Collier Edition

Male Infertility A Brief Overview

By Spencer Land, MD

Male Infertility A Brief OverviewApproximately 1 in 6 couples will experience difficulty in conceiving 1 year after unprotected intercourse. About 7 million couples seek fertility evaluation in the U.S. annually. A male factor is solely responsible in 20% of the time. It is contributory in 30-40% of the cases. Because couples are delaying pregnancy to a later age is now recommended that if fertility is ever question that both male and female be evaluated.

The goals of male infertility evaluation include:
• Identify potentially correctable conditions
• Diagnosis irreversible conditions that can be treated with assisted reproductive techniques using sperm of the male partner
• Diagnosis irreversible conditions that will require donor sperm for conception
• Identify life or health threatening conditions that affect fertility and require medical treatment
• Detect transferable genetic abnormalities if assisted reproductive techniques are used

The initial fertility evaluation consists of a complete medical and reproductive history, a physical exam, and 2 semen analysis. The reproductive history should include the timing infrequency of intercourse related to the menstrual cycle, prior fertility of both partners, duration of past or present infertility, childhood illnesses, developmental history, systemic medical conditions such as diabetes mellitus or chronic respiratory illnesses, prior surgeries, gonadal toxin exposures, sexual history including sexual transmitted disease history, and family fertility history. The physical exam will include examination of the male genitalia to determine abnormalities of the penis, urethra, testes, epididymides, vas deferens, and spermatic cords.

The semen analysis will show the following:
• Presence or absence
• Sperm count and concentration
• The motility of the sperm
• The morphology or shape of the sperm

Based on the results of the initial evaluation, additional testing may be ordered. This may include blood work, imaging with ultrasound, genetic screening, post ejaculatory urinalysis, or sperm integrity testing.

The following her common male infertility conditions that her correctable:
• Scrotal varicose sees or varicocele. This is a condition of abnormal varicose veins of the spermatic cord. This can affect both sperm production and maturation. The treatment consists of an outpatient surgery culture  varicocelectomy.
• Obstructive azoospermia. This is a condition where there is normal production of sperm but they were unable to reach the ejaculatory duct. This is most commonly caused from a previous vasectomy. This can be treated with a phase sec to me reversal or with testicular sperm extraction which can be used for assisted
reproductive techniques.
• Hypogonadism. This condition relates to inadequate signal into the testicles to produce sperm. This can often be treated with medication.

This particle gives a very brief overview of male infertility evaluation and treatment. Evaluation is is important not only to diagnosis underlying malignancies (6% of male infertility patients) but also to identify potential genetic abnormalities that can be transferred with assisted reproduction. Because some conditions are irreversible, it is essential for couples and no that they will need to consider donor sperm or adoption.

Based on the results of the initial evaluation, additional testing may be ordered. This may include blood work, imaging with ultrasound, genetic screening, post ejaculatory urinalysis, or sperm integrity testing.

The following her common male infertility
conditions that her correctable:
• Scrotal varicose sees or varicocele. This is a condition of abnormal varicose veins of the spermatic cord. This can affect both sperm production and maturation. The treatment consists of an outpatient surgery culture  varicocelectomy.
• Obstructive azoospermia. This is a condition where there is normal production of sperm but they were unable to reach the ejaculatory duct. This is most commonly caused from a previous vasectomy. This can be treated with a phase sec to me reversal or with testicular sperm extraction which can be used for assisted
reproductive techniques.
• Hypogonadism. This condition relates to inadequate signal into the testicles to produce sperm. This can often be treated with medication.

This particle gives a very brief overview of male infertility evaluation and treatment. Evaluation is is important not only to diagnosis underlying malignancies (6% of male infertility patients) but also to identify potential genetic abnormalities that can be transferred with assisted reproduction. Because some conditions are irreversible, it is essential for couples and no that they will need to consider donor sperm or adoption.

Spencer Land, MD is a board certified urologist who received his fellowship, post-graduate training at the University of Illinois, Chicago before joining the faculty of the prestigious Loyola University. He joins AUI-Naples after enjoying years of training urology residents and nearly two decades of clinical practice in Chicago. Upon graduating with honors form the University of Texas, Austin, he received his medical degree from the University of Arkansas and did his residency training at the University of Mississippi, where he excelled and served as Chief Resident.

He has performed extensive research and published numerous articles on prostate cancer, prostate specific antigen (PSA), and male factor infertility. He is an experienced robotic surgeon and treats a wide variety of urological problems, including, prostate cancer, prostate enlargement (BPH), bladder control problems and cancer in both men and women, kidney stones, Peyronie’s disease, kidney and bladder infections, no scalpel vasectomies and reversals as well as many others. He uses the latest in both minimally invasive surgical techniques as well as effective nonsurgical treatments. Dr. Land is a Board Certified Diplomat of the American Board of Urology. He is an active member of the American Urological Association, Collier County Medical Society, and American Society of Reproductive Medicine.

Advanced Urology Institute
239.465.4157
www.advancedurologyinstitute.com

1035 Piper Blvd., Suite 101, Naples, FL 34110

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