A pioneering new treatment for men with fertility problems has led to its first reported pregnancy in Ireland. The new technique increases the likelihood of men becoming fathers without needing to use donor semen.
Microsurgical Testicular Sperm Extraction (Micro-TESE) is used to extract viable sperm cells from men suffering from azoospermia, which means they have no or practically no sperm cells in their semen.
The now father-to-be had previously undergone testicular surgery which had affected his sperm production. However, he had Micro-TESE at Cork Fertility Centre and then his partner underwent IVF successfully.
In Micro-Tese, an incision is made in the scrotum through which one or both testicles can be seen.
Tubes within the testicle tissue are then inspected with a special high-powered microscope and dissected to see if they contain a trace of sperm. The use of the microscope means that the sperm retrieval rates are much higher than they are using traditional Tese and less issue is removed from the testicle.
Men can have a low sperm count due to low testosterone levels, an injury, following surgery or because of medical problems.
Up to 30% of fertility problems in couples are believed to originate with the male, another 30% with the female, a further 30% are a combination of both the man and woman, while 10% are non-identifiable.
The successful Micro-Tese was performed by CFC’s consultant urologist and andrologist Dr Ivor Cullen at University Hospital Waterford.
Dr Cullen said: “This is a landmark pregnancy and positive news regarding the treatment of male infertility and in particular azoospermia. It offers renewed hope to these men, and to men who have been diagnosed with defective sperm production, or had previous unsuccessful conventional sperm retrieval procedures.”
Micro-Tese allows the urologist to better distinguish between healthy and unhealthy testicular tissue. The healthy tissue samples are later examined in the laboratory. If viable sperm is found, it is prepared and frozen for use in a subsequent IVF cycle.
CFC head of laboratory services, Dr Tim Dineen said azoospermia is either caused by a duct obstruction or else by other hormonal or medical factors.
Obstructions are normally dealt with by a traditional biopsy while cases, where no obstruction is evident, can be helped by Micro-Tese as it is “much more targeted than traditional Tese”.
CFC has offered in-house testicular biopsy — traditional Tese — for men with azoospermia for over a decade. Micro-Tese is the more advanced procedure.
Micro-Tese is a day procedure — the patient can walk out the same day. It costs approximately €5,000 while IVF costs over €4,200.
Dr Dineen added that Irish men are handling fertility problems better than they would have 10-15 years ago.
“Certainly there is more talk about male infertility and the taboo that was once there isn’t there as much, but compared to women’s ability to talk openly about it, they still aren’t quite there yet,” he added.