Confronting infertility can be scary and stressful, but it’s helpful to learn more about what you can expect during treatment. Dr. Ajay Nehra shares six things you should know about male infertility.
Male Infertility Program
Yawkey Center for Outpatient Care, Suite 10A
32 Fruit Street
Boston, MA 02114
Mass General Waltham
52 Second Avenue, Building 40, Suite 402
Waltham, MA 02451
Mass General/North Shore Center for Outpatient Care
104 Endicott Street, Suite 304
Danvers, MA 01923
Specialist voicemail: 978-825-6221
Explore This Treatment Program
Part of one of the world's foremost academic medical centers, our program offers the complete range of services for couples struggling with infertility. Male and female patients can receive all fertility-related care—coordinated by physicians from the Department of Urology and the Fertility Center—in the convenience of one location.
A Full Range of Treatment Options
Male fertility issues include patients who have problems with sperm production or obstruction of sperm release from the reproductive system. Treatment options vary depending on the cause of infertility.
Lifestyle Changes and Medication
We may begin treatment by asking you to make lifestyle modifications such as losing weight, stopping smoking or limiting caffeine and alcohol. In addition, medication changes or hormonal therapies may help optimize sperm quality and hormonal status.
Assisted Reproductive Technology
We offer a variety of assisted reproductive technology (ART) methods, which involve manipulating sperm and eggs in a laboratory to help with conception. Examples include:
- In vitro fertilization (IVF): Learn more about the IVF/ART Program at the Fertility Center
- Intracytoplasmic sperm injection (ICSI): A single sperm is injected directly into an egg to attempt fertilization
Sperm Extraction Techniques
These procedures may help men with severe sperm production issues or blockages that cannot be addressed by surgical reconstruction. In addition to percutaneous testis biopsy (an office procedure performed under local anesthesia in which a core of testicular tissue is removed using a biopsy needle through a tiny incision), microsurgical options include:
- Microsurgical epididymal sperm aspiration (MESA): Employing this sophisticated technique, we extract sperm for use with a combination of IVF and ICSI
- Microsurgical testicular sperm extraction (microTESE): With this procedure, sperm is extracted from the sperm-producing areas in the testicle for use with IVF and ICSI
Surgery for Obstructions
We are highly skilled in microsurgical techniques that can repair or address various reproductive tract obstructions.
- Microsurgical varicocele repair: Varicoceles, a network of abnormally dilated veins in the testes, can have a negative impact on sperm or testosterone production and are the most common cause of male infertility. We use a microscope in repairing varicoceles, the gold standard for this procedure.
- Microsurgical vasectomy reversal: This delicate operation can restore sperm to the ejaculate in men who previously have had a vasectomy
- Transurethral resection of the ejaculatory ducts: We can open the ejaculatory ducts to alleviate an obstruction at the last portion of the reproductive tract
Learn more about minimally invasive surgical treatments in the Department of Urology.
Learn more about the Third Party Reproducation Program at the Fertility Center.
We understand the profound impact infertility can have on a couple. That's why we work as a team to provide you with expert medical care and psychological and emotional support throughout your journey to parenthood.
Convenient, Comprehensive Care
The Male Infertility Program offers the complete range of services for couples struggling with infertility. Our program director and fertility specialists regularly meet with members of the andrology and embryology laboratories. These interactions allow andrologists, embryologists and reproductive endocrinologists to lend us their skilled perspectives on new couples coming under our care.
Social workers are also an integral part of our program. You may choose to receive counseling and other forms of support to help you cope with the range of emotions you might experience during your fertility journey.
What to Expect
Patients typically are referred to us by community physicians or from elsewhere in Mass General. You may also contact us directly to schedule an appointment.
At your initial visit, program director Ajay Nehra, MBBS, will conduct a thorough history and physical/urological examination. He will also review your personal, reproductive and family history along with any tests you have had in the past. This information helps assess the need for more testing and formulate your individualized treatment plan.
If no further tests are needed, it may be possible to leave your first appointment with your treatment plan. If additional tests are needed, then you will receive your plan at a follow-up visit.
Most of our surgical procedures take place in the operating room under general anesthesia. All are performed by our doctors on an outpatient basis and range from one to several hours in duration. Certain procedures may take place in the office setting using local anesthetic or sedation.
Singular Focus on Male Fertility
Ajay Nehra, MBBS, director for male reproductive medicine at Massachusetts General Hospital, heads our program and focuses solely on the issue of male infertility.
- Director of Men's Health and Male Reconstructive Surgery
- Senior Urologic Surgeon