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epididymectomy
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epididymectomy

I have remarried since I had an epidimymectomy and we would like to have a child. Is there anything that we can do to achieve this? Is in-vitro a possibility?
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Dear Ken,

As sperm moves from the testicle into the epididymis, there are both alterations in the spermatozoa and significant changes in the seminal fluid.  As the seminal fluid moves into the epididymis its potassium concentration increases while lipid and protein concentrations decrease.  The spermatozoa themselves also change as they pass through the epididymis with alterations in their morphology, chemistry, motility, fertilizing potential, and metabolism.  Thus the epididymis plays a key role in the maturation of sperm and the reproductive process.


When you say that you have had an epididymectomy, I assume that it was only on one side.  If this is the case, your overall fertility should not be affected assuming that your other testicle is normal.  The majority of men who lose one testicle due to trauma, infection, etc. are able to father children without difficulty.  A couple is not considered infertile until they have had one year of unprotected intercourse without conception.  If this is the case, you and your wife should be seen by a urologist and a gynecologist respectively.  A complete history and physical will be completed by your urologist with particular attention to medical history such as mumps or physical findings such as a varicocele which could affect your fertility.  Your urologist will likely have you undergo a semen analysis.  This is a safe and easy test that measures the motility, appearance, etc. of your sperm, and is often used as a starting point of an infertility workup.  Only after you have undergone a history and physical and some preliminary tests such as a semen analysis will your urologist be able to tell you if in vitro fertilization or other therapy is an option for you.


This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).


Sincerely,
HFHS M.D.-BL
*keyword: infertility, epididymis
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