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Male Factor

Sperm Production

Sperm Detection

Sperm Abnormalities
  • Testicular Causes
  • Pituitary Causes
  • Hypothalamic &
    CNS Causes

  • Varicocele
  • Antisperm Antibodies

Clinical Evaluation

Treatment Options

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Dr Eric Daiter is a nationally recognized expert in Reproductive Endocrinology and Infertility who has proudly served patients at his office in New Jersey for 20 years. If you have questions or you just want to find a caring infertility specialist, Dr Eric Daiter would be happy to help you (in the office or on the telephone). It is easy, just call us at 908 226 0250 to set up an appointment (leave a message with your name and number if we are unable to get to the phone and someone will call you back).

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"I always try to be available for my patients since I do understand the pain and frustration associated with fertility problems or endometriosis."

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"I understand that the economy is very tough and insurance companies do not cover a lot of the services that might help you. I always try to minimize your out of pocket cost while encouraging the most successful and effective treatments available."

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Pituitary Gland Abnormalties

Case: 33 year old male with a history of unproven fertility, an unremarkable medical history, a semen analysis revealing oligospermia (a reduction in the concentration of sperm), and a hormone evaluation revealing an elevated concentration of both LH and testosterone (with a normal FSH concentration).

Question: What should be considered given this information?

Answer: The cause of oligospermia often remains unclear. However, a basic male factor evaluation should be completed, including a medical history, reproductive history, formal semen analyses on at least 2 different occasions, physical examination (usually by a Urologist), and hormone evaluation (including FSH, LH, Testosterone, and Prolactin).

If there is an elevation in both the LH and Testosterone concentrations, one should suspect and rule out the possibility of a pituitary LH secreting tumor. Pituitary LH and FSH secreting tumors are not common, but have been found more often in men than in women. If there was an elevation in the LH concentration due to testicular failure (the more common cause for elevated concentrations of LH) then one would also expect to find a suppressed concentration of testosterone and an elevated concentration of FSH.

Radiologic testing is appropriate in this context, with MRI having outstanding resolution when imaging the brain.




Case: 38 year old male with a history of unproven fertility, an unremarkable medical history, a normal semen analysis, impotence, and a hormone evaluation revealing an elevated concentration of prolactin.

Question: What should be considered given this information?

Answer: The cause of the impotence may be the excess circulating prolactin. Prolactin appears to reduce libido (sex drive) and cause impotence by suppressing GnRH, FSH, LH and androgenic hormone concentrations. Supplementation of testosterone (an androgenic hormone) most often does not restore libido or normal erectile function unless the prolactin concentrations are also (concurrently) brought down into the normal range.

Erectile or ejaculatory problems most often are thought to have a psychological basis (cause). However, they can also be due to hormone imbalances, nervous system abnormalities, or vascular disorders. Also, some medications can result in impotence.

Poor quality erections may not be able to deposit the semen completely within the vaginal canal. Long term impotence may result in abnormal androgenic hormone concentrations and this may subsequently impair the production of normal sperm.



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