Of the 15% of couples having difficulty conceiving, almost half have a male factor as the sole or contributing cause. It is currently recognized that the quality as well as the quantity of sperm greatly influences reproductive outcomes. It was once thought that assisted reproductive technologies (ART) such as Intrauterine Insemination (IUI) and more so, In-Vitro Fertilization with Intracytoplasmic Sperm Injection (ICSI) had the power to overcome almost any sperm defect but data show that…READ MORE

The semen analysis is the cornerstone of testing for male infertility problems. This test provides important information about the quality and quantity of the sperm. The semen sample is analyzed for volume, viscosity (thickness), pH and color of the ejaculate, sperm concentration, motility, morphology, and forward progression of the sperm. The sample is also examined for the presence of white or red blood cells which may indicate infection or inflammation. We perform both manual and computer assisted semen analyses (CASA). From this simple test, we can tell…READ MORE

Varicocele is a dilation (enlargement) of the internal spermatic veins that drain the testicle (picture below). It is a similar condition to varicose veins that people get in their legs. It is a very common condition present in 15% of the general male population and 40% of men evaluated for infertility. A varicocele develops because of…READ MORE

Until several years ago the belief among most reproductive specialists (including myself) was that if a man had live sperm then they were suitable for use with IVF / ICSI and if the female partner didn’t get pregnant or a miscarriage ensued then it was probably an egg quality issue. Several studies had implied that the conventional sperm parameters (count, motility and morphology) as measured on a routine semen analysis had no bearing on success when ICSI was used. Many couples pursued egg donation after failed IVF attempts because…READ MORE

What has become clear over the last several years is that our ability to treat men with severe male factor infertility has far surpassed our understanding of its causes. Over 20% of male cases were considered idiopathic i.e. “we don’t know why”. Recent advances and interest in molecular biology, genetics and technology have enabled scientists to discover some of the genes that control sperm production. We now know that almost 20% of men with azoospermia (no sperm production) or severe oligospermia (sperm counts under 5-10 million for no apparent reason) will have an identifiable genetic cause for infertility. It is possible that certain genetic diseases can…READ MORE

Sperm aspiration refers to the group of procedures used to obtain viable sperm from the male reproductive tract. The collected sperm are intended specifically for use with intracytoplasmic sperm injection (ICSI). A frequently asked question is can the sperm…READ MORE

A new surgical technique has been developed to detect sperm in the testicles of men who have poor sperm production (non-obstructive azoospermia). Prior to the era of intracytoplasmic sperm injection (ICSI), these men were considered sterile. With ICSI, the requirements for sperm have been reduced to 1 live sperm per egg. Many men who have been diagnosed with non-obstructive azoospermia either due to the pathological conditions known as hypospermatogenesis, maturation arrest or Sertoli-cell only syndrome (germinal cell aplasia) have been found to have small “pockets” of sperm production within…READ MORE

Prostatitis is a common urologic condition that many clinicians find difficult to treat effectively. It has been estimated that up to half of all men suffer from symptoms of prostatitis at some time in their lives. The prostate is a walnut sized gland that is located beneath the urinary bladder (see picture below). The prostate surrounds the urethra (urine, channel) like a donut. When the prostate becomes inflammed it can…READ MORE

Testicular pain is a fairly common condition treated by urologists. Frequent causes include infection of the testicle (orchitis) or epididymis (epididymitis), post surgical pain, trauma, tumors, hernia, torsion (twisting of the testicle), varicocele, hydrocele or spermatocele. Most of these conditions are easily diagnosed and treated. Occasionally the pain, even when treated appropriately…READ MORE

One of the most common problems a man faces with increasing age is difficulty with urination. This is usually caused by a benign enlargement of the prostate. The prostate is a walnut shaped gland located beneath the urinary bladder deep inside the male pelvis. It surrounds the urethra (urine channel) like a donut. The prostate begins to enlarge on a microscopic cellular level when a man is in his late twenties or early thirties. In some men the prostate continues to grow and this may cause…READ MORE

An ejaculation and ejaculatory dysfunction are the terms used to describe the inability of a man to have an ejaculation. This condition typically results from neurologic diseases, traumatic injury, or as a complication of surgery. The nerves that are responsible for carrying the signal for ejaculation exit the spinal cord and course along the aorta at the posterior part of the abdomen. These nerves are most commonly injured after…READ MORE

Impotence or erectile dysfunction is a very common problem that affects 20 million (1 out of 5) American Men. Erectile dysfunction is the result of a single, or more commonly a combination of multiple factors. At one time impotence was thought to be the result of psychological problems, but we now know that 90% of the cases are organic in nature. Some of the many causes of impotence include…READ MORE

Peyronie’s Disease or penile curvature is a build up of fibrous “plaque” or scar within the elastic covering (tunica albuginea) of the erectile tissue of the penis. The penis is a highly vascularized organ that is divided into three compartments. The paired copra cavernosa are the structures that contain the erectile tissue. They corpus spongiosum contains the urethra (urine channel) located on the undersurface of the penis. When a man becomes “excited,”…READ MORE

It has now been 20 years since the pioneering discovery by Patrick Steptoe, M.D. and Robert Edwards resulting in the birth of Louise Brown. To date there have been thousands of healthy children conceived, and born, utilizing the technique of IVF. The first cases of IVF performed in the late 1970′s and early 1980′s were limited to women with fallopian tube obstruction. The techniques have since evolved to assist men who have been considered sterile due to…READ MORE

Here are some helpful links to other sources of information: …READ MORE

Agglutinaton – Occurs when sperm clump or stick together. This may occur when either husband or wife develops immunity to the sperm. Can only be seen with a microscope. Asthenospermia – A condition in which the sperm do not move (swim) at all or …READ MORE