It is our goal
to provide state-of-the-art andrological services to infertile
couples in a context of individualized patient care. In this
way, treatments are designed to suit each couple's particular
needs and goals, working within the timeframes, desires and
financial constraints of each individual couple.
We are a full-service
facility that treats the entire spectrum of male infertility
problems. It is our goal to deliver customer-oriented,
individualized and cost-sensitive care to every patient.
Consultations with our physicians are
information oriented sessions based on the principles
of decision analysis and evidence-based medicine. Our male reproductive
health group works closely with the UCSF Fertility and IVF Group
to provide state-of-the-art management of infertility with the
use of assisted reproductive technologies like Intracytoplasmic
Sperm Injection (ICSI) with in vitro fertilization (IVF).
We specialize in the full range of microsurgical procedures
and medical treatments available for male infertility.
Conditions we commonly see and treat include blockages in
the male reproductive system, mechanical problems with ejaculation
and difficulties with low sperm production.
Some of our more specialized treatments include electroejaculation;
microscopic vasovasostomy and epididymovasostomy with sperm
banking at surgery; and vasal, epididymal and testicular sperm
retrieval. Several established care-packages are described
on this web page.
Fertility
Preservation for Cancer Patients |
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All patients seen within 24 to 48 hours by calling the
fertility preservation hotline at 415/353-9115 |
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Assessment of fertility preservation options |
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Education and counseling |
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Access to the full range fertility services at an accelerated
pace |
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| Vasovasostomy/Epididymovasostomy
for Vasectomy |
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Use of microscope for all procedures |
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Performed by a formally trained
microsurgeon |
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Use of "invagination"
technique for epididymovasostomy |
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Surgery on a "come and go"
basis and "packaged priced" |
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Offers banking of ejaculated motile
sperm after procedure |
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Aspiration
Techniques for Sperm Retrieval |
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Performed under local anesthesia
on a "come and go" basis |
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Freshly aspirated sperm retrieved "on
call" for use with ICSI |
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"Package priced" procedures |
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Microscopic vas deferens sperm retrieval |
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Mini-MESA epididymal sperm retrieval |
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Testis sperm retrieval by fine needle aspiration
(TESA) or biopsy (TESE) |
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Varicocele
Diagnosis and Treatment |
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Sophisticated doppler ultrasound techniques available
to diagnosis varicoceles or to evaluate suspected recurrences |
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All surgical treatment options available including
laparoscopy and incisional techniques, performed on a "come
and go" basis |
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Microscopic subinguinal varicocele repair |
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Non-surgical treatment options available (e.g. embolization) |
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Diagnosis
of Azoospermia |
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A formal office consultation, to include history
and physical examination, and hormones and semen analysis
with centrifuged pellet |
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Testis biopsy and fine needle aspiration techniques
available to determine sperm production level within the
testis |
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"Sperm Mapping" of the testis using
a fine needle technique in men with non-obstructive azoospermia
under local anesthesia in the office |
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Genetic testing and counseling services (Program
in the Genetics of Infertility)
for those men who may have a genetic reason for azoospermia |
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| Anejaculation
Diagnosis and Treatment |
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Formal consultation available for men who cannot
ejaculate because of spinal cord injury, surgery or other
reasons |
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Newest techniques available including vibratory
stimulation, electroejaculation and sexual counseling |
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Sperm banking and sperm processing on the day
of procedure |
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Collaboration with a full range of assisted reproductive
services: |
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1) Sperm insemination (IUI)
2) In vitro fertilization (IVF)
3) Single sperm injection (ICSI) |
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Ejaculatory
Duct Obstruction |
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Formal consultation and assessment for men with
infertility, painful ejaculation, or blood or stones in
the ejaculate |
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Sophisticated testing available to confirm a
diagnosis, tests include transrectal ultrasound and transrectal
seminovesculography as well as vasography and seminal
vesicle needle aspiration |
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Transrectal ultrasound-guided endoscopic resection
techniques available to treat ejaculatory duct obstruction |
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Diagnostic
Procedures
Other areas of expertise include
the routine use of diagnostic procedures: |
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Cystoscopy |
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Microscopic vasography |
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Transrectal ultrasound-guided vasography |
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Transurethral or endoscopic vasography |
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Transrectal ultrasound |
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Scrotal ultrasound |
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Testis biopsy |
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Fine needle aspiration "mapping" of
testes in cases of testis failure |
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Additional
Treatments
In addition to the other services mentioned on this site,
additional treatment options offered to infertile men include: |
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Medical therapy |
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Hormone replacement therapy |
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Spermatocele excision |
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Epididymal cyst unroofing |
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Bladder harvest of sperm (retrograde ejaculation) |
The male reproductive laboratory offers a complete range of
diagnostic tests for sperm disorders. The UCSF Cryobank is a
full-service, sperm banking facility that serves as resource
for patients interested in sperm banking. In addition, a recently
opened UCSF donor cryobank offers cryopreserved donor sperm
for the convenient use of bay area residents. The
male reproductive laboratory is associated
with the UCSF IVF Embryology Laboratory where IVF and ICSI are
performed. This association is the basis of an integrated
approach to the treatment of infertility and underlies much
of the research in technology performed by our group.
| Laboratory
Diagnostic Services |
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Semen analysis with WHO morphology |
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Kruger morphology |
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Antisperm antibodies |
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Monoclonal antibody assay for white
blood cells |
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Seminal fructose and pH |
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Post-ejaculate urinalysis |
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Sperm vital staining |
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Hyposmotic swelling sperm viability
test |
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Sperm electron microscopy |
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Sperm cryopreservation (aspirated
and ejaculated) |
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Sperm
Cryopreservation
We provided both long-term storage of ejaculated sperm
(1 or 5 years) and short term storage of sperm aspirated
during surgical procedures. Our physicians provide a consultation
service for patients that involves: |
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Infertility evaluation as part of
consultation |
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Discussion of banked sperm quality after "test
thaw" performed |
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Goal-oriented, individualized approach to
determine quantity and length of storage needed |
