BONUS 297: Diagnosis & Treatment of Male Infertility

February 5, 2021

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Today’s bonus episode guest is Dr. Allison Rodgers. She is board certified in both Obstetrics and Gynecology and Reproductive Endocrinology and Infertility and has been practicing medicine since 2004. Dr. Rodgers currently practices at the Fertility Centers of Illinois. Her personal experiences with both secondary infertility and pregnancy loss have given her a unique insight into reproductive medicine in order to help you beat infertility.

Episode Sponsor:

Infertility Coaching with Heather Huhman

Dr. Rodgers begins by answering six listener questions. The full questions are read on the air, but here are brief summaries:

  • Helena, 38, lives in Canada and is trying for her first child. With endometriosis, fibroids, low AMH, and low sperm motility, she asks about their chances and options since IVF isn’t affordable for them.
  • Kristin, 36, had a successful pregnancy on her third embryo transfer, and she’s now trying for Baby #2. Her first transfer was negative. She asks if an ERA will be helpful since she’s already had the one successful transfer and pregnancy.
  • Nontle, 41, lives in Switzerland. She’s been diagnosed with Asherman’s syndrome, had a uterine fibroid embolization, and had a laparoscopy to remove uterine fibroids in 2015; she hasn’t had a period since. Even though surrogacy has been recommended, she asks if it is possible to restore her normal uterine function.
  • Stephanie, 30, is undergoing IUI but has had lining issues. After trying Clomid, she’s now on a letrozole with follistim protocol, along with taking vitamin E. She asks if IVF or injectables would be the best next step.
  • Julie, 36, has been diagnosed with lean PCOS. After six cycles with letrozole and one IUI, her last egg retrieval yielded 28 eggs but only one embryo. She asks what can be done to improve her egg quality.
  • Emily, 28, lives in Germany and has endometriosis. So far, she has had three failed Day 5 transfers. She asks if she should have her endometriosis removed before her next transfer and if it might be affecting her egg quality.

Dr. Rodgers and Heather continue the episode by discussing the diagnosis and treatment of male factor infertility:

    • How is male factor infertility defined, and what does a normal semen analysis look like?
    • ASRM recently published new guidelines for male infertility in conjunction with the American Urology Association. What went into the development of the guideline document?
    • Can you explain the definitions of the different strengths of recommendations and evidence?
    • Let’s go through the guideline step-by-step, highlighting the strengths of recommendations and evidence:
      • Initial assessment of male factor infertility
      • DNA fragmentation test
      • Lifestyle factors, like age, medications, smoking, diet, environmental factors, surgeries, obesity, etc.
      • Official diagnosis
      • Imaging
         Treatment options

  • What questions remain unanswered about male infertility?
  • Is there anything else you would like to add about diagnosing and treating male infertility?

Have a question you want Dr. Rodgers to answer next time she’s on? Click here.

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