“We did not find any sperm in your semen analysis”
Every man dreads hearing this after providing his semen specimen. Take a deep breath and think. You now know why you are not getting her pregnant. But does this mean you can not have children that are from your own sperm? Do not panic or bury your head in the sand. It is time to think in a methodical way. The reality is a fertility doctor most often can help.
First of all you need to know that it’s not completely rare to be in your shoes. Nearly 1% of all men will be found to have no sperm at all in the ejaculated fluid and so there is an established approach to moving forward.
Lets start with the name of the condition: medical jargon for this is azoospermia. What should you do now? First, was it absolutely no sperm? If your semen analysis was performed at our clinic, Fertility Partnership, our team will certainly centrifuge and super-concentrate the semen to look for any sperm at all so you can be certain that this is the reality. If it is confirmed, then take a moment and understand what this means. Azoospermia means that you do not have sperm in the fluid that leaves your body when you ejaculate. It may not mean that you are not producing sperm and they can’t get out. There could be an obstruction that was formed after an inflammatory process. Some men are actually born without a Vas Deferens which is the tube that connects the testicles to the outside world (this can be seen on ultrasound). A man can have what is called “retrograde ejaculation” which means the sperm are being made but when the man climaxes the sperm are rerouted to the bladder (very common in men with diabetes) and can be found in the urine. If we suspect that there is retrograde ejaculation then we can check the urine after ejaculation. But so often these explanations are not the reality and we are left wondering if there are any sperm being made in the testicles. At this point blood tests will give us a strong indication as to whether or not there is sperm production. Certain hormone levels will be affected by sperm production and they are inexpensive tests with quick turnaround.
If the blood tests suggest that there may be sperm being made then the only way to be sure is to actually take a small sample from your testicle. Sounds painful, right?
Well, you can take a deep breath and relax….it is not that bad as long as you undergo a procedure called TEFNA-Testicular Fine Needle Aspiration.
At Fertility Partnership, we perform TEFNA. It is a quick procedure that causes very little discomfort. The skin of the scrotum is carefully numbed and a very small needle is used to collect tissue from the testicle. Our lab will then micro-dissect the sample and search for sperm. You will get your result while still at our office.
TEFNA is a simple, safe, and far less invasive or painful than other procedures such as TESE-Testicular Sperm Extraction which actually requires general anesthesia. Success rates for TEFNA have been reported to be similar to the more extensive and invasive procedure, TESE, which will put you off work for days after the procedure. TEFNA procedure typically gets you back to work the next day.
It is also a heck of a lot less expensive, and costs under a thousand dollars. TESE can cost several times more.
What if we find sperm in the TEFNA sample? Then we can help you have a baby.
So how do you make babies if there are sperm but they are trapped in the testicle? If there are sperm present at the TEFNA Procedure then you are in luck. At Fertility Partnership we actually use these sperm to fertilize the eggs.
So when you get the report of “no sperm” don’t sit and wonder if it is the absolute truth. Go to a specialist and get it figured out.