Hormone therapy
Testosterone should not be given as an infertility treatment. It will only make the problem worse as it will completely shut down sperm production. Instead, for men with hormone abnormalities medications such as human chorionic growth hormone (or HCG) or Clomid. These treatments can help to jump start your body’s natural production of testosterone, which can then bump up sperm production.
Retrograde ejaculation
If you are found to have semen that is passing into the bladder instead of out of the penis there may be several options based on the cause of this problem. Most commonly medications cause this issue. Stopping the medication may fix the problem. The biggest culprit is Flomax or other medications for an enlarged prostate. Prostate surgeries, such as TURP, can also cause this problem. Some men will have success using Sudafed to help push the semen in the right direction. Otherwise a washing of the urine may provide enough sperm for artificial insemination of the female partner.
Vasectomy reversal
This is obviously for men with a prior vasectomy. Success rates vary but depend primarily on how long ago the vasectomy was performed. This surgery involves reconnecting the ends of the vas deferens or plugging the vas deferens directly into the epididymis.
Transurethral resection of ejaculatory ducts
This procedure is for men who have an obstruction of the ejaculatory ducts into the prostate. Often times this is due to the formation of a cyst in that area. In this procedure a camera is passed down the penis to the level of the ducts. A special loop is then used to carve away the obstructed section.
Testicular sperm extraction
Several procedures fall under this category. The difference is where the sperm are taken from and how they are retrieved. In general, the sperm can be retrieved in the office using a needle that goes through the skin or under anesthesia by opening the skin and going straight into the testicle. The sperm can be taken from either the testicle itself or the epididymis. These are all relatively quick and simple procedures with minimal recovery.
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