Center for Male Fertility

Male factor is the cause of infertility in 40 to 50 percent of couples. The Center for Male Fertility at Shady Grove Fertility offers a range of services including basic evaluation and testing to state-of-the-art microsurgical techniques.

When patients are diagnosed with a male factor, the urologist and reproductive endocrinologist work together to optimize treatment outcomes for the couple. This integrated care model, unique to Shady Grove Fertility, was designed to provide comprehensive male and female infertility services to ensure continuity of care and communication for both partners before, during, and after treatment.

Patients outside of Shady Grove Fertility may be referred directly to Drs. Shin, Tanrikut, Hayden or Marinaro for diagnostic testing, evaluation, and/or treatment for male infertility and vasectomy.

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In vitro fertilization
Intrauterine insemination
Causes of infertility
Single parents
LGBTQIA+ family building

Services

History and physical

An evaluation involves a full medical history and physical. A thorough review of any childhood medical issues, ongoing medical treatments, current medications, as well as sexual functioning can often reveal risk factors for male factor fertility problems.

Semen analysis/male fertility testing

Male testing requires a simple semen analysis, a non-invasive, low-cost test of a semen sample to assess the sperm’s ability to fertilize an egg.

Hormone tests

Hormone testing in men can help detect a hormonal imbalance by measuring the following hormone levels as well as checking for genetic defects:

  • Testosterone: a male hormone that is vital for healthy sperm
  • Follicle-stimulating hormone (FSH): a male and female hormone; in males, FSH helps maintain sperm production
  • Luteinizing hormone (LH): a male and female hormone; in males, LH stimulates the production of testosterone
  • Prolactin: a male and female hormone; in males, higher prolactin levels can inhibit testosterone production

Treatment options

Hormone replacement therapy

One of the most common medication-induced causes of male fertility issues is testosterone replacement therapy. Our reproductive urologists offer men with low testosterone alternate methods of supplementation that allow sperm production to be maintained while still addressing symptoms.

Varicocele repair

Varicocele repair is typically done to improve the fertility of men who have both a varicocele and impaired sperm. Repair involves a quick outpatient surgery and a minimal recovery period.

Vasectomy reversal

After a successful vasectomy reversal, sperm are again present in the semen. Many factors affect reversal success, including time since the vasectomy, partner age, and physician experience and training. One unique aspect of our vasectomy reversal program is that both Drs. Shin and Tanrikut perform the reversals together, maximizing the training and experience of your operating surgeon.

Vasectomy

A no-scalpel vasectomy is a specialized way of performing the procedure that removes sperm from the ejaculate that would result in a pregnancy. It is a simple outpatient procedure that involves a minimal recovery period.

Traditional fertility treatments

Patients experiencing male factor infertility may need traditional fertility treatments to conceive including intrauterine insemination (IUI) or in vitro fertilization (IVF). In some cases, IVF may be paired with intracytoplasmic sperm injection (ICSI) — in which an embryologist injects a single, healthy sperm into the center of each egg.

Percutaneous epididymal sperm aspiration (PESA) or testicular sperm extraction (TESE)

When very small amounts of sperm are found in the ejaculate, your physician can use techniques to retrieve sperm such as percutaneous epididymal sperm aspiration (PESA) or direct sampling of sperm from the testicle (TESE). Both are outpatient surgical procedures with minimal recovery.

Vasectomy FAQs

A vasectomy is a procedure performed to achieve permanent birth control for men. During the outpatient procedure the physician cuts and blocks off the tube (vas deferens) that carries sperm from each testicle; when those tubes are cut sperm cannot leave the man’s body and cause a pregnancy once the man has been cleared to resume sexual activity without contraception.

A vasectomy can be performed in the office under local anesthesia or in an outpatient surgery center under sedation. The procedure usually takes about 15 to 20 minutes.

The Reproductive Urology team at SGF offers a no-needle, noscalpel approach to vasectomy. First, you’re given a numbing medication using a jet injector to numb the skin and the underlying vas deferens. Many patients say that feels similar to getting flicked in the scrotal skin. Once you’re numb, the physician will make one tiny puncture in the middle of the scrotal skin, allowing access to both tubes. The tubes are then cut and blocked off, and the tiny puncture heals quickly so in many cases no skin stitches are needed. Once the procedure is complete, an antibiotic ointment is applied to the site, gauze is applied to the scrotum, and you’re fitted for a compression garment that provides scrotal support.

For the 2 days after the procedure it is important to keep the dressing in place and dry. You may consider going back to work the day after the procedure if you can arrange for a quiet day mostly sitting or doing desk work. You may shower approximately 36 hours after the procedure.

Bruising and swelling of the scrotum are normal after the procedure. Most men describe roughly 1 week of discomfort afterwards, which can be alleviated by using an ice pack on and off the scrotum the first day or two. Tylenol is usually sufficient for pain management but we will give you prescription pain medication as well.

For the first week after the procedure avoid lifting anything over 20 lbs. You should also avoid any strenuous activity like working out or sports. Finally, you should abstain from sexual activity of any sort for that first week after the procedure.

You may resume sexual activity 1 week after your vasectomy but you need to be sure to use some form of contraception because there will still be sperm stored on the other side of the vasectomy site. You should continue contraception until you are told you may stop using it.

You will provide a sample for semen analysis approximately 3 months after the procedure. You should continue to use contraception until you have heard from your SGF team regarding the outcome of the test results.

Any surgical procedure has a risk for bleeding or infection. Vasectomy is very low risk in these regards. There is something specific to vasectomy called the post-vasectomy pain syndrome that is rare, occurring in fewer than 1 in 4,000 patients. Symptoms generally resolve on their own. It is described as a dull, aching sensation in one or both testes that develops within a month or so after the procedure. Finally, there is a very low risk for birth control failure once your semen analysis shows no sperm.

Vasectomy will not negatively impact your sex life. It does not impair your ability to get or maintain erections. It does not impair your sex drive nor your orgasmic experience. Your erectile and ejaculatory function will not change, although there will be no sperm in the ejaculate.

A vasectomy should be considered a permanent form of contraception. If you were to change your mind down the road there are procedures that could be done to either reverse the vasectomy or surgically extract sperm to use during fertility treatment. The issue is neither of these treatment modalities works 100% of the time and anything that you do for family building after having had a vasectomy becomes an out of pocket expense that is quite costly. If you think that there is any chance that you may change your mind down the road, we would encourage you to consider freezing sperm at a sperm bank. Both vasectomy reversals and sperm extractions for in vitro fertilization (IVF) are offered at SGF.

Vasectomy is covered by most insurance plans. Our Reproductive Urology team can assist with confirming coverage through your insurance carrier.

If insurance does not fully cover the procedure, your vasectomy costs $2,400.

How to get started

Shady Grove Fertility has treatment options to help almost everyone build the family of their dreams. And it all starts with one call:

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