Issues on Male Fertility and Treatment
The main focus that I hope to have in my practice is on male fertility and sexual dysfunction. So, two very different areas, occasionally they do overlap. For men with male fertility usually there are no signs and symptoms, except that he and his partner have been trying to have a child for a while, usually about a year or more, and when they're unable to achieve their goal of conception, and they usually get in contact with me for the male partner, as the woman is also undergoing an evaluation with her doctor.
Treatment for male fertility is totally related to the cause. So, the reason that I pay attention closely to men with fertility issues is that there's a wide range of different evaluation options that can lead to a diagnosis of what's causing the fertility issues. And then we tailor the treatment, based on, exactly, what the cause may be. So, sometimes we find a medical cause for it, that's decreasing his ability to produce sperm buddy, otherwise, could be producing. And so, when we correct the medical cause, we can improve his fertility ability.
Other times, there are hormonal reasons, and we can alter his hormones in such a way to naturally increase his sperm production. Sometimes surgery is required in the case of a varicocele in the testicle area. They can decrease natural sperm production. Surgically, repairing this can again restore the testicle to its normal functional ability to improve the sperm production function.
Twelve months of unprotected intercourse is the general guideline before most couples start to seek treatment and evaluation for some couples, particularly, older couples after about six months or so. We generally recommend that if they aren't pregnant that they seek evaluation to speed their process to conception as best we can.
I think, the biggest issue that couples and the public at large think about male fertility is that it isn't much of an issue. The most the time, when the couples are having difficulty conceiving, it's on the part of the female or the wife, in general though the man can contribute to fertility issues in 40-50% of couples that present with issues trying to conceive. So, the guy is solely responsible in about 20% of the time, and both, the man and the woman, for 20-30% of cases that we see.
All urologists are trained in the evaluation of male fertility and male sexual dysfunction, but I focused during my fellowship specifically on male fertility evaluation and treatment, making my time here in Nebraska as the only fellowship trained for male fertility specialists in the area.
Men should come to Nebraska medicine to be evaluated for their fertility issues, because I've got love for treating these guys, for understanding what's going on, and helping them to understand what the wide variety of options are and what's going to fit best for their personal goals, financial goals and the goals of developing their family.