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Male Infertility Specialist in Plano TX

Having Difficulty Conceiving? Male Infertility Diagnosis and Treatment at by Dr. Wierschem Can Help.

For a couple, the inability to conceive can be a stressful time, and it’s important that both partners get tested for fertility. In 20 percent of infertile couples, the problem is solely due to the male partner.Male infertility can be due to problems with the sperm or due to illness or various lifestyle choices.  Dr. Weirschem uses various tests to pinpoint the causes of infertility and, if possible, remedy the situation. If you are concerned with infertility, please contact our office in Plano, TX or McKinney, TX to schedule your consultation.

What is male infertility?

Male infertility is a condition where a man is unable to impregnate a woman due to low sperm production, abnormal sperm function, or blockages that prevent the sperm from being delivered. Up to 15 percent of couples find out they are infertile, meaning they are unable to conceive a child even though they’ve had unprotected sex for a year or longer. In half of these infertile couples, infertility in the male plays a role. Male infertility can stem from several causes. Illnesses, injuries, chronic health problems, and lifestyle choices can all play a part in a man being infertile.

How should the fertilization process work?

Once a month, a woman’s hormones prompt the development of an immature egg to maturity. Other hormones then trigger the release of the egg through the wall of the ovary. This egg has about 24 hours for a sperm cell to penetrate its outer layer.

Even under normal conditions, this can be difficult. Three out of every ten sperm cells are abnormally formed, and four out of ten are bad swimmers. On top of the at, the acidic nature of the vagina kills most of the sperm cells just minutes after ejaculation. At first, the woman’s body views the sperm as foreign bodies, like a virus, which it needs to eliminate.Those that make it must enter the cervix, swim through the mucus, enter the uterus and find the opening to the fallopian tube. Once in there, the hardy swimmer must find the egg and penetrate the outer wall. After all that, conception happens.

What causes a male to be infertile?

Male infertility can be traced to numerous causes, but it usually comes down to the sperm. Although there are many possible causes, here are some common causes:

  • Blockages or physical damage — Sometimes a man is born with a blockage in the testicle or other issues that prevent sperm from getting into the semen. Physical trauma to the testicles, prostate, and urethra can play a role here, too.
  • Retrograde ejaculation — When a man has this disorder, the semen doesn’t come out of the penis during ejaculation, but instead enters the bladder.
  • Varicoceles — These are enlarged varicose veins that develop in the scrotum and prevent blood from flowing properly. Varicoceles are found in 15 percent of all men, and up to 40 percent of infertile men.
  • Sexually transmitted diseases — Infections such as gonorrhea or chlamydia can cause infertility in men.
  • Autoimmune problems — If your body mistakenly sees sperm as foreign bodies, your immune system will attack them.
  • Sexual problems — Erectile dysfunction and premature ejaculation obviously the ability to conceive. Reasons behind these problems can be psychological or can be rooted in physical conditions such as diabetes, high blood pressure, and heart disease.
  • Excessive exercise — Too much exercise causes the release of too many steroid hormones, affecting fertility.
  • Use of drugs and alcohol — The use of marijuana, cocaine, steroids, alcohol, and cigarettes can reduce sperm counts.
  • Environmental exposure — Exposure to environmental hazards such as pesticides, radiation, mercury, and others lower sperm counts.
  • Stress and obesity — Both lower sperm counts and affect sexual activity.
  • Heat — There is also evidence that excessive heat from the frequent use of saunas or hot tubs can temporarily lower a man’s sperm count.

Are there symptoms beyond not conceiving?

Obviously, the main sign of male infertility is the inability to conceive a child. There may be no other symptoms, but these are some signs of male infertility:

  • Problems with sexual function — low ejaculation volumes, trouble ejaculating, reduced sexual desire, dysfunction
  • Pain, swelling, or a lump in the testicle area
  • Abnormal breast growth — clinically called gynecomastia, this can be a sign of hormone imbalances in a man.
  • Recurring respiratory infections
  • Problems with sense of smell
  • Decreased facial or body hair signifying hormone imbalances
  • Having a lower sperm count — a number of less than 15 million sperm per millimeter is considered low.

What are the tests for male infertility?

If you notice any of the above signs, or simply aren’t conceiving, you need to see us at our Plano or McKinney office. Dr. Wierschem will test you and get to the root cause of your infertility and then, if possible, treat it. We’ll start with a thorough physical exam, and then progress to a semen analysis. If the first analysis comes back normal we usually order a second test to confirm the results. Two normal tests usually confirm you don’t have significant infertility problems.

Here are issues a semen test can detect:

  • Azoospermia — The test will show that either there aren’t any sperm being produced or that the sperm aren’t making it into the semen.
  • Oligospermia — The test will show if there are too few sperm being produced.
  • Sperm mobility problems — We will be able to see if the sperm are not moving in a normal fashion and if they are likely to be incapable of fertilizing an egg.
  • Problems with sperm — We’ll see if there are problems with the sperm themselves, such as form and structural defects.

How do we treat male infertility?

Various infertility treatment options may be used by Dr. Wierschem for patients near Dallas including:

  • Surgery — Varicoceles can be surgically corrected. Sometimes blocked pathways in the testicles can be opened.
  • Treating sexual dysfunction — We can provide medication or counseling to overcome erectile dysfunction or premature ejaculation.
  • Treating infection — We may use antibiotics to cure an infection in the reproductive tract.
  • Hormone treatments — If infertility is caused by high or low levels of certain hormones, we can work to balance those out.
  • Assisted reproductive technology — Through methods such as surgical extraction of sperm, we can then insert the sperm into the female genital tract or use it for in vitro fertilization.

For further information on male infertility and infertility treatment, Contact our office in Plano, TX or McKinney, TX, call us at (972) 596-6733.


A varicocele is an enlargement of the veins in the scrotum that surround the testicle and the cord structures above the testicle.  Many men describe that there is an enlargement of their testicle/scrotum which feels like “a bag of worms”. It is more common for this to occur on the left side.

Varicoceles can be associated with low sperm production, low sperm quality and even infertility.  Not all men with a varicocele will experience infertility or an abnormal sperm count, however. Repair of the varicocele frequently leads to improvement in semen parameters and even pregnancy.

Varicoceles have also been associated with Low-T or hypogonadism.  Repair of the varicocele has been shown to increase the Testosterone levels by up to 200 points.

Some men will encounter discomfort in the testicle and groin area on the side of the varicocele.  Treatment of the varicocele often improves or even resolves the pain.

How is a varicocele diagnosed?

Diagnosis of a varicocele can be easily made through a combination of history, physical exam and scrotal ultrasound.

How is a varicocele treated?

Many men with varicoceles do not need treatment.  However, men with infertility, testicular discomfort or even Low-T may benefit from repair.

Repair of varicoceles can be performed in a number of ways.  Open surgery using a microscope and doppler ultrasound through a 2-3cm incision in the inguinal area has the highest success rates when compared to other surgical options.  This outpatient procedure typically takes less than 30 minutes and has a quick recovery with minimal post-operative discomfort. Dr. Wierschem has specialized microsurgical varicocele training from Cornell University in New York and performs this procedure regularly.

Other options include a laparoscopic approach or percutaneous ablation of the veins but these are   associated with a much higher recurrence rate than the open surgery.

What are the risks of varicocele surgery?

Varicocele repair is very safe and effective procedure and presents relatively few risks:

  • Recurrence of varicocele
  • Development of fluid around the testicle on the side of surgery (hydrocele)
  • Infection
  • Testicular injury
  • Injury to Testicular vascular supply resulting in a small testicle on that side
  • Injurty to the vas deferens resulting in infertility