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Department of Urology

Male Reproductive Health

It is our goal to provide state-of-the-art andrological services to infertile couples in a context of individualized patient care. In this way, treatments are designed to suit each couple's particular needs and goals, working within the timeframes, desires and financial constraints of each individual couple.

Health Services

We are a full-service facility that treats the entire spectrum of male infertility problems. It is our goal to deliver customer-oriented, individualized and cost-sensitive care to every patient.

Consultations with our physicians are information oriented sessions based on the principles of decision analysis and evidence-based medicine. Our male reproductive health group works closely with the UCSF Fertility and IVF Group to provide state-of-the-art management of infertility with the use of assisted reproductive technologies like Intracytoplasmic Sperm Injection (ICSI) with in vitro fertilization (IVF).

We specialize in the full range of microsurgical procedures and medical treatments available for male infertility. Conditions we commonly see and treat include blockages in the male reproductive system, mechanical problems with ejaculation and difficulties with low sperm production. Some of our more specialized treatments include electroejaculation; microscopic vasovasostomy and epididymovasostomy with sperm banking at surgery; and vasal, epididymal and testicular sperm retrieval. Several established care-packages are described on this web page.

Fertility Preservation for Cancer Patients

All patients seen within 24 to 48 hours by calling the fertility preservation hotline at 415/353-9115

Assessment of fertility preservation options

Education and counseling

Access to the full range fertility services at an accelerated pace


Vasovasostomy/Epididymovasostomy for Vasectomy

Use of microscope for all procedures

Performed by a formally trained microsurgeon

Use of "invagination" technique for epididymovasostomy

Surgery on a "come and go" basis and "packaged priced"

Offers banking of ejaculated motile sperm after procedure


Aspiration Techniques for Sperm Retrieval

Performed under local anesthesia on a "come and go" basis

Freshly aspirated sperm retrieved "on call" for use with ICSI

"Package priced" procedures

Microscopic vas deferens sperm retrieval

Mini-MESA epididymal sperm retrieval

Testis sperm retrieval by fine needle aspiration (TESA) or biopsy (TESE)


Varicocele Diagnosis and Treatment

Sophisticated doppler ultrasound techniques available to diagnosis varicoceles or to evaluate suspected recurrences

All surgical treatment options available including laparoscopy and incisional techniques, performed on a "come and go" basis

Microscopic subinguinal varicocele repair

Non-surgical treatment options available (e.g. embolization)


Diagnosis of Azoospermia

A formal office consultation, to include history and physical examination, and hormones and semen analysis with centrifuged pellet

Testis biopsy and fine needle aspiration techniques available to determine sperm production level within the testis

"Sperm Mapping" of the testis using a fine needle technique in men with non-obstructive azoospermia under local anesthesia in the office

Genetic testing and counseling services (Program in the Genetics of Infertility) for those men who may have a genetic reason for azoospermia


Anejaculation Diagnosis and Treatment

Formal consultation available for men who cannot ejaculate because of spinal cord injury, surgery or other reasons

Newest techniques available including vibratory stimulation, electroejaculation and sexual counseling

Sperm banking and sperm processing on the day of procedure

Collaboration with a full range of assisted reproductive services:


Ejaculatory Duct Obstruction

Formal consultation and assessment for men with infertility, painful ejaculation, or blood or stones in the ejaculate

Sophisticated testing available to confirm a diagnosis, tests include transrectal ultrasound and transrectal seminovesculography as well as vasography and seminal vesicle needle aspiration

Transrectal ultrasound-guided endoscopic resection techniques available to treat ejaculatory duct obstruction


Diagnostic Procedures
Other areas of expertise include the routine use of diagnostic procedures:


Microscopic vasography

Transrectal ultrasound-guided vasography

Transurethral or endoscopic vasography

Transrectal ultrasound

Scrotal ultrasound

Testis biopsy

Fine needle aspiration "mapping" of testes in cases of testis failure


Additional Treatments
In addition to the other services mentioned on this site, additional treatment options offered to infertile men include:

Medical therapy

Hormone replacement therapy

Spermatocele excision

Epididymal cyst unroofing

Bladder harvest of sperm (retrograde ejaculation)

Laboratory Services

The male reproductive laboratory offers a complete range of diagnostic tests for sperm disorders. The UCSF Cryobank is a full-service, sperm banking facility that serves as resource for patients interested in sperm banking. In addition, a recently opened UCSF donor cryobank offers cryopreserved donor sperm for the convenient use of bay area residents. The male reproductive laboratory is associated with the UCSF IVF Embryology Laboratory where IVF and ICSI are performed. This association is the basis of an integrated approach to the treatment of infertility and underlies much of the research in technology performed by our group.

Laboratory Diagnostic Services

Semen analysis with WHO morphology

Kruger morphology

Antisperm antibodies

Monoclonal antibody assay for white blood cells

Seminal fructose and pH

Post-ejaculate urinalysis

Sperm vital staining

Hyposmotic swelling sperm viability test

Sperm electron microscopy

Sperm cryopreservation (aspirated and ejaculated)


Sperm Cryopreservation
We provided both long-term storage of ejaculated sperm (1 or 5 years) and short term storage of sperm aspirated during surgical procedures. Our physicians provide a consultation service for patients that involves:

Infertility evaluation as part of consultation

Discussion of banked sperm quality after "test thaw" performed

Goal-oriented, individualized approach to determine quantity and length of storage needed



Contents of This Page

Health Services
Fertility Preservation for Cancer Patients
Aspiration Techniques for Sperm Retrieval
Varicocele Diagnosis and Treatment
Diagnosis of Azoospermia
Anejaculation Diagnosis and Treatment
Ejaculatory Duct Obstruction
Diagnostic Procedures
Additional Treatments
Laboratory Services
Laboratory Diagnostic Services
Sperm Cryopreservation



Ira Sharlip, MD
James Smith, MD, MS

Key Staff

Dennis Troyer, RN, CCRN
Nurse Coordinator

Gina Davis, MS, CGC
Genetic Counselor

Liza Jalalian CMT, Laboratory Technician

Appointments & Location

Center for Reproductive Health
UCSF Women's Health Center
2356 Sutter Street, 3rd Floor

Contact Number

Patient Consultation: 415/353-3076
Fertility Preservation Hotline: 415/353-3076
Fax: 415/885-3663

Patient Handouts

Visit our Patient Guides to Urological Treatments section to download Patient Handouts.

Related Links

Center for Reproductive Health

Fertility Preservation for Cancer Patients