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Urologic Care for Male Fertility

Problems conceiving are common in men and women.  Thorough evaluations of fertility problems often involve a review of the fertility of both members of the couple trying to conceive.

Often, the evaluation begins with the woman, through her gynecologic care and the urology service is called in to analyze the fertility of her male partner.  Virtua’s gynecology service is exceptionally experienced in assessing the status and managing and overcoming the challenges of fertility in the female patient. Sometimes compromised fertility is a result of female factors, sometimes male factors, and sometimes a combination of both.

Care Based on Cause

Virtua urologic specialists use the latest knowledge and techniques to look at the male aspects of fertility.  This includes taking a careful medical history and physically evaluating the patient.

Analysis of a sperm sample from the man is standard procedure for the coup le seeking to overcome fertility problems; however, even if the results are good, the team will want to confirm them with post-coital testing.  This involves testing the woman within 24 hours of sexual intercourse to look for sperm moving in a sample of mucus from the cervix.  Active sperm in this case provides a strong indication that the male side of the fertility equation is adequate; in other cases, the testing indicates the need for treatment, including for cases of low sperm count, shape or mobility.

Ultrasound may also be part of male testing for fertility.  With scrotal or transrectal ultrasound, the fertility team can identify or rule out any obstruction in the male reproductive tract, including abnormalities involving the prostate, seminal vesicles and ducts.

Treatment According to Basis

Side effects of certain common drugs can affect fertility, as can drug and alcohol use or a history of testicular torsion and trauma.  Injury to the spinal nerves can also affect reproduction, and in such cases Virtua urologists work closely with Virtua orthopedists or neurosurgeons to look for solutions.

Virtua’s urology service has an established record of experience and success in evaluating and addressing fertility in the male patient.

Other men, may need surgery for blockages in the reproductive tract in the epidymis, the vas deferens, or the ejaculatory duct.  Such blockages usually stem from infections, typically sexually transmitted infections, that have irritated, inflamed and damaged the lining of these tractlike structures.  Or the duct may be scarred or impinged upon due to previous surgery, tumors or cysts.  The surgeon will reconnect these passages around the blocked sections (or endoscopically cut away cysts associated with the prostate gland).  This is the same type of procedure performed in vasectomy reversal.

In other men, the Virtua urologist may recommend treatment for a common condition called variocele, in which veins in the scrotum are distended and poorly functioning, sometimes compromising circulation to the testicle.  Improper drainage of blood may keep the testicle at a temperature higher than optimal for sperm development.  A significant percentage of men with fertility problems have this condition.  Surgery for variocele may improve fertility in some men.

A Stepwise Route to Conception

Infertility can cause stress or sadness for couples and for the individual who wants to become a parent; however, treatment is often successful.   Today, more couples than ever who have been struggling with infertility have a chance to achieve pregnancy.  Couples having difficulty and wishing to conceive should consult their doctors, with the woman ultimately evaluated by a gynecologic fertility specialist and the male evaluated by a urology service such as that at Virtua with ample expertise in male fertility.


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