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All Posts in Category: Male Infertility

Comments Off on Beyond Vasectomy Reversal: Advanced Techniques for Complex Male Infertility

Beyond Vasectomy Reversal: Advanced Techniques for Complex Male Infertility

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Introduction

Beyond Vasectomy, blockages in the delicate tubes responsible for sperm transport or extremely low sperm production can make natural conception difficult. This is where Dr. Nudell’s expertise in advanced surgical techniques comes into play. Learn more about Vasectomy.

Obstructions Hinder Fertility

There are two main types of blockages that can impede the journey of sperm:

  • Non-obstructive Azoospermia: 

    In sperm production itself is severely impaired or absent within the testicles.

Advanced Surgical Solutions

Dr. Nudell offers several minimally invasive surgical procedures to address these challenges:

  • MESA (Microscopic Epididymal Sperm Aspiration): 

    For men with obstructions, sperm can be retrieved directly from the epididymis, a coiled tube next to the testicle. Dr. Nudell’s microsurgical approach (open MESA) allows for greater sperm harvest, maximizing chances for successful in vitro fertilization (IVF).

  • TESE (Testicular Sperm Extraction): 

    This technique is used for non-obstructive azoospermia. It involves a small incision and a biopsy of testicular tissue for sperm retrieval. Dr. Nudell examines the tissue immediately to locate viable sperm for IVF.

  • Microdissection TESE: 

    This specialized extension of TESE uses high magnification to identify areas within the testes with sperm production. Dr. Nudell’s microsurgical expertise maximizes chances of finding sperm in even the most challenging cases.

The Importance of Experience and Expertise

These microsurgical procedures demand a high level of skill, precision, and specialized equipment. Dr. Nudell’s extensive experience in male fertility and his microsurgical background ensure optimal outcomes and the best possible chance of achieving your dream of fatherhood.

What to Expect: Surgery and Recovery

  • Setting: 

    MESA and TESE

  • Incisions: 

    Very small scrotal incisions are used, minimizing discomfort and downtime.

  • Recovery: 

    Recovery is relatively quick. Most men experience minimal discomfort and can resume normal activities within a few days.

Fees and Collaboration with IVF Centers

Dr. Nudell works closely with reputable IVF centers to ensure smooth coordination of care. His office provides fee schedules, and IVF centers can separately discuss their costs.

Call to Action

Schedule a consultation with Dr. Nudell to explore these specialized surgical options. Let his expertise guide you on your path to parenthood.

Contact: https://www.drnudell.com/

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Comments Off on Varicocele Surgery: A Solution for Improved Fertility

Varicocele Surgery: A Solution for Improved Fertility

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Introduction

Varicoceles Surgery, often described as varicose veins around the testicles, are a common cause of male infertility. They subtly impact sperm health, decreasing count, motility, and normal shape. If you’ve been diagnosed with a varicocele, surgery can be a game-changer on your fertility journey. Learn more about Varicoceles Surgery

Why the Operating Microscope Matters

Dr. Nudell has performed over 1000 microsurgical varicocele repairs. This specialized technique is crucial for several reasons:

  • Precision: 

    The operating microscope provides high magnification, allowing Dr. Nudell to clearly distinguish the veins needing to be removed from tiny but vital arteries and lymphatic channels.

  • Safety: 

    Preserving the testicular artery is essential for blood supply to the testicle. The microscope drastically reduces the risk of injuring this crucial blood vessel.

  • Preventing Hydrocele: 

    Meticulous avoidance of lymphatic channel damage minimizes the chance of fluid buildup around the testicle (hydrocele).

  • Maximizing Results: 

    Correcting all contributing veins with high accuracy is key to optimizing improvement in sperm parameters following surgery.

The Dr. Nudell Difference: Procedure and Recovery

Dr. Nudell’s approach prioritizes patient comfort and success:

  • Small Incision: 

    A 1.5-inch incision in the groin area allows for effective surgery.

  • Outpatient Procedure: 

    The surgery typically takes about an hour, and you’ll go home the same day.

  • Quick Recovery: 

    Most men return to work within a few days and can resume strenuous activity after a week.

Call to Action

If a varicocele surgery is affecting your fertility, don’t wait. Contact Dr. Nudell for a consultation to learn how this specialized surgery can help you achieve your dream of fatherhood.

Contact: www.drnudell.com

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Comments Off on Male Infertility
Male Infertility

Male Infertility

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Introduction:

When the word “infertility” is used most people think about female infertility. Male infertility issues affects 15% of couples attempting pregnancy in the United States. In half of these cases, couples will have a male factor of infertility of about 25%.

Male infertility is due to low sperm count, blockages that prevent the delivery of sperm or abnormal sperm function. Illnesses, chronic health problems, injuries, lifestyle choices, and other factors can also be a factor in male infertility.

Symptoms

The main sign of male infertility is the inability to conceive a child. There may be no other obvious signs or symptoms. However, in some cases an underlying problem such as a hormonal imbalance, an inherited disorder or dilated veins around the testicle causes signs and symptoms.

Although most men with male infertility do not notice symptoms here are some signs and symptoms associated with male infertility:

  • Difficulty with ejaculation or small
    volumes of fluid ejaculated
  • Pain, swelling or a lump in the
    testicle area
  • Reduced sexual desire
  • Recurrent respiratory infections
  • Abnormal breast growth (gynecomastia)
  • Decreased facial or body hair or other
    signs of a chromosomal or hormonal abnormality
  • Erectile dysfunction
  • A lower than normal sperm count

Medical Causes

Male infertility can be caused by a number of different health issues and medical treatments. Some may include:

  • Varicocele. A varicocele is a swelling of the veins that drain the
    testicle. It’s the most common reversible cause of male infertility.
    Varicoceles result in reduced quality of the sperm.
  • Ejaculation issues. Retrograde ejaculation occurs when semen enters the
    bladder during orgasm instead of emerging out the tip of the penis.
  • Certain medications. Long-term anabolic steroid use, cancer medications,
    certain antifungal medications, and other medications can impair sperm
    production and decrease male fertility.
  • Tumors. Cancers and nonmalignant tumors can affect the male
    reproductive organs. In some cases, surgery, radiation or chemotherapy to treat
    tumors can affect male fertility.

When to See a Doctor

You should see a doctor after one year of being unable to conceive a child with unprotected intercourse or if you start noticing signs and symptoms.

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Comments Off on Surgical Treatment for Infertility in Men

Surgical Treatment for Infertility in Men

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Introduction

Surgery is  an option to treat male Infertility and is sometimes required to treat conditions associated with infertility.  Following are surgical treatments available to men for who are experiencing infertility problems that are preventing them from successfully conceiving a child with their partner. Learn more about sperm retrieval

Varicocele Ligation

Surgical ligation is one of the most common treatments for the treatment of male infertility and repairing the varicocele is a relatively simple surgical procedure.  Usually done by a Urologist, a Varicocele Ligation begins with an incision being made in the skin above the scrotum, down to the testicular veins and then tied off with sutures. Patients can leave the hospital the same day but about 20 percent of surgical ligation patients have an overnight stay at the hospital.  Recovery period for a surgical ligation is two to three weeks.

Vasectomy Reversal

Vasectomies are considered a permanent form of contraception however,  advances in microsurgery have improved the success of vasectomy reversal procedures.  A Vasectomy Reversal Surgery reconnects the male reproductive tract after a vasectomy.  Vasovasostomy, also known as Vasectomy Reversal, is a procedure where the cut ends of the vas deferens are stitched back together in two layers.  When the epididymis is inflamed or scarred and is blocking the sperm from reaching the vas deferens, a patient may need a Vasoepididymostomy.  In this procedure, the surgeon will bypass the blockage and stitch the vas deferens to the epididymis in two layers.

Transurethral Resection of the Ejaculatory Duct

Transurethral Resection of the Ejaculatory Duct  is a method to treat ejaculatory duct obstruction and this procedure may help couples who want to conceive naturally and avoid assisted reproductive technologies such as IVF/ICSI.  This procedure is usually done on an outpatient basis.  It is performed endoscopically by inserting instruments into the patient’s penis.  Dye is injected into the seminal vesicle, the surgeon resets the duct, removes the obstruction, and reconnect.  The dye will flow freely through the duct if the procedure is successful.  The procedure removes the ejaculatory duct obstruction and opens the ejaculatory ducts which allows for the normal flow of ejaculate and improvement of semen parameters.

Sperm Retrieval and IVF/ICSI Techniques

There are several methods available for Sperm Retrieval also known as Sperm Extraction.  Depending on the reasons why a patient does not have enough sperm in their ejaculate will determine the right method for them..

Once the patient meets with their doctor to discuss their fertility problems, the doctor will determine the best method based on the patients individual case.

Following are some of the most common methods available for Sperm Retrieval for In Vitro Fertilization (IVF) and Intracytoplasmic Sperm Injection (ICSI):

Percutaneous Epididymal Sperm Aspiration (PESA)

PESA requires a needle to be inserted into the epididymis and sperm is withdrawn.  This procedure is used to find sperm when there is no sperm found in the male partners ejaculate.  The procedure can be performed using a local anesthetic with a quick recovery time.

Testicular Sperm Extraction (TESE)

TESE is a surgical biopsy of the testis.  The surgery is performed using a local anesthetic and a small cut is made in the scrotum where a small portion of the tissue is removed to extract a few viable sperm cells.  This method is usually used when there is evidence of an obstruction.

Microsurgical testicular sperm extraction (Micro-TESE)

Micro-TESE surgery is the opening of the outer cover of the testicle and examining the inside of the testis under an operating microscope.  This procedure is performed in an operating room under local anesthesia.

More of the testis is examined however, less testicular tissue is removed.  Also this procedure causes less damage to the structure inside the testicle and causes fewer blood supply problems caused by tiny blood vessels being cut. This procedure appears to increase the number of sperm that can be retrieved.

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Comments Off on What Is Andrology? Male Reproductive

What Is Andrology? Male Reproductive

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Introduction

Andrology is the study of male diseases and male health, particularly relating to male reproductive problems and urological problems that are unique to men. Andrology addresses issues of infertility in males, erectile dysfunction, impotence, andropause, also know as male menopause, and male contraception. Although not as well known, Andrology is the male version of gynecology, which deals with medical issues of the female reproductive system.

Who is Andrologist?

An Andrologist, is a medical doctor who specializes in male reproductive issues and male sexual dysfunction. When treating patients with infertility issues, an Andrologist will devise a treatment plan that is best suited for the patient. Drugs, such as steroids or antibiotics, may be the preferred treatment plan to improve the quality of a patient’s semen. When blockages, that are affecting sperm production is the primary issue causing male infertility, surgery is the preferred method of treatment.

Factors that influence male infertility

Many factors can have an influence on male infertility with most cases of infertility due to testicular damage and the inability to produce sperm. Additional issues include a low sperm count as well as the quality of the sperm produced which is commonly referred to as sperm motility.

When diagnosing male fertility, nearly 70% of the conditions causing the male patient to be infertile can be diagnosed by examining their medical history, through physical examination, testicular volume estimation, and hormonal and semen analysis.

Common Problems

People often mistakenly associate impotence, known as Erectile Dysfunction, with male infertility; these two conditions are not related. Impotence is the inability to get and maintain an erection, which prevents a male from having satisfactory sexual intercourse. The condition is quite common and it affects a large majority of men who are over the age of 40. Although unable to have an erection, a man who is impotent is still fertile and it is still possible for him to impregnate his female partner through insemination. Male infertility allows a man to have an erection and satisfactory sexual intercourse however, he cannot impregnate his female partner and produce children.

Andrologists treatments

Andrologists treat male patients who are suffering from impotence. They can prescribe patient drugs such as Viagra, Levitra, and Cialis that can help the patient solve his erectile dysfunction issues. Another option is Hormone Replacement Therapy that will increase the testosterone in a male who has low testosterone levels. This may increase their sexual desire and their sexual libido. Andrologists also treat male menopause with testosterone replacement therapy.

Andrology in family planning

Andrology is also used to assist men in family planning. Vasectomies are a form of male contraception that many men utilize when they do not want to have children and is the most effective form of male contraception. A vasectomy is a surgical procedure that blocks the path sperm take from the testicles to the penis.

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