Southwest Fertility Center for Men Forum

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2012-02-04T15:55:35Z

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2012-02-04T10:45:35Z

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2012-02-03T20:56:26Z

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Шкафы купе на заказ в Москве

2012-02-03T18:40:39Z

Шкафы купе на заказ в Москве

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2012-02-03T15:31:39Z

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Varicocele - Semen parameters improve after a varicocele repair by 3 months

2012-02-03T11:40:52Z

In the world of male fertility, it has been recommended by the Practice Committee of the American Society for Reproductive Medicine to wait for an improvement in sperm parameters after a varicocele repair that is seen in approximately 2/3 of men. Researchers in Toronto, Canada decided to see if this claim held up in a group of Canadian men and published their work in January 2012.

Dr. Al Bakri and associates looked back at 100 men who had their varicoceles repaired with a baseline average sperm concentration of 18.2 million/mL. They watched how their sperm production improved over the first 6 months after the repair. They found that the average sperm concentration improved significantly by 3 months time. Moreover, waiting an additional 3 months did not seem to provide any additional improvement. Specifically the average sperm concentration improved by 53% at 3 months to 27.9 million/mL and by 38% at 6 months to 25.1 million/mL.

Bottomline: This novel research looking at the time line for improvement of sperm parameters after a varicocele repair needs to be confirmed; however, it does suggest that couples may be able to initiate alternate reproductive therapies such as inseminations or IVF by 3 to 6 months after a varicocele repair instead of waiting the previously recommended time of 12 months. Many thanks to this Canadian team for this exciting research which may help many couples better navigate their reproductive journey towards a building a healthy family.

Reference: Al Bakri 2012 J Urol 187: 227

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2012-01-30T08:31:00Z

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Oligospermia - Clomiphene citrate (Clomid) can help obese men optimize their fertility potential.

2011-01-21T11:33:29Z

Hormonal manipulation with medications to help men with too few sperm (oligospermia) improve the number and/or quality of their sperm is always a great challenge. Clomid or clomiphene citrate is a medication that modulates the estrogen receptors in the brain so that the brain can make more hormones to tell the testicle to make more testosterone and sperm. At the 2010 American Society of Reproductive Medicine national meeting in Denver, Colorado, Shin et al. from Hackensack University in Hackensack, New Jersey looked at 20 overweight men with a body mass index of greater than 25 and low testosterone levels. They were treated with clomid and within one month the testosterone levels increased appropriately; and 4 of the 20 showed an increase in sperm concentration and motility. More importantly, 5 of the 20 men were able to establish a pregnancy.
Bottomline: If your are oligospermic, talk to your male infertility specialist to obtain a hormone profile to see if you may benefit from medications that may optimize your reproductive health. Learn more about Oligospermia.
(American Society of Reproductive Medicine, Denver, Colorado, 2010; 94 (4):P-136)
(Note: pre-T 237-306 ng/dL, post-T 577-663 at 1month)

General - The distance from your scrotum to your anus may correlate with your testosterone levels!

2012-01-27T10:17:14Z

The distance from the bottom of your scrotum to the top of your anus, the anogenital distance or AGD, may correlate with your testosterone levels. The AGD has been known to be a marker for the development of genitals. Historically, it has been used to identify the gender of animals, and the AGD has been found to be longer in boys than in girls. Moreover, recent studies have suggested that AGD correlates with better semen parameters. Researchers from Baylor College of Medicine in Houston, Texas recently looked at AGD and looked for correlations with reproductive hormones.

Dr. Eisenberg and associates in 2012 looked at 116 men with the average age of 36. They measured their AGD as well as the following reproductive hormones (FSH, LH, testosterone and estrogen). The averaged AGD was 3.4cm and the average testosterone was 316.5 ng/dL. They found that a man’s testosterone increased by approximately 20 ng/dL for every 1 cm increased in AGD. Additionally, men with low testosterone (<300ng/dL) had a shorter AGD (3.2cm) as compared to men with normal testosterone (3.7cm).

Bottomline: This is definitely interesting research that we will hear more about in the future. It probably will not change how we evaluate men for male fertility since semen analysis and blood tests to look at hormone levels provide more definitive information; however, we just wanted to give guys a heads up just in case your male fertility doc near you whips out a ruler and starts taking measurements “down there”. This way you won’t be surprised!

Reference: Eisenberg et al. 2012 J Urol 187: 594

From Dr. K, How Do Sperm Normally Get to My Partner’s Egg?

2010-11-03T09:54:16Z

I just returned from this year’s American Society of Reproductive Medicine’s conference in San Francisco. One of my colleagues Dr. Bob Brannigan from Northwestern University presented a great review of “Sperm Transport & Fertilization.” Here are some of the highlights:
1. When a man ejaculates in a woman’s vagina, he deposits around 200-500 million sperm right behind the cervix. To move up through the uterus and into the fallopian tubes, a sperm must journey around 20 cm. It might not seem so far but to a sperm who is only 3-5 micrometers wide, it must seem like traveling half way around the world!!!
2. When it is the right time of the month, the woman’s vagina and cervix change and becomes sperm-friendly allowing sperm to swim up inside of the woman. The fluid in the cervix and the vagina become less acidic and the cervical mucus thins out and becomes less viscous so sperm can move through it more easily.
3. Sperm can survive in a woman’s cervical area by finding little caves called the cervical crypts. These sperm can keep their ability to fertilize for at least 48 hours and their sperm retain motility up to 120 hours!!!!
4. It is believed that the sperm form a home base in these cervical crypts. The sperm then take turns as individuals and/or small teams to go out up into the uterus and the fallopian tubes in search of an egg that was released from the ovary that month.
5. It is pretty cool how the uterus and fallopian tubes will actually move and contract in special ways to help sweep the sperm up towards the egg that is hopefully rolling its way down towards the sperm.
6. On average, 251 sperm can be found 18 hours later in the fallopian tubes after a woman has been inseminated. What is even cooler is that the sperm are found predominantly on the side with the ovary that released the egg. Obviously, sperm are able to preferentially know whether to turn right or left when they get to the T-intersection at the top of the uterus. How they do that is something we don’t completely understand.

Pretty fascinating stuff. Just wanted to help empower you with education to help you all make the best decisions for you and your partner as you plan on building a healthy family.

Warm regards,
Wayne Kuang MD
Southwest Fertility Center for Men