What is nice about surgical treatments for male infertility is that they can “cure” the problem and allow for conception at home and not in the laboratory.
Whatever you do to a male patient who wants a fertility procedure, try to do it only once. You make more friends that way”.
– Dr. Paul Turek
Surgical Male Fertility Treatment Options
The following are accepted surgical treatments for male infertility.
Varicoceles are enlarged veins (varicose) in the scrotum; they are the most commonly corrected reason for male infertility. Dr Turek has developed and helped popularize a safe, minimally invasive, microsurgical procedure, has performed over 1000 cases, and published his excellent success rates. Read more.
Ejaculatory Duct Resection
A diagnosis for ejaculatory duct obstruction is confirmed by transrectal ultrasound (TRUS) showing larger seminal vesicles or dilated ejaculatory ducts in association with a cyst, calcification or stones along the duct. Once diagnosed, it is treated surgically in 1 hour by ejaculatory duct resection. Read more.
The same surgical procedure used to reverse vasectomies can also be used to “unblock” infertile men with no sperm counts due to past infections, trauma, or unexplained reproductive tract blockages. Read more.
Male Fertility Treatment with Assisted Reproductive Technologies (ART)
If neither surgery nor medical therapy is appropriate for male infertility treatment, assisted reproductive technologies are available to help.
Intrauterine insemination (IUI)
This is the simplest form of assisted technology and involves the placement of a washed pellet of ejaculated sperm within the female uterus, beyond the cervical barrier. This technique is performed in the office and is indicated for low sperm quality, immunologic infertility and for men with mechanical problems with sperm delivery (e.g. Erectile dysfunction). The success rates vary widely and are directly related to female reproductive potential; given this, pregnancy rates of 8-16%/cycle have been reported with the use of IUI as a treatment for male infertility.
In-vitro Fertilization and ICSI
It has been possible to fertilize human eggs in a culture dish since 1978. IVF involves ovarian stimulation and egg retrieval from the ovaries prior to normal ovulation. Eggs are fertilized in petri dishes with 500,000 to 5 million motile sperm. Fertilized eggs or embryos are then transferred to the uterus through a simple vaginal procedure. IVF can bypass moderate to severe forms of male infertility in which low numbers of motile sperm are present. In 1992, an addition to IVF was described in which the sperm is directly injected into the egg cytoplasm with a microscopic needle in the laboratory phase of IVF. This has been referred to as sperm “micromanipulation” or intracytoplasmic sperm injection (ICSI) and has helped with the treatment of male infertility. The sperm requirement for egg fertilization has gone from hundreds of thousands for in vitro fertilization (IVF), to one viable sperm required for ICSI. This has led Dr. Turek and others to develop aggressive new techniques to find sperm for eggs from men with no sperm in the ejaculate. Presently, sources of sperm in that are usable for conceiving include all reproductive tract organs.