Providing Options, Offering Hope

There are many safe and effective treatments for overcoming all of the most common causes of infertility. As male factor infertility specialists, we are exclusively on your side. We understand that infertility is a deeply personal and life-changing issue. To that end, we are committed to earning your trust and making you feel confident about your individual treatment options. We will work with you to understand your options and to select treatments to meet your personal needs through the very latest medical innovations.

Leaders in the Treatment of Male Fertility

Dr. Zeitlin is able to utilize a broad range of personalized treatments based on the latest developments in fertility research as an Associate Clinical Professor at the David Geffen School of Medicine at UCLA and a research specialist funded by the National Institute of Health.

In addition to training urologists at UCLA Medical School, Dr. Zeitlin is an active member of the UCLA department of Urology- rated “best Urology Hospital on the West Coast” by US News and World Report.

Whether you plan to start your family the natural way or you plan to use assisted reproductive techniques, it is crucial for successful conception and your children’s eventual health that you make your role in the process the very best that it can be.

Conditions & Treatments

• Sexual Performance and ED
• Sperm Health
• Additional Treatments
• Coping and Support.

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Sexual Performance & ED

Erectile Dysfunction (ED)
ED or Impotence is when a man to has difficulty achieve or maintain an erection suitable for sex. 18% of men have some form of erectile difficulty. More than 50% of men over 40 have had some difficulty achieving and sustaining an erection.

Problems with erections may stem from:

• Vascular Disease that impedes blood flow to the penis
• Injury
• Age
• Chronic Illness including Diabetes
• Hormonal Imbalance including Testosterone
• Neurological Disease or Damage
• Medications including drugs for high blood pressure and antidepressants.
• Physical Challenges – including weight and lack of exercise
• High Blood Pressure
• Psychological causes.
• Peyronie’s Disease – causing curvature or narrowing of the penis.

ED Treatment
ED is most often treated by a variety of higly effective medications. Other treatments include lifestyle changes affecting sexual health, and very rarely by surgery.

Ejaculatory Dysfunction

The inability or impediment of successful ejaculation can be the source of male infertility. Dysfunction includes:

• Aspermia occurs when there is a complete lack of semen during climax. Causes include Ejaculatory Duct Obstruction and Retrograde Ejaculation
• Ejaculatory Duct Obstruction is the cause of male infertility for less than 5% of cases. It is by caused physical obstructions in the path to release. Usually men who have EDO produce healthy sperm and the only challenge to conception is in the delivery.
• Retrograde Ejaculation prevents some or all semen from releasing during climax. This occurs when semen, which would normally be ejaculated via the urethra, is mis-directed to the bladder.

In cases where little or no sperm is present in the semen or for patients who cannot ejaculate, there are a choice of treatments that can provide healthy sperm for conception.

Treatments for Patients with Ejaculatory Disorders
In cases where little or no sperm is present in the semen or for patients who cannot ejaculate, there are a choice of treatments that can provide healthy sperm for conception.

Sperm Retrieval

For patients with complete obstructions, dysfunction in the delivery of sperm, or conditions such as Azoospermia in which little or no sperm is found in the semen, sperm can be harvested directly from the testis or from epididymis. This can provide the best possible sperm for IVF. Sperm Retrieval can also enable patients who are unable to ejaculate to father children. Precise and minimally invasive retrieval can be done using an operating microscope for increased accuracy.

Procedures of Sperm Retrieval include:

• MESA – Microsurgical Epididymal Sperm Aspiration
• PESA – Percutaneous Epididymal Sperm Aspiration
• TESE – Testicular Sperm Extraction
• MicroTESE – Microsurgical Testicular Sperm Extraction

Options for Patients Unable to Ejaculate
For patients with spine damage or other neurological conditions preventing successful ejaculation, medical options are available to physically induce the body to ejaculate. Methods include Electroejaculation and Vibratory Stimulation.

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Sperm Health

3 months is the amount of time needed to produce healthy sperm.
During this process, there are a great many things that have to happen in order to produce healthy sperm. There are also a number of conditions & factors that can impede healthy sperm from being produced and delivered.

If you are having difficulty conceiving, the most direct way to turn the odds in your favor is to produce the best possible sperm. It is common for patients who have been told by their IVF doctor to use a sperm donor to have their own biological child through optimization of their sperm.

There are a variety of effective treatments to improve sperm quality and volume including:

• Production Therapy
• Delivery Treatment
• Medication Treatment
• Surgical Repair
• Sperm Harvesting

Dr. Zeitlin will work with you to chose a solution that best serves your needs.

Sperm Quality

Sperm is evaluated for concentration, quantity, concentration, motility (activity), morphology (structure), and genetics. Any one of these values may impede conception but all can be improved through proper treatment.

Treatments to Improve Sperm Health

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Medication Treatments

Testosterone Management
In addition to feeling less energetic and less self-assured, low testosterone can significantly impede sperm production. Medications are able increase and manage the level of testosterone in the body to improve sperm quantity, concentration, motility, and morphology.

Pituitary Regulation
The pituitary gland produces the hormones LH and FSH that influence the production of testosterone and promote the formation of sperm. Through medication, the levels of the hormones can be controlled or supplemented.

STD Treatment
Multiple STDs negatively impact fertility by damaging the reproductive system. STDs often are undetected and untreated. Prompt treatment can reduce the risk of damage.

Surgical Treatments

All treatments are performed by our veteran surgical team who have worked together for over a decade at the award-winning UCLA Urology Department.

For your convenience and comfort, our surgical treatments are done on an outpatient basis.

Vasectomy Reversal
Nearly 10% of the 500,000 men each year who have Vasectomies eventually decide to restore their fertility. Usually the reason for Vasectomy Reversal is re-marriage. For other men, children become more desirable over time. Learn More

Varicocele & Varicocelectomy
Varicoceles are varicose veins returning blood from the testicles to the body. Varicoceles are common – affecting 15% of all men and 40% of infertile men. They can cause pain in addition to causing infertility by impeding sperm production. Surgical varicocele repair (varicocelectomy) is performed to permanently improve fertility by improving the flow of blood through the veins connected to the testicles. Varicocelectomy is done on an outpatient basis a using local or general anesthetic.

Repair of Ductal Conditions
Blockage that impedes proper transportation of sperm can often be repaired. Using Transrectal Ultrasound (TRUS), ejaculatory duct obstruction can be located and targeted. Ejaculatory Duct Obstruction, Retrograde Ejaculation, and other duct impediments can be redirected or repaired through surgery

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Additional Fertility Treatments
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Sperm Washing
Better described as sperm purification, sperm washing separates and prepares the healthiest sperm for insemination. Semen and a washing agent are combined in a centrifuge to separate sperm from other elements in the semen that may cause infertility.

Preservation of Male Fertility
For patients who have reason to safely store sperm for future use, Cryopreservation provides insurance against infertility and piece of mind. Health sperm can be collected naturally or by the treatments listed above. Cryopreservation is often used by men who undergoing cancer treatment and by men in a line of work that risks the future production of healthy sperm.

Artificial Insemination
If you are considering IVF or Insemination, it is essential to have a thorough work up of your sperm to make certain that you have the greatest possible chance for a healthy child. We are partnered with some of the best fertility clinics in Southern California. We are eager to work with your infertility specialist to establish a coordinated treatment plan. Should you be evaluating fertility clinics, we will be able to provide reliable and proven referrals.
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Coping and Support
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Infertility is very difficult for the man as well as the woman. As we work with you to complete your family, we will stand with you to provide insight and support. Should wish to discuss male infertility with other patient who have experienced the condition, we are able to recommend knowledgeable support groups.