Infertility
Identify and address the male-related causes
Dr. Davy Benarroche, urologist and expert in male infertility, offers accurate diagnosis and personalized treatments to restore fertility.
The goal: to restore natural fertility when possible
Many men can regain sufficient sperm production after appropriate treatment. Early intervention by a urologist specializing in andrology often makes it possible to avoid immediate recourse to assisted reproductive technology (ART) and to optimize the chances of natural pregnancy.
Understanding, diagnosing and treating the causes of infertility in men
Male infertility affects nearly one in two couples struggling to conceive. In most cases, there is an identifiable and often reversible cause. A specialized evaluation by a urologist specializing in andrology is essential for an accurate diagnosis and appropriate treatment.
Better understanding male infertility
Infertility is defined as the inability of a couple to conceive after 12 months of unprotected, regular intercourse. In men, the causes can be:
- Testicular : defective production or maturation of sperm (varicocele, hormonal disorders, infections, fever, medication, etc.).
- Obstructive : obstruction of the genital tract preventing the ejaculation of sperm (obstructed vas deferens, sequelae of infection, congenital anomalies).
- Functional or hormonal: deficiency in sex hormones (primary or secondary hypogonadism).
- Behavioral or environmental factors: tobacco, overweight, stress, heat, exposure to toxins, etc.
- Idiopathic : sometimes, no cause is found despite a complete evaluation.
What happens during a male infertility consultation?
1. The interrogation
- Medical history, surgical history, genital infections, current treatments.
- Lifestyle (tobacco, alcohol, intensive sport, heat, stress…).
2. The clinical examination
It assesses the testicles, epididymides, penis and genital tract. The objective is to look for visible abnormalities (varicocele, small or hardened testicle, congenital anomalies, etc.).
3. Additional examinations
The semen analysis is the key test: it analyzes the concentration, motility, and morphology of the sperm. Depending on the results, other tests may be prescribed:
- Hormone assays (FSH, LH, testosterone, prolactin, inhibin B).
- Testicular ultrasound – Genetic testing (in cases of oligospermia or azoospermia).
- Exploration of the vas deferens if an obstruction is suspected.
4. The treatment plan
Depending on the identified cause, several options may be offered: testicular hormonal stimulation to restart spermatogenesis; treatment of a varicocele by surgery or embolization; correction of a hormonal or metabolic disorder ; lifestyle improvements (smoking cessation, weight loss, stress management, etc.); and, if medical approaches fail, referral to assisted reproductive technology (ART) (insemination, IVF, ICSI) if necessary.
Male infertility: solutions exist
Needs
Expertise
Why consult a urologist/andrologist?
A urologist specializing in andrology is the doctor best qualified to assess male fertility. Their role is to: Identify the medical or surgical causes of infertility; propose targeted treatments to restore natural fertility when possible; and work in collaboration with assisted reproductive technology (ART) teams, if necessary, to optimize the chances of success. For more information, you can visit my website dedicated to varicocele: varicoceleparis.com
Expertise
Male infertility
Dr. Benarroche offers individualized support for male infertility, from the precise analysis of fertility disorders to their medical and surgical management.
Dr. Davy Benarroche's expertise
Urologist and andrologist surgeon specializing in the management of male infertility and treatments aimed at restoring natural fertility.
Experience
Academic background
Dr. Benarroche offers care focused on men’s health , combining a medical and surgical approach, tailored to the needs of each patient.
FAQ – Frequently Asked Questions
When should you consult a doctor for male infertility?
After 12 months of regular intercourse without pregnancy (6 months if the partner is over 35), or earlier in cases of known history: cryptorchidism, varicocele, chemotherapy, testicular trauma. The man is involved in approximately half of couples’ infertility cases.
What does an infertility assessment in men consist of?
It is based on a clinical examination, a sperm analysis (analyzed according to WHO criteria), a hormonal assessment, and a testicular Doppler ultrasound. Depending on the results, a karyotype or further genetic testing may be recommended.
What are the most frequent causes?
Varicocele is the most common reversible cause. Next come hormonal, genetic, obstructive (absence or obstruction of the ducts), toxic (tobacco, alcohol, heat, certain medications) and idiopathic causes.
What treatments can improve fertility?
Depending on the cause: varicocele repair, hormonal stimulation, lifestyle modifications, surgical recanalization, or surgical sperm retrieval (TESE) for IVF-ICSI. Treatment is coordinated with the assisted reproductive technology (ART) center.
When to consult a doctor?
The general rule is to consult a doctor after 12 months of regular, unprotected sex that has not resulted in pregnancy. However, it is recommended to consult earlier (as early as 6 months) if your partner is over 35. Don’t wait and consult immediately if you have any known risk factors.
Should we come as a couple?
Yes, ideally. Infertility is a couple’s issue, and treatment is all the more effective when both partners are evaluated simultaneously.
What solutions do you propose if an anomaly is detected?
The strategy is personalized: it can range from simple lifestyle advice and dietary supplements to medical treatment or surgical intervention (varicocele repair, unblocking). If necessary, we work closely with fertility clinics to optimize your chances of success (IUI, IVF, ICSI).
What is the link between varicocele and infertility?
A varicocele is a dilation of the veins in the testicle (a type of varicose vein) very common in infertile men. It increases local temperature, which can impair sperm production and quality. As a microsurgery expert, I can assess whether treatment is necessary to improve your natural fertility or the results of assisted reproductive technology (ART).
What documents do I need to bring to the appointment?
To save time and refine the diagnosis, please bring all your previous test results if available: sperm analyses (even old ones), blood tests (hormonal), testicular ultrasounds, or reports from past surgeries. If you don’t have these, that’s okay; we’ll order them.
Infertility: there are solutions.