Fertility Rates Boosted by Surgery

A fertility specialist at Taipei Veterans General Hospital (TVGH) on Monday said that while about one in every 10 men might have infertility problems, the use of microsurgical testicular sperm extraction (mTESE) can helped increase fertility rates.

The hospital cited a recent case of a 33-year-old man, surnamed Yu , who was diagnosed with azoospermia — the absence of motile (and hence viable) sperm in semen — and was told by doctors at other hospitals that there no hope of impregnating his partner.

However, a team of doctors at TVGH were able to retrieve sperm from Yu’s right testicle via mTESE, and the couple recently gave birth through in vitro fertilization (IVF) treatment.

TVGH Division of Male Reproductive Medicine director William Huang, who performed the surgery, said that about 1 percent to 1.5 percent of males in Taiwan suffer from azoospermia.

Azoospermia can be categorized into obstructive and non-obstructive forms. Obstructive azoospermia means that the individual can produce sperm, but that none are present in the ejaculate, while non-obstructive azoospermia relates to abnormal sperm production within the testes, Huang said

“Non-obstructive azoospermia is one of the most challenging problems to deal with in male infertility and relies on mTESE for treatment,” he said.

Using the mTESE method, doctors can use magnification of up to 24 times to search for areas with increased sperm count to collect sperm for IVF treatment.

“The main feature of mTESE, compared with the traditional method of testicular biopsy, lies in its precision,” Huang said, adding that while a testicular biopsy can be seen as cutting down many trees in a forest and trying to find a few apples within them, mTESE is like precisely locating where the apples are growing, then picking the apples that are needed.

Division statistics showed that the fertility rate of couples with non-obstructive azoospermia after mTESE treatment was 77.52 percent last year, with rates of pregnancy that reached 24 weeks being 39.7 percent, while the 24-week pregnancy rate increased to 50 percent this year, Huang added.

Huang said that the reason for azoospermia is still unknown, but might be related to genetic mutation or environmental influences, such as exposure to high temperaturse, radioactive substances, smoking, drinking alcohol, or consuming unhealthy food.

“I urge men to undergo fertility testing before their partners, because the procedure is not as complicated as it is for women,” he said.