Overcoming Severe Male Infertility
For successful in vitro fertilization (IVF) treatment, fertility clinics need optimal sperm and eggs from patients. Severe male-factor infertility, however, can make the process difficult, but not impossible. Some men have severe azoospermia, which is an absence of sperm in the ejaculate. Natural conception is not possible in these cases, and using a sperm sample for IVF will typically not yield successful results. However, using microsurgical testicular sperm extraction (micro-TESE), sperm retrieval is possible. Micro TESE shows how advanced IVF can help couples with infertility achieve pregnancy.
The case for sperm extraction
Micro TESE involves extracting sperm directly from the testicular tissue. Although men may not produce sperm in the ejaculate, sperm cells may still be present in the testes. Using a high-powered operating microscope, a fertility specialist can locate and extract sperm from the seminiferous tubules within the testes. Multiple tissue samples may be needed, making the procedure an intensive endeavor that can take up to 4 hours in some cases. Although the procedure is minimally invasive, this is a detailed search for sperm with the patient under general anesthesia. Patients can go home the same day, while only needing a few days of recovery. Successful samples are passed to the embryologist to create embryos with eggs for future IVF cycles.
Who should try micro TESE?
Men with non-obstructive azoospermia (NOA), where sperm are not present due to a blockage, can consider micro TESE. Men with severe oligospermia, which is a significantly reduced sperm count, have also found success from the procedure. Some men have genetic disorders, like Klinefelter syndrome and Y-chromosome microdeletions, that prevent optimal sperm production. These men can still achieve parenthood by extracting sperm cells from the testicles. Fertility specialists may recommend micro TESE if attempts to extract sperm using other means, like conventional TESE or a testicular biopsy, fail. Work with the medical team for a comprehensive fertility review before proceeding with micro TESE.
Sperm success
The micro TESE procedure is ideal for men with severe azoospermia. Factors like underlying cause, age, and surgical skill all influence success rates. Statistics show that at least 38% of cases can successfully extract sperm. Men with NOA may experience even higher success rates. Retrieved sperm is usually of high quality, with almost 70% of samples successfully fertilizing eggs to create embryos. IVF success with extracted sperm is on par with healthy sperm, with over 45% live birth rates. While micro TESE is effective, there are many cases where the procedure fails. At this stage, couples must consider other forms of sperm extraction or the use of donor sperm. Couples should also consider counseling to navigate the physical and emotional challenges of infertility.
Micro TESE, maximum results
Male infertility accounts for 30% of all infertility cases among couples. Many of these cases are due to issues with sperm health, such as severely low sperm counts. Azoospermia can make conception difficult, even for couples undergoing IVF to achieve pregnancy. In these situations, micro TESE can extract enough sperm to attempt IVF. Fertility specialists can search for healthy sperm from extracted samples and create viable embryos. With micro TESE, men have renewed hope to have biological children.
