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Male Infertility and Testicular Cancer
You'd think that missing the diagnosis of a testicular cancer in a young, healthy male would scare the living daylights out of any doctor. But there exists in today's modern medicine a situation that continues to baffle me,where some bright doctors ignore the facts. Study after study has proven what urologists have known for years: that a significant number of men seeking evaluation for male infertility have a testicular cancer as the cause of their infertility!
Young men with fertility problems (poor or zero sperm counts) usually go to a fertility center. Almost always this is an OB/GYN that specializes in female reproductive issues or an OB/GYN that has done additional training after residency in female reproduction and is called a reproductive endocrinologist (RE). Because so many advances have been made in assisted reproductive techniques for the female, the cause of the husband's infertility is considered irrelevant. Sperm can be retrieved blindly and used to create a baby through the magic of ICSI with IVF. This technique is an amazing advance in helping infertile couples create a baby of their own. However, in the doctor's zeal to move ahead with the "baby making," the cause of the male's infertility is often of little concern . They can get sperm, so what difference does it make whatever the cause?
This is where the facts should help define "standard of care." There are two reasons why a urologist with special interest or training in male fertility should be an integral part of the fertility medical team.
So what can be done? First and foremost, couples need to be informed about the causes and treatment options of infertility in the male and female. Second, urologists need to be more involved in their community when it comes to fertility issues. Urologists should also work with the female fertility experts, reminding them of the importance of being included whenever there are male fertility questions. Lastly, doctors that prefer to ignore the potential risks to their infertile male patients need to refer these patients to urologists. This is not rocket science. It is good patient care. If the doctors themselves won't initiate it, then informed patients must demand it!
Related Topics: Infertility Treatment and Support, Fertility Tests for Men
Young men with fertility problems (poor or zero sperm counts) usually go to a fertility center. Almost always this is an OB/GYN that specializes in female reproductive issues or an OB/GYN that has done additional training after residency in female reproduction and is called a reproductive endocrinologist (RE). Because so many advances have been made in assisted reproductive techniques for the female, the cause of the husband's infertility is considered irrelevant. Sperm can be retrieved blindly and used to create a baby through the magic of ICSI with IVF. This technique is an amazing advance in helping infertile couples create a baby of their own. However, in the doctor's zeal to move ahead with the "baby making," the cause of the male's infertility is often of little concern . They can get sperm, so what difference does it make whatever the cause?
This is where the facts should help define "standard of care." There are two reasons why a urologist with special interest or training in male fertility should be an integral part of the fertility medical team.
- There is a real risk that some of these men have a testicular cancer as the cause of their infertility. Without a urologic exam and appropriate studies, he may be able to father a child through IVF, while the undiagnosed cancer continues to grow until it becomes much larger or shows signs of being advanced (as with Lance Armstrong). This is obviously not good for the man, or his new family. Missing an opportunity for an early diagnosis may mean chemotherapy, radical surgery and increased chances for death.
- Sometimes the urologist is able to diagnose and correct the cause of infertility, such as a varicocele, ejaculatory duct obstruction, or blockage of the vas. This could allow some couples to conceive naturally or without the risks and expense of ICSI with IVF.
So what can be done? First and foremost, couples need to be informed about the causes and treatment options of infertility in the male and female. Second, urologists need to be more involved in their community when it comes to fertility issues. Urologists should also work with the female fertility experts, reminding them of the importance of being included whenever there are male fertility questions. Lastly, doctors that prefer to ignore the potential risks to their infertile male patients need to refer these patients to urologists. This is not rocket science. It is good patient care. If the doctors themselves won't initiate it, then informed patients must demand it!
Related Topics: Infertility Treatment and Support, Fertility Tests for Men
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There are two important negative factors related to the medications such as Cialis, Viagara and others of that genre that enable or help men to maintain erect penises for sexual intercourse. First, most of the research leading to the discovery and development of these medications were carried out at universities, and paid for with grants from the U.S. Federal government. Yet the multinational pharmaceutical companies have been allowed to reap billions of dollars in per annum profits from the sale of these medications, defending this with the grossly misleading slogan "recoving research costs." The taxpayers who paid for these advances have gotten no returns. And from Washington there is a deafening silence about this. It is remarkable that the public and indeed also the regulators at state and federal level have allowed the multinational drug companies to get away with this. To phrarphrase the late European statesman Alexander Dubchek, what we are seeing here is the "Ugly and unacceptable face of capitalism." Authentic safe and effective medications of this type are being made in countries such as China and India, where for example, the well established pharmaceutical company Dr. Reddy Ltd., is marketing a "little red pill' for a small fraction of the prices of the equivalent products of the American and west European multinationals.
The second and equally important negative factor affecting matters in this arena, is the virtual abandonment of this field of health and medicine by the medical profession including researchers and especially the Endocrinologists, to the the drug companies! I write here of what has been popularly dubbed "Erectile Disfunction." Many factors can generate this condition. Hypogonadism. To cite two examples, destruction of testicular tissues by high dosage cancer medicines or "cocktails" of cancer medications, which while having tremendous curative success, unfortunately has the side effect of causing impotence. There are ways of addressing these two -- and other -- causes of what we used to call male impotence, (before the "erectile disfunction" phrase was popularised by the drug companies as part of their marketing effort). It is remis of the medical profession, and in particular the American, Canadian and European -- not least of all Swiss and German doctors and researchers, particularly endocrinologists, to have abdicated their responsibilites to address problems and opportunities in this field, and left it to the big drug companies to cover everything under a blanket of half-truths and billion dollar marketing propaganda. It is to be hoped that in time this whole problem will be properly addressed in all its dimensions and complexities.
Hello Doctor,
My email is csimax007@yahoo.com
from about 7 months ago, i noticed that i am developping some breats and it's not stopped on a size, my breats are not very big, like no one would notice, but i do and the doctor did aswell.
I made an X ray on upper chest and it was clear.
I was taking Clonazepam which I found, it maybe causes Gynecomastia, but I was taking only little doses.
From about 2 years ago, i found while showering that i have one testicle which is lover than the other ( but I found out that this is in all my family ), but after the gynecomastia thing, i became worried after 7 months!
and I am a bit hesterical in these cases.
So from 3 days ago, i notice that the testicle which is higher than the other, is not painful, but it's annoying me ( maybe i am imagining ), but I feel it's weird, it's not bigger than the other after a shower, but it feels like it's located horizontally(?)
it's not painful, and there is no fuilds.
Please email me and tell me if this can be a cancer? please...
After a diagnosis i've found that i'm having only one testicle, will that cause infertility.?
A very gppd and informative blog !
Thank you for giving me this oppurtunity, I was diagnosed with moderate sperm count, and was diagnosed as sub-fertile.
I have stopped wearing underwear, in 3 months my sperm morphology has increased by 10%. I am not sure wether this method works for all, however it is safe to try.
Dear Doctor,
I have noticed for several months now that my testicles have been heating up to total discomfort. I have also feeling of moving gel like around my testicles once ejaculating. I have been doing many exams on my self lately and noticed that one of my testicles is twice the size of the other. I also notice there was needle like pinching on my under my scrotum sac and which I could not stop by scratching. I'm not sure if this is a concern but it seems weird. I brought this matter up to my primary physician and he says there is nothing to worry about.
Should I have a second opinion about this matter at hand.
If you have a comment about this blog post, you are in the right place. However, if you have a question for Dr. Marks, please visit the Mens Health message board.
Dear Doctor,
I'm a 17 year old male in high school and i've noticed over the last few months that one of my testicles is larger than the other, i've done the self exam and all i can notice is that one is larger... what should i do?? wulfythekid@hotmail.com
My right testicle rests much higher than my left one, where I can actually push it down when cold... Is this normal ?
I'm 17 years old and have noticed that in football workouts I can only do about 50% of the amount of the weight I was doing just a few weeks ago. Ive noticed that I dont have as much "pep in my step" or "hornyness." I was diagnosed with varicocele today by my uroligist. He told me my left ball is 20% smaller than the right. He also said I need surgery soon or I'll become infertile. I'm getting my testoterone level checked tomorrow morning. How serious is this? How urgent is the surgery for this? Could this be testicular cancer? johnsampognaro@gmail.com
Before jumping to the pills, a doctors visit is definitely critical. Also, sometime simple alternative remedies like herbs or the amino acid L-arginine may do the trick. I write about this and more on my female male health blog, www.fmhweb.com
-V-
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