Surgical Male Fertility Treatment in Los Angeles & San Francisco, CA
When non-surgical infertility treatments and natural remedies fail to improve male fertility, surgical procedures may be the key to fulfill the dream of having children. What is nice about surgical treatments for male infertility is that they can “cure” the problem and allow for conception at home and not in the laboratory.
Dr. Paul Turek is an award-winning urologist and one of the country’s most trusted male fertility specialists because of his knowledge of both surgical and non-surgical procedures that help men to become fathers. If your fertility treatments come up short, Dr. Turek has precise, published and proven advanced surgical skills that can improve a man’s chance of conceiving with his partner.
Schedule a consultation with Dr. Turek to discuss all your fertility options.
Surgical Male Fertility Treatment Options
The following are accepted surgical treatments for male infertility.
Varicocele Repair
Varicoceles are enlarged veins (varicose) in the scrotum. If the valves in varicoceles veins fail, blood can amass in the scrotum. This blood can cause overheating in the testicles, which disrupts sperm and testosterone production and can impair fertility. It can also cause genital pain.
Dr. Turek finds varicocele problems in about one out of every three patients he evaluates for fertility issues. Accordingly, varicocele repair is his most-performed surgery.
Because Dr. Turek published and popularized this minimally invasive varicocele treatment (which other fertility doctors around the world now offer in their own practices), many patients specifically seek out Dr. Turek for varicocele repair. He has performed this surgery over 2,000 times and has an excellent success rate on behalf of his patients.
Ejaculatory Duct Resection
Men have two ejaculatory ducts. These ducts carry semen from the seminal vesicles to the urethra. However, if one or both ducts develop a blockage, this can obstruct semen from being ejaculated and result in male infertility.
A diagnosis for ejaculatory duct obstruction is confirmed by transrectal ultrasound (TRUS) that shows larger seminal vesicles or dilated ejaculatory ducts in association with a cyst, calcification or stones along the duct. Dr. Turek also performs a physical examination and has popularized and published (ejaculatory duct manometry) a way to to confirm whether the ducts are truly blocked before surgery to open them and restore fertility.
Once diagnosed, Dr. Turek surgically treats the obstruction with transurethral resection of the ejaculatory ducts (TURED). This one-hour procedure reopens the ducts to allow semen to flow normally again to the urethra. The success rate for this procedure is high: 75% of patients produce higher-quality semen and one third are able to conceive naturally (without requiring assisted reproduction).
Vasectomy Reversal
The vasectomy reversal is another procedure that “unblocks” infertile men who previously had a vasectomy. Dr Turek also performs a similar procedure on men who have no sperm count due to a past infection, trauma or unexplained reproductive tract blockage. Dr. Turek uses one of two approaches when performing a vasectomy reversal:
- Vasovasostomy is microsurgery that reconnects both ends of the vas deferens (the duct that transports sperm from the testicles).
- Epididymovasostomy (sometimes called a vasoepididymostomy) surgically connects the vas deferens to the epididymis, a tube at the back of the testes that matures and stores sperm after it’s made.
Because these male reconstructive microsurgeries are so complicated, very few doctors offer them, and those that do have specialized microsurgery training. Epididymovasostomy is a particularly complex procedure, so it can be hard to find a doctor who is willing to perform it. Fortunately, Dr. Turek has an exceptionally successful (and published) track record with minimal complications performing these procedures.
Male Fertility Treatment with Assisted Reproductive Technologies (ART)
If neither surgery nor medical therapy is appropriate for male infertility treatment, assisted reproductive technologies are available to help.
Intrauterine insemination (IUI)
This is the simplest form of assisted technology and involves the placement of a washed pellet of ejaculated sperm within the female uterus, beyond the cervical barrier. This technique is performed in the office and is indicated for low sperm quality, immunologic infertility and for men with mechanical problems with sperm delivery (e.g., erectile dysfunction).
The success rates vary widely and are directly related to female reproductive potential. Pregnancy rates of 8-16%/cycle have been reported with the use of IUI as a treatment for male infertility.
In-vitro Fertilization and ICSI
It has been possible to fertilize human eggs in a culture dish since 1978. IVF involves ovarian stimulation and egg retrieval from the ovaries prior to normal ovulation. Eggs are fertilized in petri dishes with 500,000 to 5 million motile sperm. Fertilized eggs or embryos are then transferred to the uterus through a simple vaginal procedure.
IVF can bypass moderate to severe forms of male infertility in which low numbers of motile sperm are present. In 1992, an addition to IVF was described in which the sperm is directly injected into the egg cytoplasm with a microscopic needle in the laboratory phase of IVF. This has been referred to as sperm “micromanipulation” or intracytoplasmic sperm injection (ICSI) and has helped with the treatment of male infertility.
The sperm requirement for egg fertilization has gone from hundreds of thousands for in vitro fertilization (IVF), to one viable sperm required for ICSI. This has led Dr. Turek and others to develop aggressive new techniques to find sperm for eggs from men with no sperm in the ejaculate. Presently, sources of sperm in that are usable for conceiving include all reproductive tract organs.
Meet with Dr. Turek
Dr. Turek’s talent and reputation attract patients from around the world seeking infertility treatment. Although Dr. Turek rarely uses surgery as the first-line option for his patients, he understands when it is appropriate to recommend a surgical procedure to best achieve pregnancy. His surgical skills and innovative techniques have helped thousands of men to become fathers.
For a consultation, please contact The Turek Clinic today.
