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Frequently Asked Questions (FAQs):

1. How common is male infertility?

15% of couples will experience infertility problems, being unable to conceive after 1 year of unprotected intercourse.  30% of the time infertility is the result of male partner issues, while an additional 20% involve factors from both male and female partners.  So in total male infertility accounts for about 50% of infertility among couples.

2. If I have a male infertility issue, can it be fixed?

Many cases of male infertility are able to be treated.  First we determine whether the cause is due to physical blockage (obstructive azoospermia) or whether it results from an “engine” problem (non-obstructive azoospermia which has limited sperm production with open “pipes”).  We approach each patient individually applying the most recent available medical techniques and research.  You can read more about the CMHR infertility evaluation here.

3. Can genetics be involved with blocked reproductive “pipes”?

Yes, the genetic cause of cystic fibrosis (CFTR transmembrane gene) can lead to blockage of the male reproductive system due to absence or partial absence of the vas deferens or epididymis.  This is different than genetic causes of non-obstructive azoospermia (such as Y chromosome micro deletions).

4. If I have had a vasectomy, what are the major factors that determine if I will be able to have a successful vasectomy reversal?

The key factors determining the outcome of vasectomy reversal surgery are:

  • Fluid quality from the vas during surgery
  • Shorter time (<15 years) after vasectomy
  • Presence of sperm granuloma
  • Increased microsurgeon experience

5. Why is a varicocele bad for fertility?

Varicoceles have negative effects on sperm production due to improperly functioning and dilated veins surrounding the testis.  The testis requires a specific temperature (cooler than being inside the body) which is why it is found in the scrotum to keep them cool.  The dilated veins of varicocele make the testis warmer than usual and heat has a known impact on sperm production and quality including possibly sperm genetic material (DNA fragmentation).  Also this blood has toxins that should be cleared from the testis which also can affect testosterone production which may further harm sperm production and characteristics such as shape (morphology).  Microsurgical varicocelectomy, which includes closure of the dilated veins, can prevent these toxic side effects.  

6. For men with non-obstructive azoospermia: is micro-TESE (microdissection testicular sperm extraction) better than sperm aspiration techniques which do not use the microscope?

Evidence indicates that this method, which is a more precise way to identify sperm in the testes of men with NOA (non-obstructive azoospermia), minimizes trauma and maximizes efficiency.  This leads to higher sperm retrieval rates than conventional methods which do not use the microscope to preserve blood supply and prevent tissue damage.