ASSISTED REPRODUCTION FOR SEVERE MALE INFERTILITY

In cases of severe male factor infertility, a single sperm can be injected directly into the egg, in the laboratory, after eggs are retrieved from the woman. This is accomplished using a high powered microscope and small glass injection needles. The process is controlled by the embryologist using highly-developed precision equipment. ICSI, or intracytoplasmic sperm injection, is performed for men having extremely low sperm counts or extremely high percentages of abnormal shaped sperm or nonmoving sperm. Some men may have no sperm at all due to absence or damage of the duct system that allows for flow of the sperm from the testicle. Some men who have had a vasectomy unsuccessfully reversed may suffer from this problem. Small numbers of sperm can be surgically retrieved from these men and directly injected into their partner's eggs. High fertilization and pregnancy rates are usually seen. Thus, we can overcome the influence of male infertility and give new hope for fathers-to-be.

Finding sperm in a severely infertile male was formerly like searching for gold. Now, a male fertility specialist, such as affiliated urologist Martin Bastuba, M.D., can find sperm by means of a simple outpatient procedure. Sperm can be found in the epididymis, which is a duct carrying sperm from the testicle to the penis. This technique is known as MESA (microsurgical epididymal sperm aspiration). By removing sperm from this duct, which may be blocked or damaged, sperm are obtained for use with IVF or ICSI. We have successfully performed this technique in our Institute and we have even achieved pregnancy through the use of frozen sperm obtained by MESA in conjunction with the ICSI procedure.

In cases where no sperm are located in the man's reproduction ducts, a biopsy of the testicle can be taken, and individual sperm cells can be teased from the tissue under a microscope and used in the ICSI process. This is known as TESE (testicular sperm extraction). Early sperm cells, known as "round cells", have been used successfully in establishing pregnancies by ICSI.

A Virtual Tour of the IVF Cycle

Assisted Reproduction: Questions & Answers