Our Services
Explore our comprehensive male fertility services, including consultations, diagnostic tests, and tailored treatments. We offer expert guidance for addressing infertility concerns and facilitating optimal reproductive health. From lifestyle changes to advanced surgical options, we’re here to support you every step of the way.
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Male Fertility Consultations
Online and face to face, if you have a specific enquiry or seeking expert advice, second opinion online consultations are sufficient, however for a more thourough evalution a face to face appointment is preferred as it allows for clinical examination.
Fertility Preservation
We can help you preserve your fertility before having any treatment (whether surgical, interventional or medical) that may impair your fertility.
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Diagnostic Tests
Our diagnostic testing services are designed to provide a comprehensive assessment of male fertility.
Semen Analysis: This is the basic test that evaluates the overall function of the testes, most important parameters assessed include number of sperm, movement and shape.
Other Semen Analysis:
- Semen culture: to diagnose chronic infection in the prostate and seminal vesicle which may affect the sperm quality and sperm fertilisation capacity​
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- Sperm DNA fragmentation: evaluates the integrity of the sperm DNA which is not evaluated in the standard semen analysis, poor sperm DNA fragmentation is responsible for unexplained infertility despite having normal semen parameters, miscarriages and failed IVF cycles.
Male Reproductive Genetic Profile: ​Indicated in men low sperm counts in order to exclude genetic causes of male infertility that may be transmitted to the offspring.
Imaging:
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- ​Scrotal Ultrasound: Prof Raheem performs scrotal ultrasound routinely on men with low sperm count in order to exclude testis cancer which is more common in subfertile men compared to men with normal fertility.
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- Transrectal Ultrasound: this scan is done to men with a possible blockage at the level of the prostate: ejaculatory duct obstruction.
Hormonal Profile: ​This is a blood test that assesses the fertility hormones, namely FSH, LH , Total testosterone, estradiol and prolactin. These hormones control testicular function and sperm production. It is indicated in men with low sperm count.
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Male Fertility Treatments
We provide tailored treatments to enhance male fertility and support your journey to fatherhood.
Lifestyle Changes: We promote lifestyle changes to enhance male fertility, emphasizing nutrition and overall well-being for better reproductive health.
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Multivitamin Antioxidant Preparations
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Treatment of chronic infections which impair sperm quality and function
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Hormonal stimulation of the testes with Clomid and HCG
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Electroejaculation: In men who cannot ejaculate due to psychological factors, neurological disease and spinal cord injury. The aim is to retrieve sperm for use in different fertility treatments such as insemination or IVF.
Varicocele treatment: There are many theories which explain how varicocele has a negative impact on male fertility, however Prof Raheem likes to simplify it to his patients: a large varicocele is like having a blocked drain pipe, it impairs testicular blood flow and therefore testicular functions and is thus an important cofactor for male infertility. Varicoceles can be treatment micro-surgically which is the gold standard or by embolization, both are day case procedures.
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Surgical Sperm Retrieval:
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In men with azoospermia (zero sperm count); the aim is to extract sperm from the testes/epididymis for use in IVF/ICSI, this done for cases with a functional cause for azoospermia that cannot be treated (non obstructive azoospermia (NOA) or cases with a blockage obstructive azoospermia (OA) that is not amenable to microsurgical reconstruction as in cases with congenital bilateral absence of the vas deferens (CBAVD).
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- ​Microdissection Testicular Sperm Extraction (MicroTESE): This is the procedure of choice for men with functional non obstructive azoospermia (NOA). This is a day case procedure under general anesthetic.
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- Testicular Sperm Aspiration (TESA) and Per-Epididymal Sperm Aspiration: These are for men a blockage; obstructive azoospermia (OA). These are day case procedures under Local anaesthesia.
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Surgical Reconstruction:
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Done in men with obstructive azoospermia (OA), the aim is to restore fertility by bypassing a blocked segment of the genital tract. Depending on the site of the blockage, the procedures include:
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- Microsurgical Vaso-vasotomy & vasectomy reversal
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- Microsurgical Epididymovasostomy
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- Transurethral resection of the ejaculatory duct (TURED)
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Fertility Support After Steroid Use
Support for men who were on anabolic steroids and want to father their own child It is well known that being on testosterone replacement therapy suppresses fertility and may lead to azoospermia (zero sperm). The subfertility may persist even after stopping testosterone treatment. At the same time simply asking those men who are used to high doses of testosterone to stop therapy is not practical. Prof Raheem can tailor combination therapies to maintain good testosterone levels in those men while at the same time stimulating the testes to produce sperm again.
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Male Family Planning (Vasectomy)
Prof Raheem developed the microsurgical vasectomy technique (BRANDING NEEDED). Using the surgical microscope which allows sparing of the vasal vessels which also supply the testes and the rich nerve plexus surrounding the vas thus reducing the incidence of chronic pain which is one of the recognized long term complications that may require another procedure to fix.
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Spinal Cord Injury and Fertility
Spinal cord injury is associated with problems with erection, emission and ejaculation. Furthermore, studies have demonstrated a progressive deterioration in all semen parameters in addition to impairment in the quality of sperm DNA post spinal cord injury. This poses challenges for men with spinal cord injury in fathering their own child.
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​Cancer & Fertility
Cancer treatment whether surgery, chemotherapy or radiotherapy may impair fertility. If your about to undergo cancer treatment we can help you preserve your fertility by quickly cryopreserving your sperm before you start therapy. We understand that many patients may be unable to produce a sample but we can obtain your sperm via electroejaculation or via surgical sperm retrieval. If you have already had cancer treatment and cryopreserved your sperm, we can still help you by investigating your fertility potential and treating you.
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Aging & Fertility
Semen parameters such as volume, count, motility and normal forms decline with age along with the quality of the sperm DNA. Several studies have demonstrated that infertility, miscarriage and lower success rates after IVF are high in men over the age of 40. If you are above the age of 40 and plan to start a family (whether naturally or by IVF), we can help optimise your fertility and increase the success-rates of fathering your own child (whether naturally or by IVF).