Male Fertility

Male Fertility

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Introduction

Around 40 per cent of fertility problems in couples originate in the man. Dr Shannon Kim is the leading expert in Male Fertility in NSW and will provide you with honest and open feedback which will help you make choices when it comes to your fertility journey.  
 
Male infertility is due to low/no sperm production, abnormal sperm function or blockages that prevent the delivery of sperm. Illnesses, injuries, chronic health problems, lifestyle choices and other factors can play a role in causing male infertility.

Not being able to conceive a child can be stressful and frustrating. However, there are a number of male infertility treatments available that might be of help to you.

See below an outline of the most common causes of Male Fertility and how Dr Shannon Kim can help you:

Male Fertility Assessment

Male infertility affects around half of all infertile couples. The most common causes include lifestyle factors, problems with sperm production, movement or shape, sperm antibodies, chromosome and DNA abnormalities, hormonal problems or erectile and ejaculation difficulties. 
Dr Kim will go through your history and examination to narrow the diagnosis.
Dr Kim will help you organise some tests such as semen analysis, sperm function test, cryopreservation/freezing of sperm, basic blood test to check your hormones and genetics and imaging (ultrasounds, CT, MRI)
 
There are non surgical, medical and surgical treatment options which can be discussed.
Non Surgical - Vitamin Supplements, lifestyle changes, hormone optimisation
Surgical options - Micro TESE, Sperm extractions, Varicocele surgery, Circumcision, Hydrocele surgery, Vasectomy Reversal, Ejaculatory Duct Obstruction, Prostatic cyst excision


Varicocele Surgery

A varicocele is a swelling of the veins that drain the testicle. It's the most common reversible cause of male infertility. Although the exact reason that varicoceles cause infertility is unknown, it may be related to abnormal testicular temperature regulation and building up of harmful metabolites to the testis. Varicoceles can result in reduced quantity and quality of the sperm.

Treating the varicocele can improve sperm numbers and function, therefore, improve natural conception rate, and may potentially improve outcomes of assisted reproductive techniques such as IVF.

Dr Kim offers Microsurgical Varicocelectomy which offers excellent success rate with least complications and recurrences. This technique is considered the gold standard of modern treatment of varicocele. 

Vasectomy

Vasectomy is a surgical technique to provide male contraception. This involves removing a small portion of the vas deferens “vas” to prevent the sperm from getting into the seminal fluid. After the procedure, ejaculated semen will not carry any sperm and instead have it reabsorbed into the body. The goal of a vasectomy is to make a man sterile, that is, unable to father children naturally. It is a very effective, safe and permanent form of contraception.
 
It’s important to have another semen analysis, however, to confirm ‘azoospermia (no sperm) before enjoying your natural contraception as it usually takes around three months from the time of procedure for it to work.

Vasectomy Reversal

Vasectomy reversal is a surgery done to reverse a vasectomy. It reconnects each tube (vas deferens) that carries sperm from the testicles into the semen. After a successful vasectomy reversal, sperm are again present in the semen and you may be able to get your partner pregnant.

Success rates with vasectomy reversal will range from about 40 percent to over 90 percent. Many factors affect whether a reversal is successful in achieving pregnancy, including time since a vasectomy, partner age, definition of success, and surgeon experience and training.

Dr Kim performs high numbers of this procedure. She can also offer Vasoepididymostomy, a more challenging bypass procedure in selected patients.  
There are some cases that vasectomy reversal is not possible due to sperm quality or tube (vas or epididymal tubule) quality from previous vasectomy. Then Dr Kim can also offer surgical sperm collection for freezing and work closely with a fertility specialist to have your partner conceive via IVF.

Klinefelter Sydrome

The most common genetic cause of male infertility is a condition known as Klinefelter Syndrome. About 1 in every 600 boys are born with an extra X chromosome in their genetic makeup – “XXY.” This condition is known as Klinefelter Syndrome, and it has been shown to drastically reduce the man’s fertility.
 
Dr Shannon Kim is the only Urological Surgeon in NSW who has expertise on children with Klinefelter Syndrome. Micro TESE (Microdissection) can be offered to men with Klinefelter to attempt for ICSI/IVF cycle or have them stored for future use.  

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