For several years, many studies have shown something that urologists instinctively understood but now we know to be a fact – that a man’s fertility tells us a lot about his general health. Research at Stanford by Dr. Michael Eisenberg Male infertility as a window to health (Choy JT, Eisenberg ML. Fertil Steril. 2018 Oct;110(5):810-814), a top internationally known urologist specializing in male reproductive health, confirms that a man’s fertility, as we know with erectile function can be a barometer of his overall health and wellness. This is especially important as we look at the semen analysis after a vasectomy reversal.
Of course, the big question is whether his health issues are what is hurting a man’s fertility or is the man’s DNA responsible for the fertility problem as well as the other medical issues such as inflammation after the reversal?
What does this mean?
Any guy should consider any issues with fertility to be an alarm to get things checked out. He should go see his primary care doctor for a comprehensive medical check-up – to include a complete physical exam, blood work, and hormone levels to check his thyroid, liver, blood sugar, heart and kidneys as well as his testosterone, estrogen and other hormone levels.
Doctors know that there are many health issues that negatively impact on a man’s fertility. This means that if a man has fertility issues then it’s makes sense to look for other possibly hidden health issues. This makes sense if a man has significant health problems such as diabetes, high blood pressure or other long-standing illnesses as these can impact on his fertility and so the ability to pass on his DNA. This is why it is important to get all issues under control before a vasectomy reversal.
Urologists know that one out of every 100 men who show up for evaluation of their infertility will be found to have a previously unknown testicular cancer (Infertility with Testicular Cancer. Ostrowski KA, Walsh TJ. Urol Clin North Am. 2015 Aug;42(3):409-20). This is why any man with fertility concerns must be seen by a urologist. Simply retrieving sperm as many doctors do for IVF without looking to understand why he has issues can be a serious problem with dangerous consequences.
Many times, any male factor issues can be successfully treated such as a varicocele, which is a collection of veins above the left testicle. If there is damage to the sperm then we think of oxidative damage which may be treatable with oral antioxidants and an increase in healthy, antioxidant rich foods. This then allows the couple to try conceiving naturally which provides the healthiest children without the risks and expenses of assisted reproductive techniques.
It is unfortunate that many men with low sperm counts are simply pushed into the sperm donor path for IVF, ignoring why he even has low counts or motility. IVF, though very effective for most couples, is significantly more expensive and has the added risks to the mother and babies. It is a disservice to the man to ignore the fact that his fertility may be correctable and may be a warning sign of something more insidious that needs to be addressed.
Key take home point- if there’s any question about fertility then it is wise to see a urologist to see if it’s something that’s treatable and also to see if it really may be an early warning sign of a deeper health issues that are impacting on fertility.
Sheldon H. F. Marks, MD, is one of the world’s top vasectomy reversal experts and founder of the International Center for Vasectomy Reversal (ICVR), one of the top, full-time, reversal only centers in the world with a published success up to 99.5% (Crosnoe LE, Kim ED, Perkins AR, Marks MB, Burrows PJ, Marks SH. Angled vas cutter for vasovasostomy: technique and results. Fertility and Sterility.2014;101(3):636-639). The fact that patients travel to have him perform their reversal from every state in the US and more than 80 countries around the world and that other respected reversal doctors come out to watch him perform reversals speaks to his reputation.