for a number of reasons, either intentionally through vasectomy (click here to learn more about vasectomy reversal) or naturally, for example by incomplete development of the vas deferens or blockage of the ejaculatory ducts. With blockage, sperm can often be retrieved for use in IVF.
Varicocele
Varicoceles, or abnormally dilated veins of the scrotum, have detrimental effects on semen quality, sperm function, and pregnancy outcomes in some men and can be seen in up to 81 percent of men with fertility trouble.
Treatment options.
Medical Management
Many hormonal problems can be helped with medications to boost sperm production.
Sperm Aspiration/ Extraction
For men with significant sperm production but no ejaculated sperm, sperm can be retrieved directly from the testicle for use in in-vitro fertilization (IVF) with a simple outpatient procedure with testicular sperm aspiration (TESA) or testicular sperm extraction (TESE).
MicroTESE
Men with sparse, but present, sperm production have the option to undergo microsurgical testicular sperm extraction (microTESE). In this outpatient procedure, testicular tissue is examined under a microscope to look for viable sperm for use with IVF.
Vasectomy Reversal
While vasectomy should be considered a permanent form of birth control, it can be reversed through a microsurgical outpatient procedure.
Varicocelectomy
Surgical correction of varicoceles in men with infertility and abnormal semen parameters has been well documented to improve semen quality and improve pregnancy outcomes.
To learn more about your fertility options, click the button below to book an appointment.