Dec 13, 2013 8:00 AM

Author: James Hotaling, MD, MS


Q: Can male infertility be treated with medications?

A: Absolutely it can. We often use clomiphene citrate or clomid (the same drug that is associated with female fertility and has been FDA approved since the 1970s for female infertility) for men with low testosterone levels. Although this is an off-label use of clomiphene citrate, its use in men has been extensively described and according to a study from an Egyptian University, can result in the return of sperm counts to normal or near normal levels. It can also double your chances of finding sperm during surgery if your counts are too low to achieve pregnancy 

Q: Will this be a painful process for me? What if I need surgery?

A: Men are typically terrified to go see the “sperm or testicle doctor” and often even more scared of the potential for invasive procedures. There seems to be a commonly held belief among men requiring male infertility surgery that healing up from the surgery will mean feeling like you have taken a sharp blow to the groin for weeks on end. This could not be further from the truth. Surgery, if necessary, is done through a very small scrotal incision as outpatient surgery. Most men report feeling essentially normal 1-2 days after surgery and can go back to work, assuming they do not perform hard physical labor for a living, in a few days. For men who have no sperm present in their sperm counts, we can use a simple outpatient surgical procedure to find it in roughly 70% of men. This sperm can then be used to enable couples to have their own biological children through in vitro fertilization.

Q: Should I bring my spouse to the appointments?

A: Absolutely, bring your spouse. We often joke with our patients that the presence of the Y chromosome means that no matter how long a physician spends explaining male factor infertility to a patient, he will always go home and tell his spouse that he was “fine”. All joking aside, we realize that this is an emotionally charged, highly sensitive couple issue for couples and that it is impossible to treat male factor infertility while ignoring the female side. We feel strongly that this condition is best managed in the context of the couple, not the individual.

Q: What Reproductive Endocrinologists do you work with?

A: We will work with any and all reproductive endocrinologists in the United States and abroad. Our lab has extensive experience freezing and storing sperm and we often transport these specimens all over the world for our patients. You can expect that on the day we see the male partner, we will send an electronic version of our note to the referring reproductive endocrinologist. If you do not have a reproductive endocrinologist, we are happy to refer you to one and would recommend that all couples see both a male and female fertility expert.

For more information contact visit http://healthcare.utah.edu/andrology/ or call 801-587-1454.

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