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TESE, Micro-TESE, and Low Testosterone

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TESEs were first performed in the early 1990s and provided men with a fertility option even if semen analysis showed no sperm – known as azoospermia. This ushered in an era of male fertility options that allowed urologists to retrieve sperm in about 30% of men, ultimately resulting in about 25% of men being able to become fathers. With 1% or so of all American men not having usable sperm in their semen, this was a major step forward.

Around the same time, we began to understand the landscape of male versus female infertility, and we now know that about a third of all infertility issues can be attributed to the male patient, a third to the female patient, and a third to both. So, finding a way to improve male fertility has addressed a key concern of couples struggling to conceive.

The TESE and even micro-TESE is an invasive procedure used for sperm extraction from the testes. Both require cutting into the testicle, at which point the urologic surgeon tests areas of the testicle for sperm. If sperm are found, they are extracted for later insemination.

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What to Know About Testicular Mapping

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While there’s plenty we don’t know, we have learned a lot about male fertility and reproduction over the past few decades. One of the most exciting areas of research and advancement has been in the management of male fertility concerns. Nonobstructive azoospermia was at one time considered difficult or impossible to treat, yet now, many men with no detectable sperm in their semen have become fathers. Today, there are several sperm extraction techniques available to these men, but most are invasive. As such, there has been a need for minimally invasive diagnostics to see whether sperm can be found in the testes.

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Can Tongkat Ali Boost My Testosterone? A Urologist’s Perspective

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Disclaimer: We want to address Tongkat Ali due to its recent and sudden rise in popularity, however, it is important to note that these studies are poorly designed and lack high-quality data. We can’t be sure of the benefits of Tongkat Ali until they are shown in well-designed clinical trials. Patients should consult with a physician regarding safety before starting any supplement regimen.

man dumping Tongkat Ali supplement from bottle into hand

Tongkat Ali or Longjack, an herb found in Southeast Asia and commonly used as part of traditional holistic medicine there, has risen in popularity due to claims about its effectiveness in increasing testosterone, reducing stress, and potentially even boosting male fertility. Various podcasters, including Joe Rogan and Professor of Neurobiology at Stanford University Andrew Huberman, have discussed this herb in depth. They posit that taking Tongkat Ali boosts antioxidant levels in the body to fight free radicals while normalizing certain hormones like testosterone and Cortisol. Do these claims hold water? Let’s dive in.

Before we evaluate each of these claims, it is important to note that the FDA does not oversee supplements. Therefore, you must do your due diligence about which supplements to buy, as their purity and concentrations can vary. Safety should be your primary concern. Continue reading “Can Tongkat Ali Boost My Testosterone? A Urologist’s Perspective” →