Austin Fertility & Reproductive Medicine

Male Infertility:

The only physician in Austin with Specialty Fellowship training in Vasectomy Reversals and Reproductive Urology

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Approximately 20% of cases of infertility are due solely to male factor, and an additional 30-40% of cases involve both male and female factor.

A man’s fertility can be affected by the following factors:

   • Endocrine (hormonal)
   • Chromosomal (genetic) disorders affecting sperm production
     and/or quality
   • History of undescended testicle
   • Varicocele (dilated veins around the testicle)
   • History of infection of the testicle
   • History of chemotherapy or radiation treatments
   • Environmental toxins and occupational exposures
   • Drugs/Medications/Tobacco
   • Duct blockages
   • Problems with ejaculation
   • Unknown causes

Dr. Kavoussi is fellowship trained in the evaluation and medical and surgical treatment of male infertility, including microsurgical expertise in the field required for sperm harvest (microTESE) under certain circumstances.

Our goals in caring for infertile men include:

   • Identifying and treating reversible conditions
   • Identifying irreversible causes in which assisted reproductive techniques using the male partners’ sperm can be      performed to achieve pregnancy
   • Identifying irreversible conditions requiring the couple’s use of other treatment options such as donor      insemination
   • Identifying underlying medical problems associated with male infertility
   • Identifying chromosomal disorders which may affect the man or his offspring

Dr. Kavoussi was involved in basic science research investigating new technologies on a cellular level to help improve the efficiency and success rates of sperm retrieval in an animal model to ultimately be applied to men without sperm in the semen to allow these couples to undergo IVF with the man’s sperm.

http://www.urologyhealth.org/adult/index.cfm?cat=11&topic=38
http://www.urologyhealth.org/adult/index.cfm?cat=11&topic=129

Varicocele

A varicocele is a dilation of the veins from the testicle. Forty percent of men presenting with infertility have a varicocele and this is the most common correctable cause of male infertility. The varicocele can be repaired through an approximately two inch incision made in the groin. This is performed as a day surgery and the patient may return to full activity in one week. Seventy percent of men with infertility, abnormal sperm counts or abnormal sperm function, and a varicocele will have improvement in sperm counts/function after varicocele repair. Dr. Kavoussi is fellowship trained in microscopic varicocele surgery.

http://www.urologyhealth.org/adult/index.cfm?cat=01&topic=510

Sperm Retrieval

It is known that 1% of all men will have no sperm in their semen and 10-15% of infertile men will have no sperm in their semen. In such cases or in cases when a man has a non-surgically correctable blockage not allowing the sperm to reach the semen, there are still options to retrieve sperm that can be used in combination with assisted reproductive techniques such as in vitro fertilization (IVF) to successfully achieve a pregnancy. There are multiple options for retrieving sperm including percutaneous epididymal sperm aspiration (PESA) where aspiration is performed from the epididymis (the structure connecting the testicle to the vas deferens), microsurgical epididymal sperm aspiration (MESA), testicular sperm aspiration (TESA) aspirating sperm directly from the testicle, testicular sperm extraction (TESE), and microdissection testicular sperm extraction (microTESE).

MicroTESE is a specialized procedure used for men without sperm in the semen who do not have a blockage. Genetic testing is done prior to the procedure to give us an understanding of what the odds are of finding sperm at the time of sperm retrieval. A precise microsurgical technique is then used to look for possible pockets of sperm production throughout the testicle under the visualization of an operative microscope to find sperm that can be used in combination with IVF. The success rates of retrieving sperm using this procedure are highly dependent on the experience of the microsurgeon. Dr. Kavoussi is specialty fellowship trained in microsurgery to find such pockets of sperm production to allow these couples a chance to achieve a pregnancy with the man's sperm.

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