San Jose/Bay Area Urologist Rec + testing ??

[scoobers]

Does anyone have a recommendation for a good urologist to check out DH fertility? Also, any specific recommendations on what to have them look for? Obviously sperm count and motility but anything else?

Thanks!

[mischievium]

We we're referred to Dr. Paul Turek (who has now just opened his own clinic in SF) and he was terrific-- personable, knowledgeable, and thorough.

In our case, my regular OBGYN ordered DH's initial SA, then when the results were "abnormal" we were referred to Dr. Turek. So... as far as what tests you should ask for, it depends on what you have already done and your DH's medical history.

Basic Tests to ask for:
1. Semen Analysis with strict morphology
2. Male blood hormone levels

Dr. Turek (or whoever you end up seeing) should also examine your DH to check for varicoceles or cysts. The key is to put yourself in the hands of someone who really knows what they're doing and who will pursue the appropriate path of diagnosis.

Some rarer conditions to be aware of:
1. Does your DH have a risk factor for anti-sperm antibodies? (even if he doesn't, if everything else comes back normal, it's something to consider)
2. Is there a history of cystic fibrosis in his family (carriers of genetic mutations associated with CF can have a condition call congenital bilateral absence of the vas deferens)? If this is the case, his sperm count will be zero.


Good luck!

[scoobers]

Thanks, mischievium! Lots of great info! SF is a bit far for us (we're in Mountain View) but I'd rather go to him knowing you've had a good experience than just randomly pick someone closer for sure.

I'm pretty sure everything should come out normal w/DH because we have one DS (5) and had no problem getting pregnant the first time. I'm now 41 though and DH is 42. We've only been trying for 3 months but given our ages I don't want to go through a bunch of tests for me and wait on testing him. (OB said to try for 3 months and then come see him if no luck.) Seems like we should do the testing in parallel.

[mischievium]

If you haven't had any testing at all done on your DH, then I would suggest you start by asking your OB to order a semen analysis (assuming your OB will order one) and go from there (if anything requires further assessment, see Dr. Turek). Also, your OB might know of an equally good urologist specializing in male infertility closer to you (probably at Stanford)-- though, as someone who's DH commutes daily from SF (where we live) to Mountain View (where he works), it really not that far .

Also, with the added info that you already have a child (and that you got pregnant with him easily), I wouldn't be worried about ASA (unless he's had an injury to the area since your last conception) or CBAVD. It's still absolutely worth doing a semen analysis to check for motility/count/ morphology/ etc., though.

Good luck!