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Sperm fertilizing ovum.

production and varicose veins. But, although they know varicoceles can impair testicular function, doctors still don't understand why some men with the problem are infertile, why they can't always be cured, or why others with similar varicoceles are fully fertile.

Urologists also understand now that hormones are important in regulating sperm production, thanks to the 1971 work of Albert Einstein Medical Center's Emil Steinberger. His basic research paved the way for laboratory tests to determine if a man's sterility is rooted in obstruction or in impaired sperm production, since serum hormones change in the patient with testicular failure but not in the one with obstruction. Steinberger's findings also opened the treatment doors for men whose infertility was due to insufficient hormone production.

Other diagnostic tools followed in 1985 when Larry I. Lipshultz and colleagues at Baylor College of Medicine popularized the use of ultrasound to identify obstructions in the male ductal system. Ultrasound proved invaluable by allowing doctors to get information without hospitalization or invasive procedures.

Though surgery was no longer as necessary for diagnosis, it was still a viable

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