Male infertility was traditionally the domain of practicing Urologists. Infertile males are diagnosed and treated in Dr. Plawner’s practice.
Infertility is usually defined as the inability to conceive after at least one year of unprotected intercourse. Since most couples are able to conceive within twelve months the evaluation of the infertile couple may start there.
Usually the evaluation starts with the male by taking a detailed history and performing a physical examination with a special focus on genito-urinary organs.
Special attention is focused on the presence of enlarged scrotal veins, size, shape and consistency of the testicles and its appendages, epididymis, vas deferens and spermatic cord.
The prostate is routinely examined as it provides the liquid part of the semen.
The patient is questioned for possible erectile and ejaculatory dysfunction (premature ejaculation).
The patient is required to perform a semen analysis to assess the quality of the ejaculate and also to perform hormonal blood test to assess the integrity of the endocrine (hormonal) balance that influences the production of sperm by the testicles.
In patients who demonstrated abnormal values (number, morphology and motility) of the semen that make the pregnancy unlikely, the treatment is geared to reverse the values of these parameters to normal levels. This can be accomplished by surgery or by application of THD device.
Surgery: usually consists to remove the varicose veins surrounding the testis. It is a minor surgery that sometimes may be performed under a microscope.
THD: is an acronym for Testicular Hypothermia Device. It is a device where heat convection lowers the temperature inside the scrotum and over time improves the semen quality. The increased temperature in the scrotum is caused by pooling in the varicose veins blood from the abdomen that is 1-2 centigrade of Celsius warmer. Over time the equalization of temperatures in the scrotum and abdomen causes poor semen maturation and causes a decrease in numbers, increases the number of sperms with poor motility and morphology.
The THD device reverses that. Dr. A. Zorgniotti and the inventor of this device Mr. A.Sealfon published very favorable results with this method of treatment in Journal of Urology. J Urol 1986;135:944-7.
Today highly specialized Infertility Clinics offer additional options to infertile couples, namely ART – artificial reproductive technologies where the Urologist is part of the team.
ART consist of retrieving a healthy sperm(s) and fertilizing an egg(s). Dr. Plawner is affiliated with such a Clinic.
If you suspect that you may have a fertility issue that may be helped by a urology specialist, and are looking for a urologist in NY (Manhattan or Brooklyn office), or urology specialist in NJ (Nutley office), contact Dr. Plawner by calling (212) 737-2330 for a consultation.