Male Fertility FAQs

Male Infertility

  • In approximately 50% of cases of heterosexual couples having difficulties conceiving, male-factor infertility issues are either the sole cause or a contributing factor.

  • For men who are trying to conceive with a female partner, it’s recommended to seek out a male fertility evaluation after six months to a year of trying to conceive without success. For gay couples and single men who are pursuing parenthood through assisted reproductive technology (ART), a fertility evaluation is typically the first step in the family-building journey.

  • It’s recommended that men seeking a comprehensive evaluation for male factor infertility do so with a urologist specifically trained in the evaluation and treatment of male infertility.

  • The initial consultation for male fertility consists of reviewing a full personal and family medical history, a physical examination, and ordering appropriate diagnostic testing. For more detailed information please read our Male Fertility Evaluation page.

  • Male infertility treatments can span the full spectrum of therapy from medication to surgery. The type of treatment needed depends on your diagnosis and reproductive goals.

Sperm Retrieval

  • Sperm retrieval is generally recommended when there is no sperm in the ejaculate due to an obstructive or production abnormality. Sperm retrieval may also be indicated when higher-quality sperm can be found in the testicle than the sperm present in the ejaculate.

  • Types of sperm retrieval include microscopic epididymal sperm retrieval (MESA/PESA) and microscopic testicular sperm retrieval (TESA/TESE). The location of the sperm determines which sperm retrieval technique will be used.

  • Due to the low count of sperm retrieved, IUI is not the recommended procedure for achieving the highest pregnancy rate. In the vast majority of cases involving sperm retrieval, the best option is in vitro fertilization (IVF) with intracytoplasmic sperm injection (ICSI).

  • The success rates of sperm retrievals are largely dependent on what’s causing the sperm issue. If sperm must be retrieved because of an obstruction in the reproductive system, then sperm retrieval is typically about 100% successful. However, if sperm is being retrieved because of production abnormalities, the success rate can range from 20-100%, depending on the patient’s histology.

  • To get immediate results for a sperm retrieval procedure, it’s ideal for a facility to have an operating room combined with an embryology lab. RBA has a state-of-the-art embryology lab and operations rooms.

Vasectomy

  • As a permanent method of birth control, vasectomies are considered to be the most effective, invisible, and inexpensive form of contraception available.

  • Vasectomies involve making an incision in the scrotum and closing up the vas deferens on both sides. The vas deferens are small tubes that carry sperm from the testicles to other parts of the reproductive system, where they mix with seminal fluids before being released from the body via ejaculation. Closing up the vas deferens prevents the sperm from entering the ejaculate.

    Vasectomies can be performed in the doctor’s office with local anesthesia or in a surgery center with IV sedation.

  • Generally considered to be a safe procedure, complications from vasectomy are rare but possible. Complications such as bleeding, infection, and chronic pain occur in approximately 5% of vasectomies. In terms of success, vasectomy failures occur in less than 1% of cases.

  • No, vasectomies have no impact on a person’s ability to get or sustain an erection, nor does the procedure affect ejaculation. Vasectomies simply prevent sperm from entering the ejaculate; all other aspects of the reproductive system are typically unaffected by the procedure.

  • Sperm continues to be made by the testicles, however, instead of being transported via the vas deferens to the ejaculate, the sperm cells degrade and are reabsorbed into the body.

Vasectomy Reversal

  • ​​Vasectomy reversal success rates vary and numerous factors may affect the outcome, such as age and other fertility issues. The success rate can be as high as 98% and pregnancy rates as high as 65%.

  • When seeking treatment for a vasectomy reversal, it is recommended that you seek care with a urologic surgeon with microsurgical training who performs the procedure at least once a month. Dr. Michael Witt meets and exceeds all these criteria.

  • Couples can expect up to a 12-month time frame for achieving a pregnancy after a vasectomy reversal procedure has been performed.

  • The alternative to vasectomy reversal is a technique called sperm retrieval, which is taking sperm surgically directly from the testicle.

  • Vasectomy reversal is usually an outpatient procedure (without an overnight stay in the hospital). General anesthesia is commonly used to achieve the highest success rate. Most men can be back to work the next day.

Schedule a Male Fertility Evaluation in Atlanta, GA

If you’re interested in learning more about male fertility and fertility testing, we encourage you to schedule a consultation to get started.

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