5 questions to ask your urologist prior to a sperm retrieval

TESE, or testis sperm retrieval, can find sperm in the most challenging of male infertility cases. Here are some answers to some common questions from patients of mine.

1. Can I do IUI with sperm retrieved from a TESE? In general no. Not enough sperm is typically found nor does the sperm have adequate motility to be useful for IUI.
2. Should a TESE be done in coordination with my IVF procedure? Answer: it depends. In cases of known blockages in the man, such as after a vasectomy, cryopreserved and thawed sperm works just as well as freshly harvested sperm. In cases where the cause of the azoospermia is unclear, I believe that fresh sperm provides the best chances for a successful outcome.
3. Is TESE covered by insurance? Sometimes. The problem is that the AMA has not come up with a CPT code (billing code) for a TESE. This makes it difficult to get pe-certs from insurance carriers in many cases.
4. Will sperm from a TESE be healthy? Yes. Sperm from a TESE works just fine and can fertilize eggs and create healthy embryos.
5. Can you guarantee you'll find sperm? Maybe. In cases of known obstruction, the likelihood of finding sperm is 99%. In cases of testis failure, that success can be as low as 20%, but is usually in the 50% range.
   

The “New” Prostate Cancer InfoLink and Social Network

I'd like to introduce Dr Arnon Krongrad to Dr Schoor's Urology Blog. Dr Krongrad is a true visionary in medicine, prostate cancer surgery, and social media. He pioneered laproscopic radical prostatectomy in the USA and has now become a pioneer in bringing the power of the internet to help patients afflicted with prostate cancer and their families.

I have recently come to know Arnon though mutual connections on Facebook.com. Though Dr Krongrad is a prostate cancer surgeon and I am primarily a vasectomy reversal and male infertility surgeon, the two of us share a passion for putting honest and accurate information on the internet and counteracting myth and falsehoods that pervade the web.

It is my priviledge to have Dr Krongrad offer to guest blog on Dr Schoor's Urology Blog. Take it away Arnon:

The “New” Prostate Cancer InfoLink and Social Network

A medical ethicist in Philadelphia, an outback guide in Australia, a sex therapist in Miami, and an oncologist in Lagos have something in common: they are all members of The “New” Prostate Cancer InfoLink social network. Why? Because TNPCIL social network allows for unstructured interaction with people whose interest is in prostate cancer and whose expertise is complementary. On TNPCIL social network geography is not a barrier. Indeed, nothing is a barrier. It is the most fluid, friendly, and increasingly authoritative public forum on prostate cancer. Where did it begin?
2007 was a terrible year. The Provenge prostate cancer vaccine story symbolized all that is wrong with patient-physician communication. By the time the FDA approval process was over, death threats had been made. If that did not prove that a remedy was in order nothing would.
At that time, About.com asked me to guide its prostate cancer program. After lengthy consideration, I opted instead to partner with Mike Scott, who had in 1994 developed the Prostate Cancer InfoLink. The idea was to bring his experience and mine to a combined rejuvenation of that site using Web 2.0 technologies: blogs, social networks, and the like. This is how TNPCIL was born.
Today, TNPCIL consists of two sites. The main sitehas a news blog with comments, structured “evergreen” pieces, and on-site navigation. We are quickly developing a Scientific Advisory Board for TNPCIL that includes some of the world's brightest minds on the subject of prostate cancer. They will give added authority and guide content development.
The social networkis a global online cocktail party where patients can interact with doctors, activists can interact with government, and more. This is a sister forum on which patients and partners can ask questions, get answers, and be surrounded with support. It is here that we see that prostate cancer is a global problem and it requires a global solution.
In 1999, I brought laparoscopic radical prostatectomy to the US. The "New" Prostate Cancer InfoLink and Social Network gives me the same feeling of birth and transformation that I had then. My hope is that it will become a site that doctors, patients, and everyone who cares about them will come to trust for its authority and humanity.
Please visit and please tell your friends. And if you have a blog or a site, please link.
Thank you.
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Arnon Krongrad, MD is Founder and Medical Director of the Krongrad Institute for Minimally Invasive Prostate Cancer Surgery. Along with Mike Scott he is co-Founder of The “New” Prostate Cancer InfoLinkand Social Network.