In the United States, one in seven couples has difficulty achieving a pregnancy. In approximately 20% of these couples, the cause is solely a male factor issue. In an additional 30%-40% of subfertile couples, there are both male and female factors impacting the ability to conceive. This means that 50%-60% of subfertile couples have some male factor involvement. It is important to optimize both sides in such couples to give them the best chance at achieving a pregnancy. The man in these couples should be evaluated by a Reproductive Urologist.
What is a Reproductive Urologist? A Reproductive Urologist is a Urologist who went through subspecialty fellowship training after general Urology training to become an expert in evaluating and treating men for fertility issues and any associated conditions. Dr. Parviz Kavoussi at Austin Fertility & Reproductive Medicine is a fellowship trained Reproductive Urologist. He states, “as the incidence of male subfertility is increasing over time in the US, it is very important for subfertile couples to consider a male factor evaluation.” He provides care for men in all areas of subfertility and associated conditions. This includes evaluation and treatment of men with abnormal semen analysis parameters, men desiring vasectomy reversals, men with no sperm in the semen, and men with difficulty conceiving due to hormonal, genetic, anatomic abnormalities and erectile/ejaculatory dysfunction. Other fertility centers loosely associate themselves with general urologists who are not fellowship subspecialty trained in Reproductive Urology and whose practices primarily consist of treating general urology problems. For highly specialized procedures such as microsurgical or robot assisted vasectomy reversals, microsurgical varicocele repairs (repairing dilated veins around the testicles which can impact fertility), and microdissection testicular sperm extraction (microTESE, which is a meticulous surgical exploration through the testicle to find microscopic sperm pockets in the testicle to use with IVF for men with no sperm in the semen and no anatomic blockage), a Reproductive Urologist will give the highest odds of success. There has been data showing this: https://www.austinfertility.com/wp-content/uploads/2014/05/www.sciencecodex.com_.pdf.
It is important that when a man is considering vasectomy reversal or microTESE that he knows the surgeon’s personal success rates in his/her own series, not that they are being quoted published success rates based on data published by expert Reproductive Urologists. Dr. Parviz Kavoussi’s vasectomy reversal success rates rival the best anywhere, and his microTESE sperm retrieval rates are higher than the average retrieval rates by experts in the field, allowing those couples who go through microTESE desiring to use the male partner’s sperm over a donor sperm backup, to have the highest odds to do so. Although Dr. Kavoussi treats many men who have failed these procedures with other physicians, the second time is more complex and difficulty. “The first shot is the best shot and it is much more difficult to match first time success rates with redo operations”. He states, “it makes sense that the fewer things a physician does, and the more of those few things he does repeatedly, the better his success rates will be for his patients”. Dr. Kavoussi does not practice general urology such as management of stones, prostates, or urinary problems. His practice is solely focused on Reproductive Urology to provide the highest level of fertility care along with the Reproductive Endocrinologists at Austin Fertility & Reproductive Medicine.