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Male Fertility

Surgical Treatment of Male Infertility

Infertility is a condition that affects about 8% of men who are of reproductive age.  About 1/3 to ½ of these men have a condition that may be reversed with one of today’s modern surgical procedures.  In the past few years, there have been advances in medical technology that can help men to become fertile.  But, before any surgical procedure is performed on a man, their partner needs to be evaluated as to their reproductive potential.

But, keep in mind there is some debate that is ongoing in the medical community as to whether all of these surgical treatment of male infertility are indeed effective in helping a man to impregnate a partner.


Available Surgical Treatment for Male Infertility

Varicocele repair is an option in about 35% of infertile men.  Varicoceles are veins in the scrotum that have become enlarged, and this leads to a decrease in blood circulation,  and this in turn hurts sperm production.  This is a condition that affects about 15% of all men, and about 40% of men who are infertile.

This can be done as an outpatient procedure, and it will repair damaged scrotal veins.  When these are surgically repaired, studies have shown that sperm movement will improve, as well as sperm concentration and structure, all of which increase the odds of getting a partner pregnant.  Recent improvement in this procedure involved using a microscope to perform it, and this has led to better outcomes and reduces the risk of complications.


Microsurgery Reconstruction

These procedures are used in cases where there are obstructions causing infertility.  Vasectomy reversal is one of these procedures.  It is proven to be effective in situations where there is blockage of sperm caused by a vasectomy.

Another microsurgery procedure is epididymovasostomy.  It can be performed where there is a blockage locate in the epididymis.  This can be the case for those who have a history of injury or a previous infection in the groin area.

All of these procedures can be done with either local, general, or regional anesthesia.  Most all of these procedures will be done on an outpatient basis, with the vast majority of men going home the same day.


Reason for Caution

There is some disagreement in the medical community as to the effectiveness of varicocele repair surgery.  There have been studies done that show little improvement in the pregnancy rates of partners whose men had this procedure done.  Some studies have shown that improvement in men who had the procedure in getting their partner pregnant was only about 1% better than men who had no procedure done.

In short, you need to talk with your doctor to get more information about your case, and see where they stand on this issue.  The medical community is still gathering data on this, and the jury is still out.  But do keep in mind that all surgery is inherently dangerous, and that includes outpatient procedures including this one.  Explore all of your options before you make the decision to go under the knife, or in this case the knife and the microscope.

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