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Male infertility is any health problem in a man that lowers the chances of his female partner getting pregnant. Infertility should be suspected when a couple is unable to have children after trying for six months. The problem may lie with the man, the women, or the sexual interaction of the couple.
When you arrive for your appointment with Dr. Lazare, he will talk to you, examine you, and perform a sperm analysis. The sperm analysis measures the concentration of sperm, the appearance of the sperm, and how well they swim. Dr. Lazare may perform an ultrasound of your scrotum and an ultrasound of your prostate. He will also order several hormone tests including testosterone, LH, FSH and prolactin. This is the evaluation in a nutshell.
The following is a list of the most important causes of male infertility.
- A varicocele refers to dilated veins that drain blood from the testicle. This results in poor oxygen delivery to the testicle. This condition is curable with surgery.
- Undescended Testicle or cryptorchidism. If you were born with an undescended testicle your risk of infertility is higher than average.
- Hormone Abnormality. Sperm production requires a normal hormone environment.
- Prior Surgery. Operations that can interfere with male fertility include hernia repair, prostate surgery, and surgery for testicular cancer.
- Chromosomal Abnormalities. Chromosome disorders causing male infertility include Klinefelter’s syndrome and cystic fibrosis.
- Testosterone Supplements. Over the counter supplements are a major cause of male infertility.
- Recreational Drugs. Drug use, including cocaine, can affect sperm production.
- Chemotherapy. Medicine used to treat cancer can lead to male infertility.
- Sexual Problems. These include erectile dysfunction, premature ejaculation, and poor timing of intercourse.
The treatment of male infertility depends upon the underlying cause. However, if you have a varicocele, the microscopic varicocelectomy is an excellent treatment option.
The procedure is performed in the hospital under anesthesia. It is performed on an out-patient basis and the patient returns home right after the procedure.
Dr. Lazare always uses an operating microscopic to perform this procedure. This allows for superior visualization of the anatomy. He makes a small half inch incision in the upper scrotum. Dr. Lazare uses special micro instruments to perform the dissection. He isolates the large veins draining the testicle. These veins are then tied and cut. Dr. Lazare takes great care to avoid injury to the testicular artery, the vas deferens and the lymphatics. The procedure usually takes about two hours.
This procedure is low risk. Possible complications include injury of the testicular artery. This can lead to damage of the testicle. If the lymphatics are injured, fluid can accumulated around the testicle. This is called a hydrocele or a lymphocele.
The procedure produces a significant improvement in the sperm analysis in the majority of cases. Many patients will impregnate their partner after undergoing this procedure.
Yes, research has shown that smoking can cause a reduction in the number of sperm cells. In addition, the sperm cells tend to be smaller and they tend to move more slowly. Smoking is believed to cause damage to sperm DNA.
Absolutely. Steroids wreak havoc on the hormone system. Steroids can completely shut off your own production of testosterone. Once you discontinue taking steroids, in can take several months for you to become fertile again.
ART, or test tube baby, is a high-tech method to join a sperm and an egg cell when sex doesn’t work. There are several centers in NYC that specialize in ART. Some of these centers accept insurance and others do not.
The success rate of ART depends upon many factors including quality and quantity of the male sperm, age of the woman, and underlying medical conditions of the woman.
A microscopic varicocelectomy will help improve sperm quantity and quality if you have a varicocele. Eliminating recreational drugs, eliminating alcohol, and eliminating vitamin supplements will also help. If you smoke, you should quit. Finally addressing the underlying medical condition, such as a hormone abnormality, can have a beneficial effect.
Male infertility risk factors include advanced age, smoking, heavy alcohol use, drugs, diabetes, environmental toxins, radiation treatments, and steroids supplement.
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If you are dealing with infertility and are seeking treatment, Dr. Lazare can help. Contact our Brooklyn, NY office today to schedule an appointment.