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Infertility- it's not always about the female

Male factor infertility is more common than most couples realize. In fact, about 15% of all couples are infertile and up to 50 percent of these infertile couples will have a male factor component. And, 30% of couples will not be able to conceive solely because of a male factor.   

Yet, when infertility becomes an obstacle to conceiving a child, most couples, and many physicians, initially jump to testing the female first. However, having the man tested initially for infertility is much easier, faster and less invasive than the fertility tests, and subsequent treatments, for the female partner. As male infertility specialists, the VRCA physician team takes a systematic, thorough approach to evaluating the man. Here is what is involved:  

-          -  Initial evaluation and exam - We take a full medical, surgical and reproductive history, and then perform a physical exam. We screen for the types of things that contribute to and cause male infertility including, disease; exposure to toxins or chemotherapy and/or radiation; trauma and injury; cancer; history of varicocele; and steroid and hormone use. Then we will examine a man's sexual function, look for normal secondary sex characteristics, and also check for possible presence of cancer in the testes and prostate. At this point, we also like to get the woman's medical and reproductive history.

 

-         -  Laboratory testing - Following the initial evaluation, blood work will be ordered and we will perform a semen analysis. Hormonal evaluations will also be performed to check the pituitary and testicular function and even genetic testing may be ordered. 

 

If a male factor is found to be a cause of infertility there are several things we look for and can do to help:

1.  Testicular function test - Is the testicle not working properly, or is there a signaling issue from the brain? If a testicular problem is found, we can use hormonal replacement therapy to optimize testicular function and stimulate the testicles to produce sperm. 

2.    Does a man have a varicocele? Varicoceles are, in essence, varicose veins. Bloods pools in these spermatic cord veins causing an increase in temperature within the scrotum, which causes sperm counts to decrease. Varicoceles are very common - about 30% of men who have infertility have varicoceles. And, they are the number one reason why men have secondary infertility. For example, in couples who had a normal first pregnancy yet are having trouble conceiving a second time, varicoceles are often a culprit. Varicoceles are progressive and a man can have them for a long time before they worsen and negatively impact testicular function over time. The good news is, we can surgically fix them using a microsurgical procedure and improve fertility in a large number of men.

 

3.    Obstructions and blockages- Between the comprehensive exam, lab tests and any advanced tests such as ultrasound, we can diagnose blockages. The specially trained surgeons at VRCA perform a delicate microsurgical procedure to remove blockages and restore sperm production and transport.  

 

When it comes to infertility, men do not typically have the opportunity to see a specialist about their issues as often as women do. Yet, men deserve to be examined by a male infertility specialist if for no other reason than to rule out any serious conditions that could be an underlying factor for infertility, whether it's a varicocele, hormonal abnormality or even cancer. Many men are surprised to learn that we do sometimes diagnose cancer in our infertile male population. 

Our goal at the Vasectomy Reversal Center of America is to optimize the situation for couples and help them conceive naturally. The physicians at VRCA are dedicated to providing couples with the compassionate care they deserve during a difficult time in their lives, along with the expertise to diagnose and remedy what is more common than most people recognize - male factor infertility. 

Contact the specialists at the Vasectomy Reversal Center of America to learn more about a male infertility consultation and treatment options.

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