Monday, August 17, 2020
Saturday, January 25, 2020
I had magical moment in my office the other day.
Man with azoospermia (no sperm in his semen). Had testicular atrophy and elevated pituitary hormones consistent with testicles that were not producing sperm. My options:
- Traditional open diagnostic testis biopsy
- Immediate testis sperm retrieval attempt
- Referral for donor sperm
- Testicular mapping biopsy
What did I choose?
What is a mapping?
- Mapping is a diagnostic procedure that can be done in the office setting under a local anesthetic. I numb the patient then use tiny gauge needles to aspirate seminiferous tubule in a grid pattern in each testicle then I inspect the fluid under 200X in my laboratory microscope. I then notate where in the grid the testicles contain sperm, if at all, then I return to those area at a future time to harvest the sperm for reproductive purposes.
- In a diagnostic biopsy I only sample one area and I sent the specimen for pathology in a fixative solution. The pathologist then gives me a diagnosis of normal spermatogenesis vs hypospermatogenesis vs Sertoli only syndrome. Then I either tell the patient there is nothing more I can do or that he needs more invasive surgery to harvest sperm for reproductive use. I only resort to diagnostic biopsies in rare instances.
Now that is magic.
Saturday, January 18, 2020
You are a smoker
You have an obesity problem
You have history cancer or cancer therapy
You have history of gonadotoxin exposure
You smoke marijuana
You use testosterone
You use chronic opioids
You have an endocrineopathy/hormonal problem
You have abdominal fat, ie a large belly
You have gynecomastia, ie man-boobs
You may a varicocele-dilated veins of the spermatic cord
You have a testicular mass
You have small testicles
Any questions? Contact me
Monday, July 22, 2019
Saturday, July 20, 2019
How does pot affect sperm? Better question is how doesn't it affect sperm.
Decreases LH and FSH release
Attaches to sperm head and tails
Decreases sperm production
Promotes loss of spermatogonia
Thursday, July 18, 2019
These 5 things will damage sperm production. So if you are trying to get your wife pregnant, avoid them.
- Marijuana: really bad for spermatogenesis for a multitude of reasons. Also bad for sperm themselves
- Cigarettes: see marijuana
- Abdominal obesity: surprisingly bad. Causes both hormonal imbalances and sperm stem cell death
- Testosterone injections: causes decrease on the natural T production needed to produce sperm
- Heat: the testes hang in the sack for a reason. Keep them cool by avoiding hot tubs, spas and steam rooms