Mr. Hai, 30 years old, had a chromosomal mutation with varicocele and did not treat it early, so he ran out of sperm and had to have surgery to have a child.
After 4 years of marriage without children, Mr. Hai and his wife went to the Reproductive Support Center, Tam Anh General Hospital, Ho Chi Minh City (IVF Tam Anh, Ho Chi Minh City) for examination. The semen test results showed that he only had 1-2 sperm, while normal men ejaculate an average of 39 million sperm each time. Genetic testing determined that he had a mutation on the Y chromosome, causing his ability to produce sperm to decline over time, and there was no radical treatment. The patient also has grade 1 varicocele
The doctor advised him to collect many sperm samples to freeze to preserve fertility and avoid future surgery, but the couple refused due to hesitation about treatment. In the middle of this year, Mr. Hai had a follow-up examination and a semen test showed that there were no sperm left and his testicles had shrunk in size. The condition of varicocele becomes more severe, the risk of blood stagnation in the testicles – both factors leading to infertility.
Doctor Nguyen Quang Vinh, Andrology unit, and his team performed micro-TESE microsurgery to find sperm from the patient’s testicles. Through a 30x magnification microsurgical system, the doctor found several potential spermatozoa. The embryologist tore apart the seminiferous tubule tissue and examined it under an inverted microscope system with a magnification of 200 times and found nearly 20 sperm for in vitro fertilization with the wife’s eggs. However, the sperm was of poor quality, so only 2 embryos were collected and frozen on day 3.
During the microsurgery, the doctor also tied off the varicose veins of the spermatic cord, improving the blood supply to Mr. Hai’s testicles.
Mr. Hai’s wife is currently having her uterine lining prepared by the doctor before transferring the embryo into the uterus.
Doctor Vinh (middle) and the micro-TESE microsurgery team found sperm for the patient. Image: Hoai Thuong
According to Dr. Vinh, it is quite common for men to have no sperm due to mutations in the Y chromosome. In the past, these cases often faced the risk of asking for sperm or adopting a child. Currently, the micro-TESE microsurgical technique is capable of finding sperm about 60-70%.
If you have multiple diseases, your fertility will be reduced and your treatment success rate will be reduced. Therefore, a couple who has not had children after a year of marriage should go for a comprehensive examination as soon as possible. Couples should also have a reproductive health check-up before getting married, which helps detect diseases early and proactively treat them. Men with genetic abnormalities or gene mutations that cause reduced sperm production should freeze sperm as soon as possible to preserve the ability to have children and avoid surgery.