Providing Options, Offering Hope
There are many safe and effective treatments for overcoming all of the most common causes of infertility. I understand that infertility is a deeply personal and life-changing issue, as a male factor infertility specialist, I am on your side; making sure that you feel confident about your individual treatment options. I’ll work with you to understand your options and to select treatments that meet your personal needs through the very latest medical innovations.
Leading Male Fertility Treatment
As a Clinical Professor at the David Geffen School of Medicine at UCLA and a research specialist funded by the National Institute of Health, I utilize a broad range of personalized treatments based on the latest developments in fertility research.
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 & ED
Erectile Dysfunction (ED)
ED, or impotence, is when a man has difficulty achieving or maintaining 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 of the spine or trauma to the penis
- Age-related conditions
- 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
Erectile Dysfunction is most often treated by a variety of highly-effective medications. Other treatments include lifestyle changes affecting sexual health and, very rarely, by surgery.
The inability or impediment of successful ejaculation can be the source of male infertility. Dysfunctions include:
- Aspermia occurs when there is a complete lack of semen during climax. Causes include Ejaculatory Duct Obstruction and Retrograde Ejaculation.
- Ejaculatory Duct Obstruction (EDO) is the cause of male infertility for less than 5% of cases. It is caused by 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 occurs when semen, which would normally be ejaculated via the urethra, is mis-directed to the bladder. This prevents some or all semen from releasing during climax.
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.
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.
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 own 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
We’ll work together to choose a solution that best serves your needs.
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.
Improving Sperm Health: Medication Treatments
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.
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.
Multiple STDs negatively impact fertility by damaging the reproductive system. STDs often are undetected and untreated. Prompt treatment can reduce the risk of damage.
Improving Sperm Health: 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.
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.
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 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.
Additional Fertility Treatments
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 peace of mind. Health sperm can be collected naturally or by the treatments listed above. Cryopreservation is often used by men undergoing cancer treatment and by men in a line of work that risks the future production of healthy sperm.
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. My practice is partnered with some of the best fertility clinics in Southern California. My team and I will work with your infertility specialist to establish a coordinated treatment plan. If you’re evaluating fertility clinics, we can provide reliable and proven referrals.
Coping and Support
Infertility is difficult for men as well as women. As we work with you to complete your family, we will stand with you to provide insight and support. If you’d like to discuss male infertility with other patients who have gone through similar obstacles, we can recommend knowledgeable support groups.