Do I need a sperm donor if there are no sperm in the testes?

Question

Hi doctor,

I am a 33 year old male. Today, I had a surgical sperm retrieval procedure at a reputable fertility clinic here. They could not find a single sperm anywhere, motile or otherwise, in my testes, and they said I simply was not producing sperm, for reasons unknown. Before my wife and I give up and start looking for a sperm donor, I wanted to get a second opinion. Is that truly the final word or is there some next step I could take, however unlikely the odds of success? I eat mostly fruits and vegetables, work out every other day, have no history of trauma to the groin or exposure to extreme environmental toxins. Testicle size and firmness, as well as hormone (testosterone, prolactin, and thyroid function) levels, were all normal. Is it even remotely possible to go from producing zero sperm to producing some sperm? Thanks in advance for your help.

Answer 1

Hi,

Welcome to icliniq.com.

I have gone through your query. I would like to know a few more details to answer your query better. Were your serum gonadotropin levels measured during the evaluation? What was the exact procedure performed? The chances of sperms appearing naturally in semen is next to impossible. If just a normal testicular biopsy has been performed, an intra-op microscopic testicular biopsy may give you an additional chance of finding sperms. If it has been already performed, then a sperm donor will be the next choice for you.

Hope this was helpful.

Answer 2

Hi,

Welcome to icliniq.com.

Yes, I did mean a microTESE (microsurgical testicular sperm extraction). Since you have a normal hormonal profile with a normal testicular exam, it is indeed surprising that there are no sperms identifiable in the biopsy. The possibility could be some genetic component which prevents stem cells from maturing into sperms. In such an event, microTESE would be the final option to assess for any possibility of sperms in your testis. However, in the event that your condition is due to a genetic defect, there would also be the possibility of transmission of the same to your children (more chance if it is a male child as most of these defects are in the Y-chromosome). So, it is a difficult choice to make, and in my medical opinion, I would advise you to consider a sperm donor as it will have the maximum chances of success.