Manhattan & Queens · All Five Boroughs
Home · Conditions · Male Infertility
Men's health · Fertility
In roughly half of couples who have trouble conceiving, a male factor plays a part, yet the man is often the last to be examined. A focused urology evaluation is quick, largely non-invasive and frequently finds something that can be fixed.
The usual advice is to seek evaluation after a year of trying, or after six months if the female partner is over 35. Come sooner if you have had undescended testicles, a hernia or scrotal surgery, testicular injury, chemotherapy, a known varicocele, low libido or erection problems, or if you are using or have used testosterone or anabolic steroids.
The cornerstone test measures volume, sperm concentration, motility and shape. Because results vary from sample to sample, a single abnormal result is usually repeated before conclusions are drawn.
Testosterone, FSH, LH and related tests show whether the testicles are being told to make sperm and whether they are responding.
A physical exam and scrotal ultrasound done at your visit look for a varicocele, blockage, or anything in the testicle that needs attention.
A varicocele, a cluster of enlarged veins above the testicle, is the most common correctable cause. It warms the testicle, and the scrotum is a thermostat: sperm production needs it cooler than the rest of the body. Our interventional radiology team treats varicoceles by embolization, closing the vein from inside through a pinhole in a vein rather than a surgical incision.
Testosterone therapy is another cause we see often. Testosterone from the outside tells the brain to stop signaling the testicles, and sperm production falls, sometimes to zero. Many men were never told this before starting. If you want children, we plan fertility-conscious alternatives that raise your own production instead, and help you come off safely.
Other factors include infections, medications, heat exposure, heavy alcohol or cannabis use, obesity and, less commonly, genetic conditions or a blockage.
When a couple is already seeing a reproductive endocrinologist, we coordinate with them so the male side is treated in parallel instead of being skipped. Improving sperm quality can make assisted reproduction simpler, and sometimes unnecessary.
Book a consultation (212) 991-9991
A male factor contributes in about half of couples who struggle to conceive, which is why both partners should be evaluated early.
Yes. External testosterone suppresses the signals that drive sperm production and can drop the sperm count to zero. Men who want children should discuss alternatives before starting or while stopping.
In men with a palpable varicocele and abnormal semen parameters, treatment often improves sperm quality. Embolization treats it without a surgical incision.
Sperm take about three months to develop, so changes in lifestyle, medication or a varicocele treatment are judged on a semen analysis roughly three months later.
No. You can book directly with our office.
Book a men's-health visit at our Manhattan or Forest Hills office — a simple step that's easy to keep putting off.
Manhattan & Queens · All Five Boroughs