Desire to have children

Unfulfilled desire to have children is a common problem and is caused by the man in 4 out of 10 couples. There are many causes of impaired male fertility and deterioration in sperm cell quality. They range from congenital diseases, hormonal disorders, operations in the groin, testicles or small pelvis to inflammatory changes in the prostate or a varicose vein (varicocele) in the testicles.

Primary infertility is when no child has been conceived after 1 year of regular unprotected sex and neither partner has fathered a child before. Secondary infertility is defined as when no child has been conceived after 1 year of regular unprotected sexual intercourse, but pregnancy has taken place earlier. The chances of success in secondary infertility are usually better than in primary infertility.

If the desire to have children is unfulfilled, not only the woman but also the man should be examined. The examination is not painful, with the most important findings being the sperm cell analyzes (spermiograms) .

Spermiogram

The sperm cell analysis (spermiogram) is an important examination in the case of an unfulfilled desire to have children. The ejaculate (ejaculate) comes almost entirely from the prostate, only the sperm cells (sperm) are added by the testicles. The assessment of an ejaculate includes determining the quantity and acidity, the duration of the change in consistency of the ejaculate (liquefaction time), the number of sperm cells, the mobility of the sperm and the shape of the sperm cells.

In 2010, the World Health Organization (WHO) again defined new standard values, which are listed in the table. Due to this new information, it is important to refer to the classification used in the analysis in the findings. The main problem when assessing sperm cell analyzes is the variance of the ejaculate, so that at least 2 spermiograms should be collected to assess fertility. It is usually obtained through self-satisfaction (masturbation) and should be done after about 2-7 days of abstinence.

Laboratories for spermiogram examinations:

Laboratory Mühl-Speiser
Praterstrasse 22 (U1 Nestroyplatz)
A – 1020 Vienna
phone Appointments: + 43 1 2605302

Labor Endler
Währingerstrasse 63 (at the corner of Schlagergasse)
A – 1090 Vienna
phone Appointments: + 43 1 4083131

Laboratory network of the Austrian health insurance fund
Wienerbergstr. 13
A – 1100 Vienna
phone Appointments: +43 5 0766-114292

Urological outpatient clinic KH Hietzing with neurological center Rosen Hügel
Wolkersbergenstr. 1
A – 1130 Vienna
phone Appointments: + 43 1 80110 2289

I ask you to take all findings with you to the discussion.


Normal sperm count (WHO 2010)

normal values
ejaculate volume> 1.5ml
pH> 7.2
Sperm count (density)> 15 million sperm / ml
mobility> 40% fast moving + agile
> 32% fast forward moving
Sperm shape (morphology)> 4% normal forms
Live Sperm (Vitality)> 58%
MAR test< 50%

Desire to have children after vasectomy

Do you want to have children again after a vasectomy? – Take advantage of my more than 20 years of experience in surgical sperm cell extraction and microsurgical vas deferens reconstruction. Together we will find the solution that meets your requirements, taking into account scientific facts.

Circumstances can change! The desire to have children again after the spermatic ducts have been severed occurs again and again. Can “man” still do something there or are there no more chances of fathering a genetically own child? Although the severing of the vas deferens causes the absence of sperm cells in the ejaculate (ejaculate), the testicles usually produce mature sperm cells (sperm) even after the vasectomy. These can now be obtained in different ways.

First, depending on the anamnesis, the hormonal findings, the physical examination, the duration of the vasectomy, but especially the age of the current partner, a microsurgical reconstruction of the vas deferens can be performed. Here, the two ends of the vas deferens are sewn together again under the surgical microscope. Contrary to the vas deferens transection, this procedure cannot be performed under local anaesthetic, but I carry out these procedures on a day-clinic basis. This means that you will be admitted to the hospital on the day of the operation, operated on and, if you feel well, will be discharged home on the same day.

Secondly, tissue samples for artificial insemination can be obtained from both testicles via a small incision in the middle of the scrotum. This so-called TESE (testicular sperm extraction) operation is also carried out under anesthesia and is also carried out in a day clinic.


First ordination: €200
Follow-up appointment: 

€160 to €180, 
depending on complexity

Appointments

Please make an appointment by telephone 
or in person.


Your doctor

Prim. Univ.-Doz. dr Eugene Plas

Specialist in urology & andrology

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