The only physicians in Austin and Round Rock with Specialty Fellowship training in Male Infertility, Vasectomy Reversals, and Reproductive Urology
Approximately 20% of cases of infertility are due solely to male factor, and an additional 30-40% of cases involve both male and female factor.
A man’s fertility can be affected by the following factors:
- Endocrine (hormonal)
- Chromosomal (genetic) disorders affecting sperm production and/or quality
- History of undescended testicle
- Varicocele (dilated veins around the testicle)
- History of infection of the testicle
- History of chemotherapy or radiation treatments
- Environmental toxins and occupational exposures
- Duct blockages
- Problems with ejaculation
- Unknown causes
Dr. Machen has written a chapter extensively describing all potential causes of male infertility in the textbook, Male Infertility.
Dr. Kavoussi and Dr. Machen are fellowship trained in the evaluation and medical and surgical treatment of male infertility, including microsurgical expertise in the field required for sperm harvest (microTESE) under certain circumstances.
Our goals in caring for infertile men include:
- Identifying and treating reversible conditions
- Identifying irreversible causes in which assisted reproductive techniques using the male partners’ sperm can be performed to achieve pregnancy
- Identifying irreversible conditions requiring the couple’s use of other treatment options such as donor insemination
- Identifying underlying medical problems associated with male infertility
- Identifying chromosomal disorders which may affect the man or his offspring
Dr. Kavoussi was involved in basic science research investigating new technologies on a cellular level to help improve the efficiency and success rates of sperm retrieval in an animal model to ultimately be applied to men without sperm in the semen to allow these couples to undergo IVF with the man’s sperm.
To read more on Male Infertility click on the following links…
A varicocele is an abnormal dilation of the veins from the testicle. Fifteen percent of men in the general population and forty percent of men presenting with infertility have a varicocele, and this is the most common correctable cause of male infertility. The varicocele can be repaired through an approximately 1/2 inch incision made in the groin. This is performed as a day surgery and the patient may return to full activity in one week. Seventy percent of men with infertility, abnormal sperm counts or abnormal sperm function, and a varicocele will have improvement in sperm counts/function after varicocele repair. Varicoceles can also damage the DNA inside of the head of the sperm cells with a process known as sperm DNA fragmentation. When men have high percentage of sperm cells with fragmented DNA, the fertilization and pregnancy rates are lower, and higher rates of miscarriage are associated with varicoceles. Varicocele repairs improve the health of the sperm cells and studies have shown higher pregnancy rates after varicoceles are repaired, even if sperm parameters do not improve and levels of reproductive assistance are required, as the healthier sperm cells do a better job fertilizing eggs and help sustain pregnancies. Dr. Kavoussi and Dr. Machen are fellowship trained in microscopic varicocele surgery and each perform multiple varicocele repairs on a weekly basis. Dr. Parviz Kavoussi was a co-author on a clinical guideline scientific paper on sperm DNA fragmentation and its importance in specific male fertility evaluations, including men with varicoceles. To read the article click here…https://wjmh.org/Synapse/Data/PDFData/2074WJMH/wjmh-38-e44.pdf
Dr. Parviz Kavoussi and Dr. Luke Machen provide care for a large number of men with varicoceles and with azoospermia (sperm count of zero) at Austin Fertility & Reproductive Medicine/Westlake IVF. Dr. Kavoussi has contributed a chapter on varicoceles and azoospermia to the Springer published textbook of Varicocele and Male Infertility. In these complex scenarios, it is always recommended that a man with a sperm count of zero without a blockage as the cause, who has a varicocele has that varicocele repaired as 20-40% of these men will have return of sperm to the semen several months after repair of the varicocele. In men who do not have return of sperm to the semen after varicocele repair, and have to go through the next step of microdissection testicular sperm extraction (microTESE), a meticulous microsurgical search for sperm in the testicle to be retrieved for use with IVF, the odds of retrieving sperm increase after the varicocele has been repaired. There will also be healthier sperm retrieved with better outcomes with IVF after the varicocele has been retrieved if microTESe is ultimately required.
To read more on Varicocele click on the following links…
It is known that 1% of all men will have no sperm in their semen and 10-15% of infertile men will have no sperm in their semen. In such cases or in cases when a man has a non-surgically correctable blockage not allowing the sperm to reach the semen, there are still options to retrieve sperm that can be used in combination with assisted reproductive techniques such as in vitro fertilization (IVF) to successfully achieve a pregnancy. There are multiple options for retrieving sperm including percutaneous epididymal sperm aspiration (PESA) where aspiration is performed from the epididymis (the structure connecting the testicle to the vas deferens), microsurgical epididymal sperm aspiration (MESA), testicular sperm aspiration (TESA) aspirating sperm directly from the testicle, testicular sperm extraction (TESE), and microdissection testicular sperm extraction (microTESE).
To read more on TESE click on the following link:
MicroTESE is a specialized procedure used for men without sperm in the semen who do not have a blockage, but have a sperm production failure. Genetic testing is done prior to the procedure to give us an understanding of what the odds are of finding sperm at the time of sperm retrieval. A precise microsurgical technique is then used to look for possible pockets of sperm production throughout the testicle under the visualization of an operative microscope to find sperm that can be used in combination with IVF. The success rates of retrieving sperm using this procedure are highly dependent on the experience of the microsurgeon. Dr. Kavoussi and Dr. Machen are specialty fellowship trained in microsurgery to find such microscopic pockets of sperm production to allow these couples a chance to achieve a pregnancy with the man’s sperm with high percentage success rates. The team at Austin Fertility & Reproductive Medicine has a 71% of retrieving sperm in men undergoing microTESE which has been published in peer reviewed scientific articles, and is as high if not higher than any program that performs microTESE. To read more click on the following links: https://www.austinfertility.com/afrm-team-71-sperm-retrieval-rates-microtese-men-sperm-count-zero/ and https://www.austinfertility.com/research-testicular-pathology-fsh-levels-and-testicular-sizes/
To read more on microTESE click on the following links…
Sperm DNA Fragmentation
Although the traditional semen parameters obtained on a semen analysis are the cornerstone to a man’s fertility evaluation, higher levels of sperm testing are useful in certain situations. Sperm DNA fragmentation is the test that has had enough scientific data to support its use in clinical practice thus far. It has been demonstrated that in men with elevated levels of sperm DNA fragmentation, there may be lower fertilization rates, lower pregnancy rates, and higher miscarriage rates for the couple. The current clinical recommendations are to offer sperm DNA fragmentation testing for couples with recurrent pregnancy losses, men with varicoceles, and in IVF failures with healthy eggs. Dr. Parviz Kavoussi was a co-author on the scientific manuscript used as the clinical guideline for testing and treating men for high DNA fragmentation. To read the full manuscript, click here…https://wjmh.org/Synapse/Data/PDFData/2074WJMH/wjmh-38-e44.pdf
The andrology laboratory at Westlake IVF offer sperm DNA fragmentation testing. To learn more about andrology laboratory services at Westlake IVF, click here…https://www.westlakeivf.com/andrology-lab-services/
Dr. Parviz Kavoussi contributed the textbook chapter on surgical, radiographic, and endoscopic anatomy of the male reproductive system in the 11th and 12th editions of Campbell’s Walsh Urology textbook, which is considered the “bible of urology” used for training urology residents as well as the primary reference for practicing urologists. A mastery of this anatomy is paramount to optimize outcomes with the complex, meticulous surgical procedures performed to optimize male fertility outcomes.
“clomid Safety to treat T & preserve Fertility” – 01/23/2017
“Paternal Age’s Impact on Male Fertility” – 09/21/2015
“Male Infertility and Associated Health Issues” – 05/11/2015
“Sunscreen and Male Infertility” – 04/14/2015
“Cycling and Male Fertility” – 11/20/2014
“Cell Phone Exposure Impacts Male Infertility” – 07/29/2014
“Cell Phones and Fertility” – 07/12/2014
“Klinefelter Syndrome & Fertility” – 07/09/2014
“Low Testosterone and Male Fertility” – 10/16/2012
“Mother’s Day Fertility” – 05/13/2012
“Fitness & Fertility” – 05/01/2012
Obesity and Male Infertility – 03/27/2012
Male Infertility – 01/24/11
Laptops & Male Infertility
Testosterone & Male Infertility
Dr. Parviz Kavoussi’s study indicates that men converting from clomiphene to Natesto desiring maintenance of spermatogenesis should be followed closely
A longstanding dilemma in male reproductive medicine has been the treatment of low testosterone in men desiring to maintain fertility. As the majority of testosterone replacement options such as gels and injections diminish sperm production, the primary option has traditionally been the off-label use of clomiphene citrate (CC) to increase serum testosterone levels in a manner that is not […]
Mom's advice to eat plenty of veggies still rings true, but men might want to do so with some caution. High-pesticide fruits and vegetables might damage men's sexual health. A new study from Harvard found that men who ate vegetables and fruits with the highest levels of pesticide residues had lower sperm counts and fewer normal sperm.
Health problems that seem unrelated to men's fertility — like diabetes or high blood pressure — may damage men's sperm. And men can take steps that can both improve their overall health and make them more fertile.
There is no better field in medicine than fertility care for treating two people at the same time for optimal results. One unique aspect of fertility care is that it requires an in-depth understanding of multiple organ systems and their complex functions between two individuals. When reproductive endocrinologists and reproductive urologists work together, they areable to optimize fertility outcomes for the couple as a whole. Although evaluating and treating both partners optimizes fertility, couples can enhance their fertility with fitness. A fitter couple is a more fertile couple.
Fitness is clearly important for men and women’s health, but what about fitness' impact on fertility? Testosterone is believed to be an important factor in a man’s fertility. Low testosterone (total testosterone level of less than 300 ng/dl by the endocrine society definition) is very prevalent in infertile men. Forty-five percent of men with no sperm in the semen, without a blockage in the system transporting sperm, have low testosterone and 43% of men with low sperm counts have low testosterone levels.
Family of Physicians Practicing at St. David’s South Austin Medical Center, Helping Couples Achieve Fertility AUSTIN, TX—In August 2010, Parviz Kavoussi, M.D., joined St. David’s South Austin Medical Center, alongside his father, K.M. Kavoussi, M.D., and his brother, Shahryar Kavoussi, M.D. This family of physicians specializes in all aspects of fertility and reproductive medicine, focusing on both the female and male factors that can affect fertility in couples. “Our patients really like having all of these services offered in one office because it ensures that everyone is on the same page, so to speak,” Dr. Parviz Kavoussi said. “Examining infertility from both sides is the more effective, and less expensive, approach.”
Having Klinefelter Syndrome does not mean it is impossible to father children A common concern for males with KS and their families is the ability to father children. Although subfertility is characteristic of KS and the majority of KS men do not have sperm in the ejaculate, there are exceptions as well as other techniques to help with fertility potential. Although small, firm testes are common among all KS men, up to 50% have normal testosterone concentrations. Men with the mosaic form of KS (having 46XY cells mixed with 47XXY cells) are occasionally fertile. KS men with low sperm counts in the semen may have the sperm used for assisted reproductive techniques (such as in vitro fertilization- IVF) by simply collecting the sperm through semen samples obtained by masturbation.