If the father had an abnormality in the Y chromosome (the male chromosome), the same fertility problem will occur in his son(s). Fortunately, the vast majority of the patients' offspring will have no genetic problems but we do recommend seeing a genetic specialist if an abnormality is identified. If your husband had an identified genetic problem it is good idea to have your son tested.

Under2: Do mumps or chicken pox cause male infertility? Does it matter if you have these as a child or an adult?

Speaker-_Dr__Edmund_Sabanegh: It is rare, but mumps can cause fertility problems when the infection spreads to the testicles. Fortunately this is very unusual and occurs when the infection is during the time around puberty.

Chicken pox does not cause fertility problems.

pelp543: Can pollution cause male infertility? What are the environmental factors, if any, that can cause male infertility?

Speaker-_Dr__Edmund_Sabanegh: We believe that pollution can impact sperm counts and motion. We are most concerned about environmental exposures that involve heavy metals such as lead and pesticides.

nobody8: Do hot tubs kill sperm?

Speaker-_Dr__Edmund_Sabanegh: This has been the subject of a lot of debate in the medical literature.

We know that heat hurts testicular function. With that in mind, I recommend all men discontinue use of hot tubs and steam saunas while trying to cause a pregnancy.

And remember, the sperm cycle is almost 90 days so it will be almost 3 months before you will know if this will improve your sperm.

HappyB: Is there a true correlation between traditional underwear and infertility?

Speaker-_Dr__Edmund_Sabanegh: Again, this is another hotly debated issue. In general, I recommend switching to boxer style briefs although the scientific literature on this topic is not strong.

robertcan: In terms of possible causes of fertility, such as cell phone, hot tubs, etc., are any of these permanent?

Speaker-_Dr__Edmund_Sabanegh: We do not know the answer to this question. It is something that we are actively studying in our research laboratory.

Male Infertility: Treatment

jamesTbooker: Can male infertility to be treated?

Speaker-_Dr__Edmund_Sabanegh: Yes. The majority of men can be treated. There are a variety of causes of male problems that include: obstruction to sperm flow; infections; varicoceles (dilated scrotal veins); as well as hormonal and genetic problems.

In many patients, simply adjusting their lifestyle, changing medications which may be hurting their fertility or treating the infection or varicocele can restore fertility. In men with obstruction of their sperm flow, we can do a microsurgical reconstruction to restore the sperm counts.

On occasion, we will use medications to stimulate increases in sperm count and fertility. Sometimes we perform surgical procedures to remove sperm and use that sperm for in vitro fertilization (IVF commonly called test-tube baby).

jmartin: I am about to begin infertility treatments. How long does it take for my sperm count to improve after treatment? Will it take more than one treatment? Is it always successful?

Speaker-_Dr__Edmund_Sabanegh: It depends on the type of treatment that you are getting. In general, medication therapy to improve sperm counts can take a minimum of 3 months to start to show improvement.

JulesV: Can you discuss Viagra and infertility?

Speaker-_Dr__Edmund_Sabanegh: Some men find Viagra and other erectile medicine treatments helpful during the time that they are trying to cause a pregnancy. These medications do not seem to cause any improvement or harm to the sperm.

Male Infertility: Vasectomy

hectate: I had a vasectomy 8 years ago. Is this reversible?

Speaker-_Dr__Edmund_Sabanegh: Yes it is. You should consult with your physician.

bobT: How soon after having a blockage repaired, can one start having sexual intercourse?

Speaker-_Dr__Edmund_Sabanegh: You may resume intercourse as early as 3 weeks after surgery.

If you have had a repair of the vas deferens, such as a vasectomy reversal, sperm flow will usually resume within one month.

If you have had a surgical procedure involving the epididymis (the very small tubule behind the testicle,) which is sometimes required for vasectomy reversal after many years of blockage, or in some patients with an obstruction, sperm flow may require 3-6 months to start.

bobT: What are the chances of conceiving after having a blockage removed?

Speaker-_Dr__Edmund_Sabanegh: It really depends on how long the patient has had a blockage. For instance, the chances of resuming sperm flow after less than 3 years of blockage is approximately 95%. If the blockage has been in place over 10 years, the odds drop to 70%.

Male Infertility: Varicocele

pleased: How can a varicocele be treated?

Speaker-_Dr__Edmund_Sabanegh: As you may know, a varicocele is a dilated vein in the scrotum which can hurt sperm production by keeping the testicles too warm.

To correct a varicocele, we perform a minor surgery through the lower abdomen which involves identifying the enlarged veins and interrupting them. We perform this surgery under a microscope to allow complete treatment of the veins without injuring the adjacent structures. The procedure takes about one hour and men are able to resume most activities within several days.

Closing

Cleveland_Clinic_Host: I'm sorry to say that our time with Dr. Dr. Edmund Sabanegh is now over. Thank you again Dr. Edmund Sabanegh for taking the time to answer our questions about male infertility.

Speaker-_Dr__Edmund_Sabanegh: Thank you very much for having me here today.

More Information

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This chat occurred on October 27, 2009.

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