Vasectomy

Azoospermia (No Sperm)

 

If your ejaculate has no sperm in the semen specimen and there is no history of a vasectomy, this condition is called non-obstructive azoospermia.   It is very important that if a standard semen analysis shows no sperm, that the next semen specimen is processed with a centrifuge and that the pellet is examined according to a specialized protocol.  Even if a few sperm are found in your semen specimen, it could eliminate the need for a surgical procedure to harvest sperm.

We have the good fortune of working with excellent embryologists and reproductive endocrinologists so that together we can maximize your odds of a successful pregnancy even if you have no sperm in semen analysis.

What is the process of getting pregnant if there is no sperm in the semen analysis?

We perform specialized testing of the male partner’s chromosomes and a Y microdeletion study in addition to a hormonal profile.  These tests help me determine if there is the potential of harvesting sperm from the testes or epididymus (a structure on the back of the testicle).  If sperm are successfully harvested, these are then used for in vitro fertilization along with intracytoplasmic sperm injection (IVF with ICSI).

How is sperm obtained when no sperm is present in the semen analysis?

Testicles often have sperm production (i.e., spermatogenesis) even though no sperm may be present in the ejaculate.   Several different patterns of sperm production may be seen in non-obstructive azoospermia such as hypospermatogenesis, sertoli cell only, and maturation arrest.  The process of harvesting sperm from the testicle is called Testicular Sperm Extraction (TESE), and the process of harvesting sperm from the epididymus is called Microscopic Epididymal Sperm Aspiration (MESA).   In certain surgical cases, a more extensive search for sperm is required.  In these cases,  a micro-TESE  procedure is performed.  The exact procedure needed depends on the individual circumstances and is either determined before surgery or at the time of surgery.

The entire process of obtaining sperm and ultimately getting pregnant is emotionally engaging and involved.   With our experience in this area and we do our best to guide you through this process.