Thomas J. Walsh, MD, MS

Clinical Interests

Male Infertility and Reproductive Health
Walsh is the Director of Male Reproductive Health services in the UCSF Center for Reproductive Health. The center provides comprehensive and multidisciplinary care to address the entire spectrum of male infertility problems. By working closely with female infertility experts, the center is able to provide state-of-the-art medical and surgical treatment for infertility, including:

• Semen analysis, sperm processing and functional testing
• Genetic testing and counseling through the Program in the Genetics in Infertility (PROGENI)
• Non-invasive and microsurgical sperm retrieval procedures combined with intracytoplasmic sperm injection (ICSI)
• Fertility preservation through sperm cryopreservation
• Microsurgical vasectomy reversal
• Varicocele evaluation and treatment
• Hormone evaluation and replacement
• Vasectomy (no scalpel technique)

Research Interests

Walsh’s background in epidemiology and public health has influenced his research interests. The causes, impacts, and outcomes of male infertility and its treatments are poorly understood. The study of male infertility has been limited by the lack of centralized data registries to follow and record male reproductive health over time. The underlying aim of Walsh’s research is to assemble populations of fertile and infertile men of reproductive age, in whom data can be collected in order to clarify the impact of genetics, the environment and other health conditions on male reproductive health. Additionally, Walsh aims to understand how male infertility may impact general health later in life. His specific research projects are summarized below.

Varicoceles: Predictors of Poor Semen Quality and Successful Surgical Treatment
Varicoceles are a common, reversible cause of male infertility. This study aims to identify the risk-factors for poor testicular function and poor sperm production in men with varicocele, and to identify what factors predict improved function after microsurgical varicocelectomy.
Investigators: Alex K. Wu, BS; Mary S. Croughan, PhD; Thomas J. Walsh, MD, MS; Paul J. Turek, MD

Quality of Life in Men’s Reproductive Health
This research aims to identify key factors that contribute to quality of life in men with infertility. The study will look specifically at the financial, emotional and relationship burden that infertility imposes on individuals and couples. Patients will be recruited to participate in this project which will begin June, 2008.
Investigators: James F. Smith, MD, MS; Patricia P. Katz, PhD; Thomas J. Walsh, MD, MS

Financial Impact of Infertility
Infertility treatment can be costly. By analyzing data collected from 425 couples over 18 months Walsh and his collaborators seek to determine the cost of infertility from both an institutional and couple-level perspective.
Investigators: James F. Smith, MD, MS; Thomas J. Walsh, MD, MS; Patricia P. Katz, PhD            

Cost-Effectiveness Analysis of Infertility Care
Using modern decision analysis techniques Walsh and his collaborators are working to answer a series of questions related to the costs and benefits of infertility care.
Investigators: James F. Smith, MD, MS; Simon Conti, BS; Thomas J. Walsh, MD, MS; Patricia P. Katz, PhD

The Benefit of Early Treatment for Undescended Testicles (Cryptorchidism)
The failure of a testicle to descend normally into the scrotum during infancy (cryptorchidism) may cause decreased fertility and increase the risk for testis cancer. This study analyzes the results of several research studies with the aim of learning new information about the best time for surgical intervention.
Investigators: Paul J. Turek, MD; Thomas J. Walsh, MD, MS

Race and Ethnicity in Erectile Dysfunction
An analysis of 81,000 men in the Kaiser Permanente health care system seeks to estimate the role that race and ethnicity play in erectile dysfunction. The study is adjusted for the effects of age, medical co-morbidities and socio-demographic factors.                                                     
Investigators: James F. Smith, MD, MS; Thomas J. Walsh, MD, MS; Stephen K. Van Den Eeden, PhD 

Male Infertility and the Risk of Testicular Cancer
A worldwide increase in both testicular cancer rates and male infertility has been observed for the past five decades. Whether or not the two increases are connected is unclear. In an effort to determine if there is a relationship, we are studying the association between male infertility and the later development of testis cancer using data from the largest group of infertile men ever collected in the United States.
Investigators: James F. Smith, MD, MS; Mary S. Croughan, PhD; Thomas J. Walsh, MD, MS

Male Infertility and the Risk of Non-Germ Cell Cancers
Certain genetic abnormalities or environmental exposures may predispose men to both poor sperm production and the development of certain cancers. Specific cancers of interest include colorectal cancers, malignant melanoma and prostate cancer. The current study aims to evaluate a large cohort of infertile men with a median follow-up of more than 30 years to determine if infertile men are at higher risk for cancer development.
Investigators: Mary S. Croughan, PhD; June Chan, ScD; Thomas J. Walsh, MD, MS

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