Dr. Yefim Sheynkin, Director of Male Infertility and Microsurgery at Stony Brook University Medical Center, has joined RMA Long Island IVF to enable male patients to receive comprehensive infertility diagnosis and treatment in one convenient location. His initial evaluation includes an overview of medical history, a physical examination, a complete semen analysis, and sperm function tests if necessary.
Treatments may include:
- Medical treatment
- Surgical correction of varicocele or obstruction
- Hormonal manipulation
- Surgical sperm retrieval (TESE) for IVF with ICSI
The most commonly used sperm retrieval techniques are MESA (microsurgical epididymal sperm aspiration) and TESE (testicular sperm extraction). These are minimally invasive procedures and have a short recovery period. During a MESA procedure, a small incision is made in the scrotum while the patient is under anesthesia. Seminal fluid is retrieved with special micropipettes using an operating microscope. Microsurgical TESE requires retrieval of a small piece of testicular tissue and is usually performed in patients lacking sperm production. Even in extreme cases of azoospermia (when no viable sperm are present in the semen), many men maintain some sperm production in the hidden areas of the testes. Both procedures are usually performed around the time that the woman's eggs are retrieved.
For men with significant infertility, we use a form of assisted fertilization called intracytoplasmic sperm injection (ICSI). We inject one sperm into each egg obtained through ovarian stimulation (IVF). This way an egg can be fertilized by a single sperm that otherwise is unable to bind or penetrate the permeable barrier around the egg.
We offer ICSI to men whose sperm has not fertilized eggs in previous IVF cycles, whose sperm has severe abnormalities, or who have abnormalities in the steps required to achieve normal fertilization. Men with unsuccessful vasectomy reversals, congenital or acquired absence or obstructions of the ejaculatory ducts, spinal cord injuries, or pituitary deficiencies are also potential candidates.