You are here
Doctor of the Month: Marc Goldstein, M.D., F.A.C.S.
Marc Goldstein, M.D., F.A.C.S.
Surgeon-in-Chief, Male Reproductive Medicine and Surgery, Executive Director, Men's Service Center, Cornell Institute for Reproductive Medicine
Director, Center for Male Reproductive Medicine and Microsurgery, New York Weill Cornell University Medical Center.
Marc Goldstein is an internationally renowned surgeon and a pioneer in the field of microsurgical repair of varicoceles and blockages and vasectomy reversals. FertilityAuthority is pleased to honor Goldstein as our Doctor of the Month in recognition of his tremendous accomplishments in the field of male fertility.
It is well documented that infertility is one-third male factor, one-third female factor, and the remaining third is a combination of factors. This suggests, Goldstein says, “half of infertility is male factor.”
“Men don’t have a relationship with a urologist as women do with a gynecologist," Goldstein says. When a couple is having a hard time conceiving, “smart doctors order a semen analysis. Women are often worked up with invasive procedures and there’s no male testing – I see a lot of that,” he adds.
The male evaluation he performs is a semen specimen carefully examined with a microscope following a detailed medical history and good physical exam. The single most important device in the evaluation is a heating pad, to warm the scrotum which enables a proper examination of the scrotum and its contents, Goldstein says.
A visit to Goldstein’s office is a testament to how passionate and enthusiastic he is about his work. He quickly rattles off what his day has entailed. On this particular day it was all surgeries. One day a week he focuses on varicocele repair. Approximately 15 percent of all men have varicoceles - enlarged varicose veins in the scrotum that prevent adequate blood flow or may cause reverse blood flow. But the percentage is higher in certain populations. According to Goldstein, 35 percent of infertile men have varicoceles, as do 81 percent of men who have secondary infertility.
In addition to causing infertility, varicoceles are associated with low testosterone levels. “Seventy percent of men have an increase in testosterone and semen quality,” following the microsurgery he says. In addition, temperature -- which is higher in men with varicoceles -- is normal after surgery. This improves semen quality and pregnancy rates.
On Wednesdays, Goldstein is back in the operating room to perform microsurgical repairs of blockages of the vas deferens. These blockages can preventing sperm from flowing out of the testes and can prevent sperm from entering into the ejaculate. These can be 4 - 7-hour surgeries, Goldstein explains.
Goldstein, who did his surgery internship and residency at Columbia-Presbyterian in New York, found his calling during his urology rotation. At that time, the late 70s, Goldstein says clinical andrology was still in its infancy - there were no operating microscopes used in surgery. He was then inspired by reading about a testicle transplant from a man to his identical twin who had lost both testicles (the recipient went on to father a child). Goldstein went to St. Louis to learn from Dr. Sherman Silber, the only urological microsurgeon in the world at that time. This led him into urologic microsurgery.
If you’re sitting across the desk from Goldstein, you’ll notice a floor-to- ceiling white board on your right, with notes on research he’s working on or interested in pursuing. About 20 percent of his time is spent doing research. And, he says he is “always teaching.”
And in his “spare time?" Goldstein is co-author of the newly published book, A Baby at Last!: The Couple's Complete Guide to Getting Pregnant--from Cutting-Edge Treatments to Commonsense Wisdom (Fireside, 2010). And on weekends, he’s a distance runner and tri-athlete.
FertilityAuthority applauds Dr. Goldstein for his achievements which have greatly advanced the treatment of male infertility.