Erectile Dysfunction – As many as 10% of men may experience psychosexual impotence (erectile dysfunction). This condition is defined as the inability to achieve or maintain a sexual erection. This condition can be caused by medications (blood pressure medications, most commonly), hormone imbalances, physical disease, and/or stress. Please feel free to discuss these issues openly with our physicians.

Sperm abnormalities – Abnormal semen analysis may be associated with infertility. High or low sperm counts, high or low semen ejaculate volume, motility problems, or sperm anatomy problems may be the underlying cause. Two separate semen analyses should be performed in the case of semen abnormalities. Please feel free to discuss these issues with our clinical staff.

Genetics – The importance of genetic evaluation in infertile males with severe oligospermia (sperm counts of less than 5 to 10 million per ejaculate) or non-obstructive azoospermia (absence of sperm in semen not due to blockage) has recently been established. These patients may have abnormalities in the number of chromosome (karyotype) or abnormalities in the structure of the male chromosome (microdeletion of the Y chromosome). Patients with azoospermia as a result of being born without two vas deferens have a mutation of a gene responsible for the disease of cystic fibrosis, but do not have the disease itself. Your physician may order genetic testing in the case of abnormal semen analysis (Reference – American Society of Reproductive Medicine Fact Sheet 8/01).

Obstruction – Blockage in the tube, which normally allows the sperm to exit the body may account for infertility. This blockage may be from birth or surgical (vasectomy). Your physician may evaluate this condition. Often times with obstruction, sperm can be surgically retrieved, and infertility can be cured.

Retrograde Ejaculation – Certain conditions are associated with the sperm or ejaculation going into the bladder and not exiting the body. Such conditions include diabetes, nerve conditions, prior surgery, cancers, and genital injury. Your physician may order evaluation of your urine to look for live sperm.

Hormones – Normal sperm production and sexual function are dependent upon normal hormone environment. A hormone evaluation should be performed if (1) a low sperm concentration is detected, (2) there is impaired sexual function, or (3) there are other signs of hormone disease. Hormone evaluation includes measurement of FSH, testosterone, LH, prolactin, and/or thyroid hormone. Your physician may order a hormone blood test in the case of abnormal semen analysis (Reference – American Society of Reproductive Medicine Fact Sheet 8/01).

Low sperm counts – Low sperm count is defined as sperm concentration lower than 20 million sperm/mL. In the case of low sperm counts, further testing may be indicated. During the recent years, significant advances have been made in treating low sperm counts. While medications and treatments have generally not found to be effective for raising the sperm count of the man, intrauterine insemination and In Vitro Fertilization have proven to be quite successful in cases of low sperm counts.

Erection Problems - As many as 10% of men may experience psychosexual impotence (erectile dysfunction). This condition is defined as the inability to achieve or maintain a sexual erection. This condition can be caused by medications (blood pressure medications, most commonly), hormone imbalances, physical disease, and/or stress. Please feel free to discuss these issues openly with our physicians. The following treatments are available for erection problems:

• Oral medications (Viagra™)



• Local injections



• Surgical penile implants



• Advanced treatments

Please feel to discuss sexual function or erection problems with your physician.