Male Infertility Services
Our comprehensive services for male infertility include:
For more information, read about the causes of male infertility.
Diagnosis
Testing can help uncover the specific cause of
male infertility so that you may begin the appropriate
treatment. At Penn Fertility Care, a physician
evaluates the male patient by obtaining a detailed
medical history and a physical exam.
Following
the evaluation, the doctor may perform or order
the following tests:
- Andrology tests: semen analysis, sperm immunology
tests, fructose analysis and seminal plasma
markers.
- Genetic tests: Y-chromosome, cystic fibrosis
and karyotype.
- Microbiology tests: such as chlamydia or various
sexually transmitted diseases.
- Other diagnostic testing: hormone evaluation,
testicular biopsy and post-coital urine analysis.
Intracytoplasmic
sperm injection (ICSI)
ICSI is a procedure that has revolutionized the
treatment of male infertility. A single sperm
is injected directly into the partner’s
egg. As a result, men with a failed vasectomy
reversal or with a congenital (from birth) absence
of the vas deferens
now have a high chance of fatherhood without
using donor sperm. This procedure has decreased
the need for donor sperm and almost eliminated
the concept of untreatable male infertility.
Azoospermia
Services
When sperm is absent from the ejaculate (called
azoospermia), Penn Fertility Care offers a number
of procedures and treatments, such as:
- PESA: Percutaneous epididymal sperm
aspiration, a procedure for men with either
congenital or acquired obstructions causing
an absence of sperm in the ejaculate (obstructive
azoospermia). This procedure involves local
anesthesia and does not require an incision
or hospitalization. The amount of sperm collected
through PESA is sufficient to assure the fertilization
of an egg and for freezing. PESA is less expensive
than other infertility procedures and offers
the patient a quick recovery.
- TESE: Testicular sperm extraction,
a procedure for men who do not have sperm in
the epididymis. TESE is an effective procedure
used to retrieve sperm by performing a testicular
biopsy. The testicular biopsy is a minor surgical
procedure and can be performed on an outpatient
basis.
- Both of these procedures allow doctors to
freeze unejaculated sperm for future use.
Collaborative Approach
Penn Fertility Care works in collaboration with Penn Urology when treating male infertility.
At Penn, we have had an integrated, cooperative
program between urology and gynecology for over
15 years.
Penn Urology performs microsurgical
reversal of vasectomies and offers a range of
surgical and radiological treatments for the correction
of a varicocele, a possible cause of male infertility.
Vasectomy
Reversal
Vasectomy is a sterilization surgery in which
the vas deferens is “tied” preventing
the release of sperm and therefore preventing
the possibility of pregnancy. Approximately 5
percent of American males undergo vasectomy. Of
that number, some 2-3 percent choose to reverse
the procedure.
If the reversal is performed within
10 years of the vasectomy, the rate of successful
reversal is about 60 to 75 percent. After 15 years,
however, it drops to about 30%. Fortunately, surgical
reversal is no longer the only way to obtain sperm
from men who've undergone a vasectomy. With PESA
and TESE, Penn Fertility Care is able to obtain
sperm about 98% of the time.
Varicocele
Services
Varicocele is a condition in which the valves
within the veins (blood vessels) of the male reproductive
system disintegrate. This allows heated blood
from the abdomen to back-up to the testes, making
the temperature too high for sperm production.
The main technique for treating varicocele is
called internal spermatic venography and embolization.
This radiological procedure involves plugging
the affected vein with a coil. It is similar to
a needle puncture to draw blood, requiring only
a local anesthetic. Both the right and left sides
can be fixed through one puncture. Patients can
return to normal activities within 48 hours. Correction
of the varicocele frequently improves the liklihoos
of pregnancy.
To learn more about varicocele and varicocele
embolozation, visit our Interventional
Radiology web site.
Paraplegics
and male infertility
Penn Fertility Care uses two methods to obtain
sperm from paraplegics who have either failed
or do not want to try electroejaculation and vibratory
stimulation. One technique is testicular
sperm extraction (TESE) and the other technique is called
seminal tract wash-out (STW). With this method,
sperm is flushed from the vas deferens into the
bladder where it is collected.
Sperm
banking
Ejaculated sperm is frozen and stored for later
use in conjunction with artificial insemination
or IVF. The sperm can also be retrieved in several
ways, primarily from the epidiymis, the passageway
for sperm, and from the testes, the male reproductive
gland. Also see: Reproductive
Needs for the Cancer Patient.
Although the basic causes of male infertility
largely remain a mystery, Penn Fertility Care
has developed a number of tools and methods to
help couples get pregnant and have a healthy child.
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