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Male Reproductive Health
Center
It is the goal of the Male Reproductive Health Center and Laboratory
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 timeframes, desires and financial constraints
all couples bring to bear.
Health Center Services
The Male Reproductive Health Center at UCSF is a full-service
facility that treats the entire spectrum of male infertility problems.
It is the goal of the Center to deliver customer-oriented, individualized
and cost-sensitive care to every patient.
Consultations with Thomas Walsh,
MD, MS are
very information-oriented sessions that are based upon the principles
of decision analysis and evidence-based medicine. Walsh is a
fellowship trained microsurgeon whose practice is wholly devoted
to the diagnosis and treatment of infertility. This center 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).
The Center specializes in the full range of microsurgical procedures
and medical treatments currently available for male infertility.
Blockages in the male reproductive system, mechanical problems
with ejaculation and difficulties with low sperm production are
commonly seen and treated conditions at the Center. Some of the
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 offered by the Center are described
on this web page.
| 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 & 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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Offers 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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Subinguinal varicocele repair with microscope
is offered. |
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Non-surgical treatment options available-Xray
embolization |
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Diagnosis
of Azoospermia |
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Formal office consultation including history
and physical examination, hormones and semen analysis with
centrifuged pellet. |
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Testis biopsy and fine needle aspiration techniques
available to determine sperm production 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 (PROGENI)
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 the
diagnosis, including 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 at the Center 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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Testis biopsy review and consultation (for biopsies
performed elsewhere) |
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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) |
Laboratory Services
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. In addition, the
Male Reproductive Laboratory is unqiuely and intricately associated
with the UCSF IVF Embryology Laboratory where IVF and ICSI are
performed. This association has formed the basis for an integrated
approach to the treatment of infertility and underlies much
of the research in technology performed by the Center.
| 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
A special service provided by the Center includes long
term storage of ejaculated sperm (1or 5 years) and short
term storage of sperm aspirated during surgical procedures.
Dr. Walsh provides 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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C. Goal-oriented, individualized approach to
determine quantity and length of storage needed. |
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Contents of This Page
Faculty
Thomas Walsh,
MD, MS
Key Staff
Gina Davis, MS, CGC
Genetic Counselor
davisg@obgyn.ucsf.edu
415/353-7397
Liza Jalalian CMT, Laboratory Technician
Appointments & Location
Center
for Reproductive Health
UCSF Women's Health Center
2356 Sutter Street, 3rd Floor
Contact Number
Patient Consultation: 415/353-7475
Fax: 415/353-7744
Patient Handouts
Visit our Patient
Guides to Urological Treatments section to download Patient
Handouts.
Related Links
Center for Reproductive Health
http://www.ucsfivf.org/
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