In-Vitro Fertilization: Good success rates with Zero Sperm Counts

For men with zero sperm counts, sperm can be obtained directly from the testis using testicular biopsy (TESE). The most common reason for this procedure is an obstruction of the sperm transport system. As a result, no sperm are present in the ejaculate.  However, large numbers of sperm may still be produced in the testis. This blockage can be congenital, or can result from infection or vasectomy, because the fine tubules in the testis can become scarred.

In most patients, a fine needle biopsy is performed. Local anesthetic is used to induce numbness in the testis. The needle is placed through the skin into the testis, and a small piece of tissue is removed. The embryologist then examines the fine tubes contained in the biopsy sample and removes sperm to be used in the microinjection procedure ICSI. The fine needle biopsy takes about fifteen minutes. Occasionally, extra sperm can be frozen and used for subsequent microinjection cycles. Alternatively, the biopsy can be performed again. The results of the microinjection procedure using testicular sperm in such cases are good (approximately 41% clinical pregnancy rate per retrieval).

In cases where no sperm are found during the biopsy, couples may consider freezing the eggs or using donor sperm.

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