Typically testing for men begins with a semen analysis to check the sperm count, movement and appearance. We perform this test in our offices. If the results of the tests are abnormal, he may be asked to perform laboratory tests for hormones to check for possible causes of sperm abnormalities. These hormones often include testosterone, follicle stimulating hormone (FSH), luteinizing hormone (LH), and estradiol (estrogen levels). Sometimes, when the sperm count is very low or when there is an abnormality of physical exam, her may be asked to go for genetic testing. Genetic testing usually consists of chromosome testing, y-chromosome micro-deletions, or cystic fibrosis testing.
Male Medical Treatments
After an appropriate evaluation, medications may be helpful to increase the sperm count. Not all men will benefit from these therapies. Common medications include clomiphene citrate and/or letrozole pills as well as hCG (human chorionic gonadotropin) injections. Your physician may recommend and supervise those treatments if you are an appropriate candidate.
MALE SURGICAL PROCEDURES
After the evaluation of a male, some abnormalities may be seen that require surgical intervention. Some men who have previously undergone vasectomy may already know they require a procedure. We work very closely with trained urologists in male reproductive surgery to provide you with comprehensive care.
TESA involves the surgical extraction of sperm from the testicle. TESA obtained sperm can then be used in combination with IVF/ICSI to achieve pregnancy. TESA can be used for men with obstruction of sperm release. The procedure can also be used in men without obstruction who do not produce enough sperm through ejaculation to lead to pregnancy.
Sometimes the blood vessels surrounding testicles can be swollen and enlarged. The increased blood flow can affect the sperm quality. Some men will benefit from the surgical repair of these varicoceles. Sperm production and quality may improve afterward.
During a vasectomy the pathway of sperm from the testicle is blocked. However sperm production continues. This procedure can help re-establish the flow of sperm through the urethra. If successful this can help achieve pregnancy without the use of IVF