Fertility Archives - Page 3 of 4 - Urology Clinics Manchester

Sperm retrieval

July 10, 2023 in Fertility

When a man hears the words that he is infertile and sterile, he may understandably assume that he is out of options for becoming a biological father. In reality, most sterile men have viable sperm in the male reproductive tract that can be used to fertilize an egg.

A sperm retrieval procedure is a process that carefully harvests this sperm so that it can be used to achieve pregnancy with assisted reproductive technology. It is a valuable tool for men with azoospermia (i.e., no sperm in the ejaculate) or who cannot ejaculate at all. Depending on your circumstances it may be used as an alternative to, or in conjunction with corrective surgery to maximise the chances of achieving a successful pregnancy.

The procedure used will depend on the outcome of your tests and the nature of exploration. Testicular Sperm Aspiration (TESA) is a simple procedure to extract some of the substance of one (or preferably both) testes for further analysis (e.g. with Obstructive Azoospermia). At the same time, testicular tissue is frozen so that any sperm present can be subsequently used.

Sperm retrieved from organs in the reproductive tract are not considered fully mature or fertilizable. They may be fine genetically, but they have not learned how to move, find an egg or meet and penetrate the egg. Those processes are learned as the sperm pass through the organs of the reproductive tract. As the sperm is not fully mature, assisted reproduction through intrauterine insemination (IUI), in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) is needed to result in pregnancy.

Who may be recommended a sperm retrieval?

A sperm retrieval might be recommended for patients that have no sperm in the ejaculate and have had one or more failed IVF cycles. If the lack of sperm is caused by an obstruction this can be a very successful procedure.

There are two reasons why sperm may not be reaching the ejaculate.

Obstructive azoospermia – the testicles are producing sperm; however, an obstruction is preventing it from reaching the ejaculate
Non-obstructive azoospermia – this refers to a condition meaning that no (or only a small amount) sperm is produced, therefore meaning there is none in the ejaculate.

If you would like to speak to our team about our sperm retrieval procedures, please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Fertility Screening

June 19, 2023 in Fertility

Individuals and couples may have concerns about their fertility status or may want to optimise their fertility for when the time comes to start a family.

For some patients, they look to get fertility screening prior to trying to conceive to try to determine whether there may or may not be any complications when the time comes. The reason for this is because any fertility issues could be identified earlier, issues that would normally only have been discovered on investigation, perhaps after several years of trying to conceive, thus allowing earlier action and treatment.

These are the usual checkpoints for fertility screening:

Medical History: Overview of your medical, surgical and family history to assess any factor that may impact on fertility
Lifestyle Advice: Assessment of your lifestyle factors and advice on any modifications that may be of benefit
Semen Analysis: Assessment of a semen sample to look at sperm number, movement and structure.
Summary Report: You will receive copies of the test results as well as a detailed explanation of their meaning and any recommendations.

Male fertility screening will help you to understand your fertility status. The semen is analysed and with the results, you will understand your fertility status and ability to conceive.

The most common causes of male infertility are associated with sperm abnormalities, therefore, initial investigations for the male include a semen analysis which examines the density (sperm count), morphology (shape) and mobility of sperm. A normal sperm count would be measured at around 15 million sperm per millilitre of semen.

What is analysed

The following parameters will be examined in a semen analysis:

The number of sperm present within the ejaculate (the sperm count)
The number of sperm that are moving (mobility)
The number of sperm that are normally formed (morphology)
Whether or not there are anti-sperm antibodies present (in cases of poor sperm parameters)
Whether there are any observable infections present within the sample

Depending on your diagnosis, you may find that you need to draw on reserves that you never knew you had and there are a variety of ways to be able to father a child through advances in fertility treatment.

Many male infertility diagnoses can be successfully treated.

If you would like to speak to our team about fertility screening, please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Male factor infertility

June 5, 2023 in Fertility

Male factor infertility is defined as ‘the presence of abnormal semen parameters or sperm functional assays’, or ‘the functional inability to adequately deliver semen into the vaginal canal’, by the male partner of an opposite-sex couple who are unable to achieve conception after trying for 1 year of unprotected intercourse.

Male factor infertility alone contributes up to around 30% of cases of infertile opposite-sex couples and to an additional 30% to 40% in combination with other factors.

Most cases are of unknown causes. However, there are a number of tests that can be done to try to understand the cause. These is the usual pathway for a patient.

History and exams that are usually taken and these consist of:

Key diagnostic factors

presence of risk factors
inability of an opposite-sex couple to conceive
vasectomy
palpable and dilated testicular veins

Other diagnostic factors that are considered:

headaches, galactorrhoea, and visual disturbance
anosmia
frequent respiratory infections
pain, blood, or pus with ejaculation

Risk factors

varicocele
cryptorchidism
prior chemotherapy or radiotherapy
current medications

Diagnostic investigations that might be performed include:

Investigations usually consist of:

sperm concentration
sperm motility
sperm morphology
seminal fluid parameters

Other investigations that are considered:

sperm viability
sperm membrane function
MRI of the pituitary and hypothalamus
hormonal assays

Assisted reproductive techniques such as TESA, PESA and MicroTESE are often the fastest and most effective method to achieve pregnancy regardless of the cause of male factor infertility.

If you would like to speak to our team about male factor infertility, please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Thinking of a vasectomy reversal?

March 7, 2023 in Fertility

Thinking of a vasectomy reversal? In life, sometimes your situation changes, and a vasectomy is no longer the best option for your needs. Whether you have remarried or had a change of heart, Urology Clinics Manchester can help restore your fertility with a vasectomy reversal procedure.

A vasectomy is a very popular contraceptive for men. After a vasectomy procedure, sperm is no longer able to leave your body when you ejaculate. However, your testicles continue to produce sperm, so a reversal may be possible should you decide to reverse this.

Although vasectomies are claimed to be a a permanent contraception method, they can be reversed. A small, but significant subset of men who undergo a vasectomy decide to reverse the procedure.

There are multiple reasons you might decide to get a vasectomy, even if you were certain at the time of having a vasectomy. Our lives can change unexpectedly. One common reason is that you have re-married and would like to start a family with your current partner. You may have simply changed your mind about parenthood or having additional children.

Vasectomy reversals are more complicated and involved procedures than vasectomies. The procedure involves rejoining your vas deferens so that they can, once again, carry sperm from your body.

A vasectomy reversal involves one of two methods:

Vasovasostomy – A vasovasostomy involves reconnecting the vas deferens. A vasoepididymostomy involves connecting the vas deferens directly to the epididymis, the small structure that connects your testicles to your vas deferens.
Vasoepididymostomy – A vasoepididymostomy is a longer, more complicated procedure than a vasovasostomy.

Our consultants are more likely to perform a vasoepididymostomy if your vasectomy was a very long time ago, or if they think that a vasovasostomy would not work. We will discuss in detail which option is best.

The procedure usually takes two to four hours, depending on the technique used, and you are under a general anaesthetic whilst undergoing the procedure for a vasectomy reversal. You are then go home the same day.

You might be sore for a few days to a week after the procedure. Our consultants will provide detailed aftercare instructions and may prescribe pain medication if needed.

It may take six months to a year before your fertility returns after the procedure. It is recommended to have a semen analysis at 3 months after to look at your sperm count and quality.

If you would like to speak to our team about vasectomy reversal options, please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk.

7 smoking related urological conditions

December 20, 2021 in Bladder, Fertility, Kidney, Penile, Testes

Everyone that does or does not smoke will know that it can have a major impact on your health. Each year millions of people die prematurely due to smoking related illnesses. In this blog we will highlight smoking relating urological conditions.

Bladder cancer – every year around 10,000 people are diagnosed with bladder cancer. Smoking causes harmful chemicals to collect in your urine. These chemicals can have a big effect on the lining of the bladder and increase the risk of developing bladder cancer.
Erectile disfunction – around 1 in 5 men experience erectile dysfunction in the UK. Smoking can harm blood vessels, therefore affecting the flow of blood to the penis. Erectile dysfunction can have a serious effect on sexual intercourse and a man’s self esteem.
Kidney cancer – kidney cancer is the 9^th most common cancer in the UK for both men and women. The harmful toxins in a cigarette enter the blood stream which is then filtered through by the kidneys. These toxins and chemicals can increase your risk of getting kidney cancer.
Kidney stones – research has shown that the risk of getting kidney stones is increased if you smoke.
Painful bladder syndrome – this condition is more common in women than men. As smoking irritates the lining of the bladder, it can worsen the symptoms of painful bladder syndrome.
Incontinence – urinary incontinence is an extremely common condition, especially for those that smoke. Coughing fits caused by smoking can worsen the frequency of incontinence and lead to stress incontinence.
Infertility – this affects both men and women. Smoking can chance the genetic makeup of in both eggs and sperm. Did you know that the infertility rate in smokers is twice the rate of those who do not smoke?

If you need help with quitting smoking then you should speak to your GP about getting the right help. Sometimes a simple change can improve your health significantly!

Hypogonadism

November 9, 2021 in Fertility, Penile, Testes

Hypogonadism is a condition that affects the sex gland in both men and women called the Gonads. Patients with hypogonadism produce little to no sex hormones, which can lead to low sex drive or libido.

For the purpose of this blog, we will focus on the effect on men.

Testicles in the male reproductive system are responsible for producing testosterone, which is the main male sex hormone. If you have hypogonadism this means that your testosterone level is low.

Hypogonadism can either be caused by a problem with the productive system or a problem within the brain

Primary hypogonadism: A problem within the sex glands that slows or stops hormone production.
Secondary (central) hypogonadism: A problem with brain signals that affects hormone production (pituitary gland or hypothalamus)

As we get into our late 40’s/50’s the production of sex hormones naturally goes down; resulting in a reduced sex drive. These changes are normal so it is important to note that it is not necessarily the hypothalamus. If reduced libido and sex drive occurs in younger men then this may be linked to hypogonadism.

Here are some of the most common causes of primary and secondary hypogonadism:

Primary

Conditions such as diabetes and Addison’s Disease (affecting the adrenal gland)
Cancer treatments such as chemotherapy or radiotherapy
Genetic disorders such as Klinefelter syndrome
Undescended testicles
Liver or kidney disease
Previous surgery on the reproductive system

Secondary

Obesity
Pituitary disorders
Use of steroids or opiods
Previous brain surgery or cancer treatment
Infections

These are just some of the possible causes.

Here are some of the most common signs and symptoms in men:

Enlarged breasts tissue
Erectile dysfunction
Infertility (this is related to the low sperm count)
Muscle loss

There are two main ways that hypogonadism can be diagnosed in men:

A blood test – this looks at the different levels in the blood
Semen analysis – this looks at the amount and quality of sperm

If you would like to speak to our team about hypogonadism please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

DNA fragmentation test

August 20, 2021 in Fertility

DNA fragmentation test is a male fertility test which can be used in conjunction with a semen analysis to assess the quality of the sperm. A semen analysis assesses the quantity and motility of sperm whilst a DNA fragmentation test can assess the levels of fragmentations of the sperm DNA to determine the quality of the sperm. It can be a very useful test to have if you are struggling with male fertility problems as it gives a fuller picture of the situation. During this test, a urologist that specialises in the treatment and investigation of male fertility will look at the quality of a man’s sperm. By doing this help it can help to identify any DNA damage to sperm that may be affecting fertility.

Results show that damage to the DNA of sperm can have a major effect on male fertility and therefore the chance of becoming a parent, which is why DNA fragmentation testing is so important. For many years fertility problems were thought to primarily stem from the female partner, however research has shown that 50% is actually related to male factor.

So how is a DNA fragmentation test done?

A sample of sperm is taken then analysed by an expert in male fertility. From this they are able to test if there is damage to the DNA of sperm cells, assess what might be causing it and if there are any treatments that can be recommended to improve the quality of the sperm and chances of getting pregnant.

Infertility can be a very difficult and emotionally challenging situation for a couple to go through so it is important that you get the relevant tests sooner rather than later. We recommend that couple that have been try for baby for over a year or have had failed fertility treatment should have a DNA fragmentation test to identify any male fertility factors or rule out any issues.

At Urology Clinics Manchester, our fertility clinic and DNA fragmentation testing is all done by a urologist specialising in male fertility, to ensure that all our patients receive the highest quality of care.

If you would like to speak to our team about having a DNA fragmentation test please call us on 0161 327 1269 or email us at info@urologyclinics.co.uk

Thinking of having a vasectomy reversal?

July 7, 2021 in Fertility, Penile, Testes

Are you thinking of having a vasectomy reversal? Do you know all the facts?

What is a vasectomy?

A vasectomy is a surgical procedure performed on men to make them sterile or to be used as a long-term contraception. During the procedure the vas deferens (a duct that takes sperm from the testicles to the urethra) are cut and tied or sealed to prevent the delivery of sperm.

What is a vasectomy reversal?

A vasectomy reversal is usually requested when a couple decide to try for more children. During the procedure the previous cut ends of the vas deferens are put back together to ensure that the sperm cells can travel to the urethra from the testicles. This procedure can usually be done in 2 hours and is done under general anaesthetic. A vasectomy reversal is a common procedure that has a success rate of around 95%. At our practice we have been serving the North West for almost a decade, helping patients to achieve their wish of expand their family.

What are the risks and side effects of having a vasectomy reversal?

Any operation that requires you to go under general anaesthetic carries risks, however these are generally quite small. Please discuss any concerns with medical staff before the procedure, so that you have a full understanding of what will happen.

Side effects

Common- you will experience some pain and discomfort after the operation. You are advised to take pain killers for 2-3 days.
Occasional- after this operation, infection and/or swelling may occur in the scrotum or wound. If this occurs you may require further treatment.
Rare- bleeding after the operation may occur which may result in bruising and swelling of the scrotum; which may result in further treatment.

Please contact us to find out any further information about this operation.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Mens Health

June 16, 2021 in Bladder, Fertility, Kidney, Penile, Prostate, Testes

This week is men’s health week (14th-20th June 2021). While the focus is on men’s mental health, we also think it is important that we talk about men’s physical health. Since lockdown last year the way we see our GPs has changed. We hope to answer some of your men’s health questions that you may not have answers to. Simple, yet very important!

Fatigue, weight gain, hair loss and changes to sexual behaviours may be caused by a low level of testosterone. This can be easily diagnosed with a blood test!
An enlarged prostate, medically known as benign prostatic hyperplasia, is not a warning sign of cancer. It can however cause uncomfortable symptoms such as pain when urinating or urinary incontinence.
Prostate cancer is the second most deadly cancer for men in the UK. When caught early it can be very treatable. Always attend your prostate examinations!
Erectile dysfunction should not be considered normal and is not something that comes with age. If you are suffering from erectile dysfunction it is important that you speak to a medical professional about possible causes and treatment.
Men between the ages of 20-40 are most likely to have a tumour that is caused by testicular cancer. It is important that you carry out self-examinations and go and get any changes checked out.
A prostate specific antigen (PSA) test can pick up inflammation and even cancer of the prostate by looking at the levels of protein in the blood. It is important that you have this test annually.

If you have noticed any urological changes and would like to speak to a specialist at Urology Clinics Manchester please call us on 01613271269 or email us on info@urologyclinics.co.uk

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.

Erectile dysfunction & the possible treatments

May 18, 2021 in Fertility, Penile

Erectile dysfunction is the inability to get or maintain an erection in order to have sexual intercourse. Although it is more common in older men, around 25% of men under the age of 40 are affected by erectile dysfunction.

If you are suffering with erectile problems, it could be caused by a number of different reasons. These can include:

Problems with blood flow
Diabetes causing nerve damage or a low testosterone level

The best initial step is to seek your GPs opinion; as come cases can easily be dealt with. If you are referred to a specialist you will need a blood test at your consultation to check for any unknown causes for the erectile problem. In many cases the erectile dysfunction cannot be cured, however symptoms can be managed by using medication such as Viagra or Cialis.

It always helps to maintain a healthy and active life style, with a balanced diet to ensure that your weight stays at a healthy level. Reducing habits such as smoking and drinking can also help minimise the risk of developing erectile dysfunction.

Many men with erectile dysfunction (ED) have this problem due to a reduction of blood flow to the into penis. Previous research has shown sufferers of heart disease benefit from shocks waves over a period of time to help promote the growth of new blood vessels, which can tell to prevent further heart problems. This research has been extrapolated to help find a treatment for ED patients.

ED 1000 therapy is a relativity new treatment. The process is 9 weeks long, and uses small shock waves to help increase the number of blood vessels and therefore improve the flow of blood to the penis. The treatment consists of two 20-minute treatments a week for three weeks, then a three-week break followed by a further two treatments a week for three weeks. The pain free treatment is done in an outpatient clinic while the patient is awake and does not affect any day to day activities. Research has shown that the effects of ED 1000 can last over two years.

This treatment helps to increase the number of men who benefit from the use of medications such as Viagra, therefore resulting in a better patient satisfaction rate. Medical trials have shown that ED 1000 therapy can help two thirds of men achieve better erections with medications such as Viagra. Although this treatment is primarily for patients with vascular related erectile dysfunction, ED 1000 therapy has also been used to treat patients with ED problems related to diabetes.

Urology Clinics Manchester are currently the only clinic in the North West of England that offers ED 1000 Therapy. Please contact us to find out more or if you wish to known if ED 1000 is the right treatment for you. Often patients will come to us with a referral from their GP, however we also welcome self-referrals.

If you have never seen a specialist about your erectile dysfunction, we can offer a full consultation with the appropriate tests as needed prior to receiving the ED 1000 therapy.

Please note that the ED 1000 treatment is given at the discretion of the specialist. A consultation with us does not grantee that ED 1000 is the right treatment plan for you.

This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.