Dr. Hanna – Male Infertility

Male infertility can result from various factors. Common causes include:

• Low sperm count – producing fewer than 15 million sperm per milliliter
• Poor sperm motility – sperm that cannot swim properly to reach the egg
• Abnormal sperm morphology – sperm with irregular shape and structure
• Hormonal imbalances – low testosterone or other hormonal issues
• Varicocele – enlarged veins in the scrotum affecting sperm production
• Genetic factors – inherited conditions affecting fertility

A fertility doctor for male like Dr. Hanna can perform comprehensive testing to determine the underlying cause and recommend appropriate male infertility treatment.

Our office performs Semen Analysis (SA) for male patients Monday-Friday. Please call our office 212-794-0080 to schedule appointment. SA report is ready in two days. Dr. Hanna, male infertility specialist, will expertly explain SA results and answer questions on male fertility.

We provide sterile cup (container) for specimen collection. You may also get sterile container from other physician office or from pharmacy. Specimen is produced by masturbation and collected into sterile cup.

Specimen collection can be done at home or in our office. When bringing sperm from home, you will have 1.5 hours for transportation. During transport, keep specimen in the body temperature condition.

Healthy lifestyle, fertility boost diet and herbal supplements improve and maintain male fertility with higher testosterone levels and increased sperm production in young and older men.

Dr. Hanna, male reproductive doctor in Manhattan, includes natural remedies into patients' daily routine:

• Maintenance of normal BMI (Body Mass Index, tabulated weight/height ratio)
• Regular exercises
• Limited alcohol consumption
• Balanced diet with fruits, vegetables and antioxidants including vitamin C, and folates
• Herbs, "natural" medications with a moderate potential to increase fertility

Natural remedies are less effective for low and very low sperm counts. Medications for male infertility treatment aim to increase sperm production, treat hormonal imbalances, and improve testosterone levels. Dr. Hanna has expertise in using male infertility medications alone or in combination with other treatments:

• Clomid (oral tablets) regulates hormones involved in sperm production.
• Injectable meds (HMG, HCG) stimulate testis to produce more testosterone and boost sperm production.

Varicocele, dilatation of the scrotal veins, detected by physical exam and ultrasound is associated with diminished sperm production (low count) and low motility (slow sperm swimming).

Outcomes after varicocele surgery are unpredictable. Sperm production (sperm count) and sperm motility may increase up to 20% (the most). Therapeutic improvement after surgery takes long time and additional medications are often needed. Very low sperm counts show no improvement following varicocele repair.

Intrauterine Insemination (IUI) with partner sperm is a medical procedure to introduce sperm separated from seminal fluid into women uterus (womb). IUIs are primary treatment for erectile dysfunction and for women who use Donor Sperm to get pregnant.

Couple with partner having over 5 million motile sperm count in ejaculate benefit from IUIs the most when IUI is used to treat lower quality sperm.

IVF with ICSI (single sperm injected into women egg) is recommended for complex infertility cases, very low sperm counts (less than 5 million motile sperm in ejaculate), failed inseminations and in azoospermia (no ejaculated sperm) when sperm is surgically recovered from the testis (TESA).

ICSI procedure performed on some and/or all IVF retrieved eggs is today standard treatment for all patients undergoing IVF.

TESA is surgical procedure to obtain sperm directly from testicular tissue in patients with azoospermia (no ejaculated sperm), including men after vasectomy. Donor sperm insemination is another treatment option for azoospermia.

1. TESA is performed with local anesthesia
2. Small needle is used to sample testicular tissue
3. There is no bleeding and no stitches needed

Sperm is separated from testicular tissue in the laboratory under microscope. Sperm obtained from the testis is too immature and weak to be used for insemination. IVF with ICSI injection is a technique of choice to fertilize eggs with testicular sperm.

TESA sperm can be cryopreserved (frozen) and stored for future use.

1. Patients with azoospermia, who previously had no chance to father a biological child, TESA and IVF/ICSI (sperm injection inside the egg) offers 50% pregnancy rates.
2. With over 80% recovery rate, TESA is effectively used for men who earlier underwent vasectomy and with pregnancy rates superior to reversal surgery.