Nearly 15 percent of couples are infertile, meaning they haven’t gotten pregnant after trying without protection for at least a year; but infertility is not just a women’s issue. Both genders can have problems that affect fertility. In fact, men can be the cause of infertility in a couple in up to 50% of cases.
For men facing fertility problems, one of the biggest challenges can be simply opening up and talking about the issue. The good news is that we can help most couples with fertility problems conceive. We have a busy infertility and men’s health program and the only fellowship-trained andrologists in Utah. Our specialists also participate in leading-edge fertility research, bringing the latest research findings directly to your care.
What To Expect During Your First Visit
Prior to your first visit, we will obtain any medical records related to your fertility issues and will ask that you obtain 2 semen analyses, blood testing to check hormone levels that are important to fertility, and in some cases an ultrasound of your scrotum.
When you visit with us, we will go through a detailed history with you, including a medical and surgical history, as well as a sexual history and whether or not you or your partner have previously initiated a pregnancy. We will do a physical examination and discuss your findings with you and will review the studies that you obtained prior to visiting with us in the clinic. At the end of your first visit, we may recommend other studies, such as genetic testing or additional imaging studies, or we may begin discussing a treatment approach.
It may take us a couple of visits to narrow down what your potential issue is and to propose a plan of care, but by the second visit, we often have a path forward.
We support everyone's journey to becoming a parent. We're happy to provide services for same-sex couples, single parents, and non-traditional couples. Call Utah Men’s Health at to schedule a consultation today!
Azoospermia is when a man doesn’t have any sperm in his semen. The average man has 100–300 million sperm in his semen, but if a man has no sperm detected, it can be difficult for couples to get pregnant. Azoospermia can be diagnosed by performing at least two semen analyses.
Genetic abnormalities can cause infertility by affecting sperm production or transport from the testicle to the semen. Three common genetic tests related to male infertility are:
- Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) Gene Mutations
- Y-Chromosome Microdeletions (YCMD)
Changes in your life or relationships may cause you to want to have a child after a vasectomy. In many cases vasectomies can be reversed. It’s important for men to have an honest discussion with their partner to decide if having a vasectomy reversal is the best choice for them. If your female partner is older than 40, it may be harder for you and your partner to conceive naturally.
Testicular Sperm Extraction (TESE)
Testicular sperm extraction (TESE) or testicular sperm aspiration (TESA) is a simple procedure to obtain sperm in men with obstructive azoospermia (i.e. men who have had vasectomies). These men have normal sperm production but a blockage exists that does not allow sperm to reach the semen. A TESE or TESA can be performed in your doctor’s office under local anesthesia or in the operating room under general anesthesia.
Male ejaculation is a complex process. To ejaculate correctly, a man’s central and peripheral nervous systems must work together. During ejaculation, the bladder neck must close and sperm must be forced from the vas deferens into the ejaculatory ducts, along with fluid from the seminal vesicles. Rhythmic contractions of the muscles around the urethra in the penis help to move the ejaculate through the urethra and out of the body.
Spinal Cord Injury & Male Fertility
Some patients with a spinal cord injury may have erectile and/or ejaculatory dysfunction. Some treatment options include the following:
- Vibratory Stimulation
- Testicular Sperm Extraction (TESE)
Semen Analysis Interpretation
One of the first tests a urologist orders is a semen analysis because sperm abnormalities are very common. How the results are interpreted can vary from lab to lab, because there are many methods for evaluating sperm. Abnormal findings, then, should be confirmed with a repeat semen analysis. Men with abnormal findings should be evaluated for genital tract anomalies as well as hormonal abnormalities. Most men with an abnormal semen analysis can father children with appropriate treatment.
A varicocele is a variation of normal anatomy in which veins in the scrotum (the sac that holds the testicles) become enlarged and sometimes even visible. Varicocele usually is first found at puberty and is much more common on the left side than on the right side. Sometimes it occurs on both sides.