Management of Male Infertility

Management of Male Infertility

Men with Azoospermia

Azoospermia is a condition where no sperm is found in the semen due to poor testicular function or obstruction of the male reproductive tract. It is the most challenging male infertility condition to manage.

At our Fertility Center, we provide a wide range of advanced diagnostic modalities for men with poor semen parameters due to reproductive tract obstruction. These ranges include high-resolution scrotal and trans-rectal ultrasonography, microsurgical vasography, and microsurgical testicular biopsy. We also provide various microsurgical reconstructive procedures for men with obstructive azoospermia including microsurgical vasectomy reversal, microbot vasovasostomy, and vasoepididymostomy. These advanced techniques are performed by our world-class surgeons on an outpatient basis with success rates among the highest in the world.

In addition, we provide advanced microsurgical and minimally invasive procedures for sperm retrieval for couples undergoing assisted reproduction with IVF, or ICSI. These procedures include microsurgical epididymal assisted reproduction with IVF or ICSI. These procedures include microsurgical epididymal sperm aspiration (MESA) and percutaneous epididymal sperm aspiration (PESA), where sperm is collected directly from the fine tubules behind the testis and prepared for IVF/ICSI by advanced laboratory methods. Other advanced sperm retrieval procedures provided at our Center includes testicular sperm aspiration (TESA) and testicular sperm extraction by microsurgical dissection (micro-TESE) where sperm are directly obtained from the testis. Additionally, for couples who opt for future repeated IVF/ICSI cycles we provide the option of preservation and storage of part of the retrieved sperm, using advanced cryotechnology.

Cancer Survivors

The fertility of men who have survived cancer and have undergone chemotherapy, radiation therapy or aggressive surgery, is often severely impaired. The andrologists/urologists at our Center are experts in the fertility management of cancer patients, using advanced microsurgical techniques such as micro-dissection testicular sperm extraction to treat cancer survivors who are interested in fertility management.Fifty percent of men with no sperm found in the ejaculate can have sperm retrieved using the microsurgical sperm retrieval techniques.

Sperm banking and proper counseling to cancer treatments are crucial steps in the fertility management of cancer patients. We provide a sperm preservation and storage service using advanced cryo-technology for patients who are about to undergo cancer treatment.

Men with Genetic Disorders

Recent molecular genetic studies suggest that unexplained infertility in men may be due to underlying genetic disorders. At our reproductive center, we provide advanced genetic evaluation for infertile men. This evaluation includes a blood test for karyotype analysis to evaluate anomalies in the chromosomes, a Y-chromosome microdeletion analysis, and a CFTR mutation screening to identify cystic fibrosis or related disorders. Our andrologists / urologists and geneticists provide professional counseling to all couples before and after genetic screening to address concerns about their general and reproductive health as well as the health of their future children.

Men with Spinal Cord Injury or Ejaculatory Disorders

Men with spinal cord injury or other neurological conditions may have severe impairment to their sexual function, particularly in the ejaculation of semen. We provide special options to retrieve sperm for assisted reproduction such as ejaculation by vibrostimulation, electro-ejaculation, and percutaneous needle aspiration of sperm on an outpatient basis.

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