Andrology · Microsurgery
Male infertility
A male factor is responsible for about half of all difficulties with conception. I provide full diagnosis and treatment of infertility - from pharmacotherapy and hormonal stimulation to microsurgery, including mTESE biopsy.
Book a qualification consultation(opens in a new tab)Where male infertility comes from
Reduced fertility can result from unfavourable environmental factors and lifestyle, hormonal disorders, urogenital infections, anatomical abnormalities (such as a varicocele of the spermatic cord) and postponing the decision to have a child.
The good news: many of these causes can be diagnosed and treated effectively.
Diagnosis
We start with a detailed medical history that takes environmental factors into account, an assessment of the semen analysis (seminogram) and hormone tests. During the physical examination I assess the testes, spermatic cords, penis and prostate; ultrasound allows the whole urogenital system to be evaluated.
Before an mTESE biopsy I always order genetic testing: karyotype, CFTR, AZF and SRY.
Conservative treatment and hormonal stimulation
When the cause is a hormonal disorder, I use modern stimulation methods that - by harnessing the natural mechanisms of the male reproductive system - can improve semen parameters and the chance of natural conception.
Treatment is accompanied by lifestyle modification and the treatment of infections and coexisting conditions.
Surgical treatment and microsurgery
- Microsurgical varicocele surgery - removal of a common, reversible cause of impaired semen parameters (more).
- mTESE - microsurgical testicular biopsy: retrieval of sperm directly from the testes under an operating microscope in men with azoospermia (no sperm in the semen).
- Reconstructive procedures - including microsurgical vasectomy reversal (vasovasostomy).
- TURED, laser TURED and vesiculoscopy - procedures used in the treatment of male fertility disorders, performed at Szpital na Klinach hospital.
Thanks to cooperation with a fertility centre, an mTESE biopsy can be performed together with a simultaneous in vitro fertilisation (IVF) procedure.
mTESE biopsy - procedure, success rate, complications
The procedure usually takes 60–90 minutes, or 90–120 minutes bilaterally, and is performed under general anaesthesia. Discharge follows after a few hours, and the recovery instructions are the same as after varicocele surgery.
The result is known immediately - during surgery I work with an embryologist who assesses the retrieved samples as we go and freezes those suitable for freezing.
In published series, sperm are retrieved on average in about 40–50% of men with non-obstructive azoospermia. The chance depends significantly on the cause - which is why I assess it individually after full diagnostics, before deciding on the procedure.
Like any operation, mTESE carries a risk of complications:
- haematoma
- wound infection
- very rarely, testicular hormonal insufficiency
Such complications are rare; I discuss the exact risk individually during qualification.
What the patient pathway looks like
First consultation with a review of your tests → completing the diagnostics → a treatment plan (conservative or surgical) → follow-up of the results with a semen analysis. If the couple is also under the care of a fertility clinic, I coordinate the treatment of the male factor with its team.
Video
Watch on TikTok
A short clip on infertility, azoospermia and microsurgical testicular biopsy (in Polish).
Price of diagnosis and treatment in Kraków
An andrology consultation costs PLN 350 and includes full ultrasound diagnostics. Microsurgical procedures are performed at the KrakOvi and ARTVIMED fertility centres - you will get their cost directly from the centre and during the qualification consultation.
- Andrology consultation - PLN 350, full ultrasound diagnostics included in the visit
- Microsurgical testicular biopsy mTESE - performed at KrakOvi or ARTVIMED, priced after the qualification consultation
- Payment by cash, card, BLIK or bank transfer · invoice on request
- Private visits, not covered by the Polish NFZ
The full list is on the pricing page.
Where I qualify and operate
The qualification consultation takes place at my office: Andromeda Centrum Medyczne, ul. Mogilska 69A, 31-545 Kraków, Poland. Microsurgical procedures - including mTESE - are performed at two Kraków facilities: KrakOvi and ARTVIMED. TURED, laser TURED and vesiculoscopy are performed at Szpital na Klinach hospital.
- Mon
- 8–18
- Tue
- 8–17
- Wed
- 9–17
- Thu
- 8–18
- Fri
- 8–18
- Sat, Sun
- closed
Frequently asked questions
Where should the work-up start?
With a semen analysis (seminogram) taken after 2–7 days of abstinence and a consultation to review the result. This test tells us the most to begin with.
What is mTESE?
It is a microsurgical testicular biopsy - the surgical retrieval of sperm under a microscope in men who have none in their semen. The sperm obtained are immature and are suitable only for in vitro fertilisation (ICSI), not for insemination.
What if no sperm are found?
The procedure can be repeated; before another attempt, hormonal stimulation is sometimes used - this is not always possible or indicated, and the decision is made individually.
Does mTESE damage the testes or lower testosterone?
Permanent damage is very rare: the testis is opened precisely, without unnecessary damage to the vessels, and under the microscope a minimal amount of tissue is taken from the most promising areas. Testicular hormonal function is almost always preserved. Sometimes a biopsy of one testis is enough.
Does a varicocele always need surgery?
Not always - an indication includes, among others, a varicocele combined with impaired semen parameters or symptoms. We make the decision after examination and ultrasound.
Should my partner be examined too?
Yes - infertility is a couple's issue, and the work-up should be carried out in parallel for both partners.
Next step
Book a qualification consultation
The sooner we identify the cause, the more options we have. Book a consultation with a semen analysis result - we will plan the rest together.
See available appointments(opens in a new tab)Andromeda Centrum Medyczne · ul. Mogilska 69A · Kraków