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Male Infertility

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Understanding and treating male infertility at UC San Diego Health System

Approximately 15 percent of couples cannot conceive successfully after two years of trying. With some overlap, approximately half of the fertility issues relate to the female and half relate to male infertility. UC San Diego Health System is the only medical center in the region focused on treating male infertility.

As men generally see doctors less often than women in this country, many men do not have medical examinations until problems arise. Few men are referred for proper evaluation even after significant time and resources are spent at OB/GYN clinics determining that the female partner is reproductively healthy. In addition, only a minority of medical centers in the nation have developed expertise in male reproductive medicine. UC San Diego Health System’s Department of Urology is dedicated to male reproductive health, providing balance to the unmet needs of infertile couples.

Male infertility can result from a number of health conditions, including:

Obstruction of Sperm Passage
Microsurgical Vasectomy Reversal

Many men who have undergone vasectomy may wish to become a father again. Vasectomy reversal is a procedure designed to reconstruct the vas after vasectomy enabling passage of sperm. Because the vas has approximately the diameter of spaghetti (1/10th of a millimeter), the surgical approach with the highest success is microsurgery (vasovasostomy and epididymal vasostomy). At UC San Diego Health System, we offer microsurgical vasectomy reversal surgery as an outpatient procedure. That means you are in and out of the clinic in a matter of hours. We also perform endoscopic procedures to unblock ejaculatory duct obstructions in an outpatient setting. Patients are frequently referred to UC San Diego Health System for the most complex cases, as well as following failed surgeries elsewhere.

Ejaculatory Disorder

Retrograde ejaculation is a condition where the semen exits into the bladder. It can be caused by numerous health conditions (e.g. diabetes), spinal cord injuries and medication side effects. Numerous medications and retrieval techniques can be utilized to provide adequate sperm for conception.

Preserving Fertility Before Cancer Treatment

Oncofertility is the field of medicine that addresses fertility preservation in people diagnosed with cancer. UC San Diego Health System is the regional leader in reproductive research and preservation techniques for cancer survivors. Working closely with Moores Cancer Center, our oncofertility specialists counsel patients on sperm banking and testicular tissue banking before chemotherapy, radiation and surgical cancer treatments. All cancer patients should discuss their fertility desires before starting any type of treatment.

Hormone Imbalance

Without sufficient testosterone, the body is not able to produce sperm properly. Certain medications, including some antibiotics and cancer drugs, reduce testosterone production. Steroid abuse shuts down the body’s ability to make testosterone and sperm and is a common cause of impaired sperm production. Our urologists have extensive experience in the field of andrology and work with you to carefully restore hormonal balance.

Sperm Production Impairment

Various conditions can lead to sperm production problems. Men without sperm or with abnormal semen analysis need to consult with an urologist. Our doctors are able to perform microsurgical dissection of the testes to find sperm suitable for in vitro fertilization (IVF).

Varicocele

Varicocele refers to the abnormal swelling of veins that drain the testicles, similar to varicose veins. When varicoceles form, the temperature rises in the scrotum, inhibiting proper testicular function. We perform varicocelectomy to correct this abnormal blood flow from the testicles. This microscopic surgical repair has been shown to increase testosterone output and sperm count.

Genetic Causes

Advances in our understanding of genetics enable UC San Diego Health System physicians to identify conditions that affect fertility, such as Kleinfelter syndrome or cystic fibrosis, which can also impact the child. Our interdisciplinary team includes genetic counselors who help patients understand the implications of these results.

Cancer

In rare cases, a brain tumor disrupting signals for testosterone production or testicular cancer can be responsible for infertility. UC San Diego Moores Cancer Center is the only NCI-designated Comprehensive Cancer Center in the region performing advanced, minimally invasive techniques to treat cancer. Our oncofertility program is the regional leader in reproductive research and fertility preservation for cancer survivors.

Other Health Issues

Male infertility can also be caused by spinal cord injuries, chronic health conditions and other factors. Diagnoses made at the male fertility clinic range from nutritional deficiencies, high blood pressure and diabetes to undescended testicles and cancer. Before becoming a father, see a physician with the appropriate expertise to properly diagnose and effectively treat any abnormal findings.

Video Resources

Dr. Mike Hsieh discusses male infertility and options for treating it.