Comprehensive care for contraception and infertility.
Facing Male Fertility Issues or Considering Permanent Contraception? We Can Help
Male fertility concerns are more common than you might realise. Whether you are dealing with infertility, post-vasectomy pain, or considering male contraception, these issues can be deeply personal and emotionally challenging to you and your partner. Conditions like varicocoeles (swollen veins in the scrotum), neurological disorders or ejaculatory duct obstruction can affect your ability to conceive and your overall quality of life. Major pelvic surgery may also have the unintended effects of causing infertility. Lastly, circumstances may change, and you may wish to restore your fertility potential following a vasectomy.
If you’ve been struggling with fertility issues or experiencing discomfort after a vasectomy, you’re not alone. Effective treatments are available to help address these concerns.
Understanding the Principal Causes of Male Fertility Issues
Male fertility can be affected by a variety of factors, ranging from a physical obstruction to hormone imbalances or impaired production resulting from conditions like varicocoeles. Whether you’re facing challenges with male conception, infertility, or post-vasectomy pain, a comprehensive diagnosis and thorough counselling are essential to finding the right solution.
Dr. Lee takes a detailed approach to male fertility care. He will assess your medical history, perform necessary diagnostic tests, and conduct a thorough physical examination. This may include imaging studies like ultrasounds and MRIs, or hormone tests to identify issues such as ejaculatory duct obstruction or varicocoeles. With a clear understanding of the underlying causes, Dr. Lee can design a tailored treatment plan to address your specific reproductive needs.
Conditions We Treat
Vasectomy & Vasectomy Reversal
Contraception and fertility restoration.
Male Infertility
Difficulty conceiving due to issues with sperm production or function.
Varicocoele
Enlarged veins in the scrotum that may impact sperm quality or cause discomfort.
Post Vasectomy Pain
Chronic pain after a vasectomy.
Ejaculatory Duct Obstruction
Blockage in the ducts that carry semen, affecting fertility.
Comprehensive Treatments for Male Fertility and Contraception
Based on your assessment and diagnosis, Dr. Lee will recommend a treatment plan specifically designed to meet your fertility or contraception needs. These treatments range from non-invasive procedures to advanced microsurgery.
Vasectomy:
A safe and effective procedure for permanent male contraception, where the vas deferens is cut or sealed to prevent sperm from entering the semen.
Microsurgical Varicocoele Ligation:
A delicate and precise approach to treat the distended spermatic cord veins to improve sperm quality and relieve discomfort.
Varicocoele Embolisation:
A non-surgical, catheter-based procedure to block off the problematic veins causing a varicocoele, reducing the risk of infertility.
Sperm Retrieval Procedures (TESA, MESA, PESA):
For men with low or no sperm count, these procedures extract sperm directly from the testicles or epididymis for use in assisted reproductive technologies like IVF.
Micro-TESE (mTESE):
A more advanced form of sperm retrieval for men with severe infertility, where sperm are harvested from testicular tissue using high-precision microsurgery.
Your Path to a Healthier, More Confident You
FAQs
What is involved in surgical sperm retrieval for severe infertility?
Surgical sperm retrieval is a specialised technique used when sperm are not present in the ejaculate – a condition known as azoospermia. This may be due to a blockage (obstructive) or poor sperm production (non-obstructive). It’s commonly performed for men pursuing IVF with ICSI (intracytoplasmic sperm injection).
The most advanced method is called:
Micro-TESE (microdissection testicular sperm extraction)
This involves:
- A small incision in the testicle under anaesthesia
- Use of an operating microscope to identify and extract the tiny tubules most likely to contain sperm
- Immediate analysis by an embryologist to confirm sperm presence
- Sperm may be used fresh or frozen for future fertility treatment
Benefits of Micro-TESE:
- Higher success rates than standard extraction methods in non-obstructive azoospermia
- Minimises testicular tissue damage
- Can be repeated if needed
- Suitable for men with previous failed sperm retrieval attempts
At my clinic, I work in collaboration with expert fertility labs and embryologists as a multidisciplinary team to ensure the best possible outcomes. All procedures are performed with precision and discretion, as part of a personalised male fertility treatment plan.
What causes male fertility problems and what tests are involved?
Male fertility problems are more common than many realise and can account for up to 50% of infertility cases in couples. The causes can be physical, hormonal, genetic, or lifestyle related.
Common causes include:
- Low sperm count or poor sperm motility
- Varicocoele: enlarged veins in the scrotum that impair sperm quality
- Hormonal imbalances, such as low testosterone or high prolactin
- Obstruction in the reproductive tract (e.g. vas deferens blockage)
- Previous surgery or trauma including vasectomy
- Genetic conditions, such as Klinefelter syndrome or Y-chromosome microdeletions
- Lifestyle factors: smoking, alcohol, obesity, heat exposure, or anabolic steroid use
- Infections (e.g. mumps orchitis, STIs)
Key tests for male fertility assessment:
- Semen analysis: assesses sperm count, motility, and morphology
- Hormonal blood tests: including testosterone, LH, FSH, and prolactin
- Scrotal ultrasound: to evaluate varicocoeles or blockages
- Genetic testing: for men with very low or no sperm
- Physical examination: to assess testicular size, consistency, and any palpable abnormalities
At my clinic, male fertility assessments are handled discreetly and in coordination with fertility specialists. We also offer advanced treatment options, including microsurgical sperm retrieval and microsurgical varicocoele repair, where appropriate.
Does age affect male fertility?
Yes, although men can remain fertile later in life, age does affect male fertility in several important ways.
From around age 40 onward, men may experience:
- Reduced sperm quality – lower motility, concentration, and morphology
- Increased DNA fragmentation in sperm, which can impact embryo development
- Longer time to conception when trying to conceive with a partner
- Higher risk of miscarriage and certain developmental conditions in offspring
- Gradual decline in testosterone levels, affecting libido and sexual function
Unlike female fertility, which declines sharply after a certain age, the decline in male fertility is more gradual, but still clinically significant.
Even healthy men may notice subtle changes in:
- Ejaculate volume
- Sexual performance
- Fertility outcomes in assisted reproduction
At my clinic, we assess male fertility comprehensively, including hormonal evaluation and sperm analysis. If age-related changes are impacting your ability to conceive, we can explore sperm optimisation, lifestyle adjustments, and assisted options like sperm retrieval or referral to a fertility specialist.
Can male infertility be reversed?
In many cases, male infertility can be improved or even reversed, depending on the underlying cause. Advances in andrology and microsurgery mean that effective treatments are now available for a wide range of fertility issues.
Reversible causes may include:
- Hormonal imbalances, such as low testosterone or high prolactin
- Varicocoele – treatable with minor surgery or embolisation to improve sperm quality
- Obstructive azoospermia – due to vasectomy or congenital blockage, which may be corrected with vasectomy reversal or sperm retrieval
- Lifestyle factors – such as smoking, alcohol, obesity, and heat exposure
- Infections – when diagnosed and treated early
Treatment options may involve:
- Medication or hormone therapy to stimulate natural sperm production like clomiphene (Clomid)
- Microsurgical procedures such as varicocoele repair or sperm retrieval (e.g. Micro-TESE)
- Vasectomy reversal, if family planning goals have changed
- Referral to fertility clinics for IVF with ICSI using retrieved sperm
Not all types of infertility can be fully reversed, but many men go on to conceive with the right support. Early diagnosis and specialist care offer the best chance of success.
At my clinic, I offer comprehensive male fertility evaluation and personalised treatment planning, always in a confidential, supportive environment.
How do I prepare for a male fertility test?
Preparing properly for a male fertility test helps ensure accurate and reliable results, particularly for a semen analysis, which is the key test in evaluating sperm health.
Here’s how to prepare:
- Abstain from ejaculation for up to 3 days before the test (Too short or too long an interval may affect sperm count or motility)
- Avoid alcohol, smoking, or recreational drugs in the days leading up to the test. These can impact sperm quality, even in the short term
- Avoid hot baths, saunas, or tight underwear. Heat can temporarily lower sperm production
- Inform your doctor about any recent illness, fever, or medication. Some antibiotics, hormonal treatments, or supplements may affect results
- Stay hydrated and get good sleep, as overall health influences reproductive function
Semen samples can be collected on-site or brought in within a short time frame, depending on your preference and location. We’ll also advise whether additional testing, such as hormone levels, scrotal ultrasound, or genetic screening, is needed. An abnormal semen analysis will have to be repeated to confirm the finding.
Clear preparation helps us give you the most accurate assessment of your fertility and design a treatment plan if needed.
What happens during the surgery for sperm retrieval and what are the key stages of recovery?
The specifics of surgery and recovery depend on the procedure, but all follow a structured pathway to ensure safety, comfort, and optimal results.
During the surgery:
- You’ll receive anaesthesia (general or spinal, depending on the procedure)
- The operation is performed in a specialist hospital using the latest techniques, including microsurgery or minimally invasive approaches where appropriate
- Surgery typically lasts 1 hour, with additional time in recovery
- You will have padding over the wound, but the wound itself will be sealed with skin glue so that it is waterproof and protected from infection
Key stages of recovery:
- Immediate recovery:
- You’ll be monitored in a recovery area or ward
- Pain is managed with medication, and wound care is explained
- You will be discharged with an escort (family or friend) once fully awake and after tolerating something to eat and drink.
Early healing (Weeks 1–2):
- Swelling, bruising, and tenderness are normal
- You are welcome to change the dressings as required but do not remove the skin glue layer covering the wound
- Most patients can return to light activity immediately with gentle walking
- Wear supportive (tight) underwear for better pain relief due to the support provided (also called “scrotal supports”)
- Consider taking a week of work depending on occupation
- Avoid sexual activity for 2 weeks
Functional recovery (Weeks 3–6):
- Return to daily activities, with restrictions lifting as comfort permits
- Regular check-ups if required to ensure healing is on track
Full recovery (6–12 weeks+):
- Final outcomes become more visible: improved confidence, appearance, and comfort
- Surgical scars continue to fade
Recovery plans are personalised and include clear aftercare instructions, access to follow-up support with myself and my nursing staff, and collaboration with your wider medical team if needed.
At my clinic, we guide you through each step, from consultation to full recovery, with privacy, professionalism, and continuity of care.
Can fertility be preserved or restored in conjunction with gender affirmation surgery?
Absolutely, fertility preservation is an important consideration for many individuals undergoing gender-affirming surgery, and it should ideally be discussed early in the transition process, even prior to commencing hormone treatments.
For individuals assigned female at birth undergoing phalloplasty or hormone therapy, options like egg freezing are available prior to surgery or testosterone use.
For individuals assigned male at birth undergoing vaginoplasty or hormone therapy, fertility preservation typically involves sperm banking (cryopreservation) before starting oestrogen or having orchidectomy.
If fertility preservation wasn’t pursued before treatment, options may still be available, though more limited. It would depend on the possibility of temporarily ceasing gender-affirming hormone therapy for a short duration.
As a surgeon specialising in genital reconstruction and fertility, I work closely with fertility specialists, gynaecologists and endocrinologists to ensure that patients have access to the right support at the right time.
Key options include:
- Sperm freezing (for AMAB individuals before medical or surgical transition)
- Clear referrals and advice for fertility counselling and reproductive planning
The decision to preserve fertility is deeply personal. We offer inclusive, supportive guidance to help you make the choice that aligns with your gender identity, values and long-term goals.
STEP 1
Schedule a Consultation
Book an appointment in a confidential and supportive environment.
STEP 2
Personalised Treatment Plan
Our team creates personalised plans to meet your unique health goals.
STEP 3
Regain Your
Confidence
Improve your health and well-being with expert guidance.
Take The Step to Improve Your Fertility – Explore Your Treatment Options Today
Whether you’re seeking male contraception, dealing with fertility challenges, or experiencing post-vasectomy pain, Dr. Lee offers understanding and expert care with a variety of advanced treatments to help you achieve your goals. Schedule a consultation today to discuss your personalised fertility or contraceptive treatment.
