In many cases, the absence of normal sperm is known to be a barrier to fertility, as for patients with a history of vasectomy. In other cases, a thorough evaluation may find that abnormalities exist in the quantity or proportion of normal sperm. The New Hope Center is pleased to offer individualized treatment plans to address these circumstances.
Surgical Sperm Extraction
Removal of sperm from the testicle can be accomplished by an experienced Urologist with specialized experience in male infertility. Under local anesthesia, a small incision is made in the scrotum and the testicle. Under magnification, sperm can be removed from the epididymis (microsurgical epididymal sperm aspiration, or MESA), or from the testicle itself (testicular sperm extraction, or TESE). These procedures are appropriate when vasectomy reversal is unsuccessful or not desired. In situations where there is no sperm on the semen analysis without a known blockage, surgical sperm extraction may be attempted as well. In cases of inability to ejaculate (such as in spinal cord injury), surgical extraction of sperm is a viable alternative.
Donor sperm may be utilized by couples for numerous reasons including severe male factor infertility, a male partner with significant genetic conditions, single female and lesbian couples, or as a back-up if the male partner's sperm has previously been unsuccessful with fertilization. The New Hope Center works with numerous accredited spermbanks or cryobanks, which allows our patients the broadest possible range of potential donors. Two companies our patients frequently select are Fairfax Cryobank (http://www.fairfaxcryobank.com) and California Cryobank (http://www.cryobank.com)
As sperm problems affect around 40% of couples with infertility, it is important to do a semen analysis to identify any issues. After 2-5 days of abstinence, the male partner can provide a semen sample collected through masturbation into a sterile cup. This can be done at home if the couple lives within 30 minutes of the clinic. Alternatively, a collection room can be available. Usually collection is done via masturbation; however, a 'collection condom' can be used to collect sperm during intercourse. The semen analysis will give information about sperm numbers, the percentage of sperm moving, and the percentage of sperm that look 'normal' in shape. Certain treatments are not successful with low numbers of moving sperm, so this is important information for your fertility specialist to have.
The above tests are commonly done for couples having problems with fertility. Your doctor will let you know if there are further tests to consider for your specific situation. After basic testing, the next step will typically be a consult visit with your doctor to determine the best approach to get you closer to your goal of growing your family!