Male infertility should be thoroughly evaluated, as there are many treatable causes. We offer expert evaluation and treatment including microsurgery. The microsurgical procedures offered include vasectomy reversal (vaso-epididymostomy and vaso-vasostomy), microscopic sub-inguinal varicocelectomy, and microTESE. We also offer electroejaculation for patients with spinal cord injuries and diabetics who have lost the ability to ejaculate. Transrectal ultrasound is used to diagnose and treat male infertility. The ultrasound of the prostate and seminal vesicles can help in the diagnosis of ejaculatory duct obstruction, and we make the definitive diagnosis using seminal vesiculography.



When no sperm are seen on analysis, it is referred to as Azoospermia. One of a few things is going on. I have seen patients not ejaculate, and only produce pre-seminal fluid, and therefore there was no sperm. Otherwise, in most instances either sperm is not being made, or it is being blocked from coming out.

Obstructive Azoospermia refers to a blockage anywhere from the testicle to the prostate. Some patients are blocked by virtue of having been born without the vas deferens (the tube that connects the epididymis and the prostate).

NOA, or Non-Obstructive Azoospermia, refers to sperm not being made, or made in insufficient quantity to appear in the ejaculate. These are patients who may have sperm in their testicles in small quantities. The sperm then needs to be extracted to be used with the IVF/ICSI (In Vitro Fertilization/Intracytoplasmic Sperm Injection) procedure.



There are many fine urologists in Los Angeles, but very few who have knowledge and experience in treating male infertility. Infertility is a couple's issue, and needs to be addressed in this fashion. Many causes (of male infertility, just like female infertility) can be corrected, but correcting a problem that has no impact on your ability to achieve a pregnancy can delay more appropriate treatment. You may be treated very differently depending on your partner’s age (referred to as maternal age). This is critical to your care. You need to know your best options.