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Fertility Doctor of the Month: Moshe Wald, M.D.

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Moshe Wald, M.D., University of Iowa

August 2013

Dr. Moshe Wald is a urologist at the University of Iowa specializing in male infertility. Wald says he was drawn to this area of medicine as it allows him to combine both medical and surgical procedures (most often microsurgical, he explains). “I really enjoy it,” he says, “It’s a very satisfying specialty area and allows for very interesting research opportunities.” FertilityAuthority is pleased to recognize Dr. Wald as Doctor of the Month.

As a researcher, Dr. Wald has developed computer models that predict outcomes of fertility treatment to help clinicians best counsel fertility patients on whether they should do IUI or IVF. The algorithm takes many factors into account including patient age and hormone levels, and can help determine a patient’s chance of success with either fertility treatment.

He has also conducted extensive research on mechanisms of vasectomy failure, and ways to prevent or avoid it, as well as the use of biodegradable graft “scaffolding” for reconstructive surgery of the male reproductive tract. This surgery is necessitated by trauma, surgery or birth defects and is also performed to bridge obstructive segments of the male reproductive tract that prevent sperm from reaching the semen. Dr. Wald’s research in these areas is ongoing.

In his clinical practice, Dr. Wald sees men and couples where male factor infertility is present. He says anatomical problems – specifically varicocele – are the most common. Other causes of male infertility he treats include congenital bilateral absence of vas deferens, hormonal problems, genetic problems that interfere with production of sperm, surgical intervention that causes obstruction, medications and occupational exposure.

Dr. Wald places great importance on identifying the particular need of each couple he sees – taking both partners into consideration during the evaluation - and then tailoring a treatment plan that will fit their needs. For example, if a male has a varicocele, but his female partner has significant endometriosis, it wouldn’t make sense to fix the varicocele, Wald says, but instead proceed with IVF.

“If you can help a couple who cannot have a child, it is one of the most satisfying things,” Wald says.

Many patients wonder when they should see a urologist. Dr. Wald explains that if the semen analysis as part of the evaluation with the reproductive endocrinologist is abnormal, or if there is a history that would indicate male factor infertility, it’s very reasonable to be referred to urologist who specializes in male infertility.

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