Hi,
One of the factors you'd want to consider in looking for "the best"
place for your treatment is how often they diagnose and treat male
infertility factors. You probably already know that many of the
infertilty specialists are gynocologists, specializing in women's
factors. Knowing the success rate for a clinic that works with that
population won't really help you to pick one for yourself.
There is a good site that talks about
Criteria for Selecting a High-Tech Infertility Clinic
http://www.inciid.org/chart.html
Scroll down to the section that discusses "Reproductive Urologist (May
also be Reproductive Surgeon)." You'll need someone who is familiar
with the causes of azoospermia. It is often not a simple diagnosis. If
there is an obvious blockage, you want a surgeon who has a good
success record with that surgery.
Infertility clinics in the United States need to report to the CDC
every year. So, the CDC site is a good place to start comparing
clinics - and a good place to find the ones that comply with the
repoting law. They have the reports broken down into results for each
state. The link to the latest available (2001) results for WA is:
http://apps.nccd.cdc.gov/ART2001/clinlist01.asp?State=WA
*Kevin M. Johnson, M.D. - OVERLAKE REPRODUCTIVE HEALTH, INC.,
P.S./BELLEVUE/Male factor 7%
*James I. Kustin, M.D. - WASHINGTON CENTER FOR REPRODUCTIVE
MEDICINE/BELLEVUE/Male factor 6%
*Emmett F. Branigan, M.D. - BELLINGHAM IVF/BELLINGHAM/Male factor 5%
*James F. Moruzzi, M.D. - OLYMPIA WOMEN'S HEALTH/OLYMPIA/Male factor
4% (was 0% in 2000)
*Lee R. Hickok, M.D. - PACIFIC GYNECOLOGY SPECIALISTS/SEATTLE/Male factor 22%
*Nancy A. Klein, M.D. - UNIVERSITY OF WASHINGTON FERTILITY & ENDOCRINE
CENTER/SEATTLE/Male factor 10%
Gerard S. Letterie, D.O. - VIRGINIA MASON CENTER FERTILITY & REPROD.
ENDOCRINOLOGY/SEATTLE/Male factor 29%
*Edwin Robins, M.D. - THE CENTER FOR REPRODUCTIVE ENDOCRINOLOGY &
FERTILITY/SPOKANE/Male factor 24%
*Joseph A. Robinette, M.D. - GYFT CLINIC, P.L.L.C. /TACOMA/Male factor 14%
From this data, it appears that the two clinics that see men for
fertility problems on a regular basis are Virginia Mason in Seattle
and The Center for Repreductive E & F in Spokane. Your referral to the
Washington Center is probably based on the overall quality of the
center - and it may be that your primary care physician has
established a relationship with that doctor that makes it easy to
recommend the clinic.
The clinic in Bellingham has about the same percentage of patients
with male factor diagnosis - and it's much closer to you. If you're
travelling to Bellevue, you might as well just go to Seattle for the
Virginia Mason Clinc.
As far as the professional standing of the doctors is concerned, the
only one who has any professional publications is Dr. Letterie from
the Virginia Mason Clinic. Although publishing is not necessarily an
indication of the doctors ability to successfully treat you, it does
indicate an understanding of the procedures involved in infertility
treatments on a professional level. Dr. Marik,
http://www.tylermedicalclinic.com/Dr.%20Marik.htm, at Tyler in Beverly
Hills is one of the most respected infertility experts practicing
today. Their site has a very clear page on azoospermia:
http://www.tylermedicalclinic.com/Azoospermia.htm
Dr. Letterie would probably be the closest in professional recognition
to Dr. Marik.
Dr. Kustin (http://www.seattleivf.com/staff.html) has a very good
background with 12 years in private practice and international
training.
While you may be looking for a friendly doctor, often the best doctors
are not the friendliest. A good bedside manner is nice -- especially
when dealing with such a sensitive issue -- but the bottom line is
that you want the person who will give you the most chance to
conceive. If that's not the one who smiles the most, you'll make up
for it when you're smiling at the results.
There are several good sites that deal with azoospermia
http://www.rscbayarea.com/articles/azoosper.html - IVF with ICSI - for
Men with Azoospermia
http://www.uhmc.sunysb.edu/urology/male_infertility/AZOOSPERMIA.html -
Presently, testicular biopsy may not only discriminate between the
types of azoospermia, but have a predictive value for sperm presence
in the testis in cases of nonobstructive azoospermia.
This government site has a technical, but short, paper on the
management of obstructive azoospermia
http://www.guideline.gov/summary/summary.aspx?doc_id=2922 -- they have
a couple of links to pamphlets foe patients that also may help clear
up any questions.
What you need to know is whether the lack of sperm is due to a
blockage - which can be corrected, a hormonal imbalance - which may be
correctible, or if it a genetic or disease produced malfunction. Some
viruses cause sperm production to stop and in some cases a man is born
with testicles that are not built to produce sperm.
You'll want to get a clear idea of which tests will be recommended and
the order they will be done in. Generally, the least invasive tests
are done first to diagnose and treat -- or rule out -- the easy
problems. What are the tests they use and what can you expect before,
during and after each procedure. Even if the doctor is extremely busy
- there are assistants who can, and will, take the time to answer
every question. You are not the first person they are dealing with who
has been through this. They are there to help you - and they will.
Search terms:
Selecting an ART Clinic
fertility clinics male infertility diagnosis %
I hope this helps. If you need additional information, just post a
clarification. It's a complicated subject, and a difficult decision.
Discuss your concerns with your physician to get a professional
opinion. It may be that there are some very good reasons that he is
making the recommendation - or it may just be that he's heard of one
clinic and is not familiar with the others.
Good luck with the procedure!
Regards,
bcguide-ga |
Request for Answer Clarification by
tuta-ga
on
07 Aug 2004 17:44 PDT
out of marik and the two seattle doctors, as well as any others in
the u.s give me the listing of the nations best and seattle's best...
|
Request for Answer Clarification by
tuta-ga
on
07 Aug 2004 17:45 PDT
you did give me this info. but i need it in a more formal manner.
you know what i mean.................................
|
Request for Answer Clarification by
tuta-ga
on
07 Aug 2004 18:26 PDT
i have already seen a urologist in vancouver and i have had all the
tests that can be done to determine that i have non obstructive
azoospermia.
it is now a question of finding the best place to have a biopsy or to
do testicular fine needle aspiration which are the two methods of
finding out if there is sperm collected in my testicles which can be
used for IVF or ICSI (implant one sperm into my wifes egg).
|
Request for Answer Clarification by
tuta-ga
on
07 Aug 2004 20:38 PDT
hi, it has also come to my attention that some of the Drs are more
specialised in womens infertility and gaenecology.... i want to know
who is more experianced and specialised in male infertility surgery.
|
Clarification of Answer by
bcguide-ga
on
08 Aug 2004 06:29 PDT
Hi Tuta-ga,
You are correct in stating that many of the infertility doctors have
specialized in problems with the female reproductive tract. That is
beginning to change, but you do want to make sure that the place you
choose is very familiar with treating male factor infertility.
I am looking for an online source that compares or rates urologists
specializing in azoopermia.
It may take some time to get the information and I understand that
you'd like it as soon as possible.
There is an organization, RESOLVE, which is an infertility advocacy group.
http://www.resolve.org/main/national/index.jsp?name=home
Toll-Free HelpLine: 888-623-0744 - Email: info@resolve.org
If I can't find the information you need online - it may not be
available - I will contact them Monday to find out if they have this
type of information, and if they have it, whether they'll give it to a
researcher or if the person involved needs to contact them directly.
You also may want to give them a call to speak to some of the members
who have been through the same experience. Patient to patient
communication is often the best way to get an idea of where to look
for answers - or at least which questions need to be asked.
I will keep looking in the meantime and post as soon as I find any
rating information besides the CDC report.
You may also want to take a look at a couple of documents.
The American Society for Reproductive Medicine's Report on Evaluation
of the Azoospermic Male (2001). It outlines the procedures for
diagnosing the causes of azoospermia. It may be a bit more technical
than the usual patient information, but it is very clearly written and
it might add a bit more information to what you already know.
http://www.asrm.org/Media/Practice/azoospermic.pdf
The American Society for Reproductive Medicine's Patient Fact Sheet -
Diagnostic Testing for Male Factor Infertility.
http://www.asrm.org/Patients/FactSheets/Testing_Male-Fact.pdf
Also an update...it seems that the University of Washington?s
Fertility and Endocrine Center (FEC) will be closing. The doctors are
going into private practices. They provise a list of fertility
practices in King County for patients who were being treated at UWFEC:
Overlake Reproductive Health (Dr. Johnson), Bellevue, 425-646-4700
Pacific Gynecology Specialists (Drs. Hickok, McIntosh, Smith, Uhlir,
Williams), Seattle, 206-215-3200
Seattle Reproductive Medicine (Drs. Lin, Klein, Soules, Thyer)
Seattle, (206) 273-7858
Virginia Mason Center for Fertility and Reproductive Endocrinology
(Drs. Marshall, Letterie), Seattle, (206) 223-6190
Washington Center for Reproductive Medicine (Dr. Kustin), Bellevue,
(425) 462-6100 -
http://depts.washington.edu/fec/
Again -- I will post as soon as I can get the information you need.
bcguide-ga
|
Clarification of Answer by
bcguide-ga
on
09 Aug 2004 14:09 PDT
Hi,
Just wanted to let you know that I'm waiting on call backs from a
couple of places. Haven't been able to get anything more substantial
online, just that male factor infertility is a relatively new field,
which we already knew!
I'll try calling again tomorrow if they don't get back to me.
Sorry for the delay. I know the waiting must be difficult.
bcguide-ga
|
Request for Answer Clarification by
tuta-ga
on
09 Aug 2004 16:56 PDT
well i need all info. before i will pay.....
|
Clarification of Answer by
bcguide-ga
on
10 Aug 2004 15:13 PDT
Hi,
A step closer. I have contacted two doctors in Texas and New York who
are recognized in the field of male infertility. The people I have
spoken to advise that a fertility clinic is probably not the best
choice for male factor treatments, since for the most part, they do
focus on women's issues. I am working on getting information on
urologists who specialize in male factor infertility treatments in
your area.
Should have more for you tomorrow. Just keeping you up to date.
Regards,
bcguide-ga
|
Request for Answer Clarification by
tuta-ga
on
10 Aug 2004 18:12 PDT
what about cornell university. Dr. Goldstein and one of the other
guys. Goldsteins resume is good. Give me your opinion on him?
|
Clarification of Answer by
bcguide-ga
on
13 Aug 2004 05:22 PDT
Hi,
Yes, Dr. Goldstein is one of the top men in the field.
Dr. Mark Goldstein
212-746-5470
There is another doctor at Baylor in Texas who seems to be recognized
as THE top person.
Dr. Larry Lipshutz
713-798-6163
None of the phone calls came up with doctors in Washington, but I did
find some references on line that may help.
American Urological Association
Has a listing of 154 practicing urologists in WA
2 specialize in male fertility factors.
http://www.urologyhealth.org/find_urologist/
Special Interest Area: Fertility
Doctor's Full Name:
Richard E. Berger, M.D.
Address: Univ. of Washington
HSB Box 356510
Seattle, WA 98195-6510
Phone: 206 543-3270
Doctor's Full Name:
R. Dale McClure, M.D.
Virginia Mason Clinic (which probably explains the high number of male
factor cases that Virginia Mason diagnoses and treat)
1100 9th Ave C7-S
Seattle, WA 98101-2756
Phone: 206 223-6179
Another link, the Society for Male Reproduction and Urology, also
lists doctors in your area
http://www.smru.org/cgi-bin/SMRU_search.cgi
Richard E Berger M.D. Seattle WA USA 206-543-3270 Urology
R. Dale McClure M.D. Seattle WA USA 206-223-6179 Urology
Richard S Pelman M.D. Bellevue WA USA 425-454-8016 Urology
Wayne D Weissman M.D. Seattle WA USA 206-292-6488 Urology
Charles H Muller Ph.D. Seattle WA USA 206-543-9504 Andrology
C. Alvin Paulsen M.D. Seattle WA USA 206-284-8225 Andrology
I'd contact Dr. Lipshultz and either see him or find out if he works
with any of the doctors in your area.
I still have several call backs coming and I'll post a clarification
if any new information is added, but this seems to be the best way to
go.
The best of luck - post a clarification when you bring the baby home :-)
Regards,
bcguide-ga
|
Clarification of Answer by
bcguide-ga
on
13 Aug 2004 05:35 PDT
Hi,
The doctor at Baylor is Dr. Larry Lipshultz - I left out the 'L' in
the previous post.
bcguide-ga
|
Request for Answer Clarification by
tuta-ga
on
13 Aug 2004 13:01 PDT
ya, thanks so far, but we are now thinking about a Dr. Phillip
Werthman in L.A, b/c of his expertise and location. Can you tell us
what you and other people feel about him and can find out about him.
Travelling to Texas would be difficult for us so we are deciding to
stick to LA or that general area.
Also, can you help me find a list of any other male fertility doctors
in that area.
That would be great and you have done a wonderful job thus far!!!
|
Clarification of Answer by
bcguide-ga
on
14 Aug 2004 06:15 PDT
Hi,
http://www.maleinfertilitymds.com/database/cvs/werthman.htm
He sounds like an excellent choice.
http://www.maleinfertilitymds.com/ has a database of male infertility
specialists - you can search by any area. I had used them to look up
doctors in Washington, but they didn't list any. They do have a few in
the LA area.
One in particular stands out, Dr. Spitz. He has studied both at
Cornell and Baylor, which means he probably studied with the two top
names we discussed before.
http://www.maleinfertilitymds.com/database/cvs/spitz.htm
As I said before, the fact that they write textbooks and publish
articles in peer reviewed journals is not an absolute guarantee that
they are good... but it is a very, very good indication.
I think either of those two would be excellent - another option is to
speak to them and see if they can recommend anyone -- at their level
-- practicing in Washington or at least in Northern California. If you
have to, you can travel to LA, but if you can get the same level of
care closer to home, you'd be better off. Both of these doctors are
very active in their professional organizations and would know who to
recommend for your specific needs.
Regards,
bcguide-ga
|
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