UPMC Video Rounds - The UPMC Men's Health Center

July 22, 2020

 

Kathleen Hwang, MD, Associate Professor of Urology and Obstetrics, Gynecology and Reproductive Sciences, and the Director of the Male Reproductive Health Service:

At the Men's Health Center, we treat diagnoses including erectile dysfunction, ejaculatory dysfunction, Peyronies disease, as well as reproductive diagnoses such as male infertility, in places where patients can be azoospermic and we need to do procedures such as sperm retrieval and things such as vasectomy reversals.

At UPMC, for patients who have the most severe form of male factor infertility, these non-obstructive azoospermic men require sperm extraction. Often times it's a microdissection testicular sperm extraction. Here, we've taken it to the next level where we have state of the art equipment in the OR, as well as outside. While it's a long surgery, in order to make it more efficient, we have an embryologist in room with us, to give us live feedback for sperm identification. This makes the whole procedure more efficient, it makes the fact that we're able to identify sperm a little bit more easily, and it minimizes the amount of anesthesia for the patient as well.

In general, for these patients, we are able to extract sperm at about 55% of the time.

The micro TESE sperm extraction, it stands for micro dissection testicular sperm extraction, and this is a form of surgical procedure where we use it for non-obstructive azoospermic men. The procedure itself is often done frozen, where if you were to find sperm, it's frozen and used for future usage of an IVF cycle with their female partner. Recently we've offered a couple where we can do it fresh. So this is a fresh cycle, where it's coordinated with the female partner at the time of her IVF cycle. And so this allows the couple to not have to freeze any of their sperm, allowing all the sperm to be accessible for their IVF cycle.

Fertility preservation has recently become very high priority for oncologists, hematologists, basically anybody involved with anyone who's been recently diagnosed with cancer.

In younger patients who are adolescent or pre-pubertal even, that becomes an issue, because they haven't made any sperm cells that are mature enough to actually freeze. So in this process we actually go in and we freeze and harvest testicular tissue to target the testicular stem cells in hopes that in the future, we'll be able to help mature the stem cells into mature sperm that they can use when they're an adult.

The Men’s Health Center, what our true vision is, is that we want to make it an easier place for men to find comprehensive health care.


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