Approximately 15 percent of couples cannot conceive successfully after two years of trying. With some overlap, approximately half of the fertility issues relate to females and about half to males. UC San Diego Health is the only medical center in the region focused on male fertility.
Understanding and Treating Male Infertility
As men generally see doctors less often than women do, 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. UC San Diego Health is among the minority of medical centers in the country with urologists who are experienced in are dedicated to male reproductive health.
Male Fertility Conditions and Treatment Options
Decreased fertility or infertility can be the result of several conditions.
Prior Vasectomies and Vasectomy Reversal
Many men who have undergone vasectomy may wish to become a father again.
Microsurgery 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, 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 for the most complex cases, as well as following failed surgeries elsewhere. For more information, see microsurgery vasectomy reversal.
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.
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 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.
Advances in our understanding of genetics enable UC San Diego Health 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 Treatment and Fertility Preservation
In rare cases, a brain tumor disrupting signals for testosterone production or testicular cancer can be responsible for infertility. In other cases, chemotherapy, radiation, or other cancer treatments can cause decreased fertility. Moores Cancer Center at UC San Diego Health, the only NCI-designated Comprehensive Cancer Center in the region, performs advanced, minimally invasive techniques to treat cancer. Our
oncofertility program is the regional leader in reproductive research and fertility preservation 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.
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.