Infertility

INFERTILITY

Dr. Herman and Dr. Kester, top South Florida urologists, serving the Fort Lauderdale, Miami and Palm Beach areas, specialize in MALE INFERTILITY, using sophisticated testing to determine the underlying cause and appropriate treatment. Contact us immediately to schedule an appointment for a thorough diagnosis and treatment plan.

Infertility is the inability to conceive (reproduce) after at least one year of unprotected intercourse. Since most people are able to conceive within this time, physicians recommend that couples unable to do so be assessed for fertility problems. In men, hormone disorders, chronic illnesses, reproductive anatomy trauma, genitourinary obstruction, or sexual dysfunction can temporarily or permanently affect the sperm and prevent conception. Some disorders become more difficult to treat the longer they persist without treatment.

Sperm development (spermatogenesis) takes place in the seminiferous tubules (ducts) of the testes. Cell division produces spermatozoa (mature sperm cells) that contain one-half of a man’s genetic code. Each spermatogenesis cycle consists of six stages and takes about 16 days to complete. Approximately five cycles, or 2 ½ - 3 months, are needed to produce one mature sperm. Mitochondria (energy-generating organelles) inside each sperm power its tail (flagellum) so that it can swim to the female egg once inside the vagina. Sperm development is ultimately controlled by the endocrine (hormonal) system that comprises the hypothalamic-pituitary-gonadal axis.

Because sperm development takes about 3 months, illnesses that were present during the first cycle 3 months prior may today affect mature sperm, regardless of a man’s present health at the time of examination.

According to the National Institutes of Health, male infertility is involved in approximately 40% of the 2.6 million infertile married couples in the United States.

CAUSES of INFERTILITY

The primary causes of male infertility are problems with sperm production due to Varicocele or sperm delivery related to obstruction. Other causes are:

• Cryptorchidism (failure of testes to descend; can impair spermatogenesis)
• Cystic fibrosis (may cause absence of sperm, vas deferens, or seminal vesicles)
• Ductal obstruction (caused by repeated infection, inflammation, or developmental defect)
• Hemochromatosis (metabolic disorder; causes iron deposition in the testes)
• Hormone dysfunction (caused by disorder in the hypothalamic-pituitary-gonadal axis)
• Drugs
• Retrograde ejaculation
• Sexually transmitted diseases (STDs; cause obstruction, infection, and scarring)
• Sickle cell anemia (can cause hypogonadism)
• Systemic disease (fever, infection, kidney disease, metabolic disorder; can impair spermatogenesis)
• Testicular cancer
• Testicular trauma (damage to testes)

DIAGNOSIS of INFERTILITY

The search for an infertility cause usually begins with the male, because male examination and testing is less complicated. A thorough examination and a review of the man’s medical and surgical history are necessary, because chronic disease, pelvic injury, childhood illness, abdominal or reproductive organ surgery, recreational drug use, and medications can affect fertility. Physical examination may detect testicular irregularities (e.g., vericocele, absence of vas deferens, tumor), evidence of hormonal disorders (e.g., underdeveloped reproductive organs, enlarged breast tissue, or evidence of testosterone deficiency).

Call us immediately to schedule an appointment with Dr. Herman or Dr. Kester for the relief you deserve.