Shane T. Russell, MD

1)    Assessment of male fertility potential

• Careful review of reproductive history
• Semen testing- typically 2 recent good quality tests are needed to get an accurate idea of your fertility status.

•  Careful review of the medical, social, family, and reproductive history of   both you and your wife, which is facilitated by your filling out the ‘Male Reproductive questionnaire’ which will be sent to you prior to your initial appointment.

• A focused physical exam will be performed during your appointment.
  

• A standard panel of blood tests is typically ordered to evaluate hormone levels which can impact fertility.
  

• Semen testing- typically 2 recent good quality tests are needed to get an accurate idea of your fertility status.

• Further testing may be recommended depending on the particular findings found in your history, physical exam, standard blood tests, or semen testing.

• There will be a thorough review of test results with formulation of individualized treatment plans based on the fertility needs and timelines of each particular couple.

3)    Treatment of varicoceles

Varicoceles are dilated veins in the scrotum (similar to varicose veins in the legs), and are thought to develop from abnormalities in the valve mechanisms present in normal veins.  Varicoceles are quite common, being present in about 15-20% of the post-pubertal male population.  Small varicoceles typically do not cause problems, but larger varicoceles can cause increased temperatures in the scrotum due to pooling of blood in the enlarged scrotal veins.  This elevation in temperature over time can result in testicular damage and decreased sperm counts and quality.  Varicoceles are one of the most common causes of male factor infertility.  In properly selected patients, repair of varicoceles can significantly improve sperm numbers and quality in approximately 70% of cases.  If left untreated, varicoceles can cause a progressive decrease in sperm quality over time in some patients due to the persistent heat effect.  Also, some patients with varicoceles may also experience a chronic dull scrotal discomfort which typically improves with lying down.  If chronic scrotal pain is thought to be caused by a large varicocele, surgery cures or significantly improves the discomfort in approximately 85% of patients.

Varioceles can be treated in several ways.  One treatment option is outpatient microscopic surgical repair, in which the dilated veins are carefully ligated (tied off) using an operating microscope.  The other treatment option is embolization, in which a specially trained radiologist uses a transvenous catheter to permanently block the veins using small metal coils.  The choice of treatment is based on individual clinical parameters as well as the personal preferences of the patient. 

Male Reproductive Medicine of Southwest Ohio focuses exclusively on male infertility issues.  We work closely with the female partner’s gynecologist or female reproductive specialist to ensure top quality care individualized to the specific needs of each couple. 

Services that we offer:

1. Assessment of male   fertility potential
2. Evaluation and            treatment of male      factor infertility
   
3. Microsurgical repair of varicoceles