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Advances in Male Fertility

Posted Apr 06 2010 10:07am
By: Ash Kshirsagar, MD

Infertility is a challenge that burdens roughly 1 in 5 couples. It can be a very sensitive and emotionally frustrating issue causing stress in an otherwise healthy relationship. Guilt, resentment, and inadequacy can surface impairing the intimacy between a couple and hinder the support a couple needs from one another in facing such an issue. Historically, the focus and burden of infertility treatments has focused on the female partner.

Of all infertile couples, the reason for the infertility will lie within the male in about 10-15% of the cases. Because of this, a new field of medicine has emerged that is known as Male Infertility. A male infertility specialist is a urologist who has received additional formal training (a fellowship) to learn how to treat men with fertility problems. Fortunately, recent advances in this field can offer men hope of fathering their own biological children.

The major advances in the field focus on accurate diagnosis and use of the newest technology to improve success of finding sperm. The accurate assessment of men with infertility problems includes ensuring the male doesn't have a hormone imbalance or underlying medical condition impairing sperm production. Additionally, a detailed review of prescription medications must be done to check for unwanted interaction with medications and sperm production.Using the latest genetic testing, one can predict which men are candidates for surgical sperm retrieval and which men are not. In the assessment of the male, we can also determine with greater than 90% accuracy which men have a blockage in their tubes. The main advantage that a male fertility specialist can offer is using the most cutting-edge technology: this resides in using a true operating microscope to improve outcomes for patients while decreasing complications. An operating microscope is a free standing real microscope that is used during surgery to treat conditions such as a varicocele (the most common cause of infertility in men) or to find sperm in men who were otherwise thought to have none. The operating microscope provides 15 times the magnification compared to that of the human eye. Studies have shown that when an operating microscope is used, complications such as bleeding decrease and success rates in finding sperm increase substantially. This translates to finding sperm in men who were otherwise resigned to the thought they would never have their own biological children.

Using the operating microscope, the male infertility specialist can also improve the success rates of vasectomy reversal surgeries to over 90%. The vasectomy reversal is one of the most technically challenging surgeries a urologist performs. A male fertility specialist has received dedicated formal training in microscopic surgery for this specific surgery. During the surgery, the two ends of the vas are sewn back to each other using sutures finer than a human hair. Given the delicate nature of the surgery, studies have shown that a surgeon who implements the latest technology of the operating microscope can provide the best success rates for patients.
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