Sperm Hunters: Bourn Hall’s specialist urology team marks ‘500’ milestone

What happens if a man is told that he has a zero sperm count? Does that completely rule out a man’s chances of being a biological father?

The answer is that for those men with very low or zero sperm count it can still be possible to retrieve healthy sperm from the testes using specialist sperm retrieval techniques – which Bourn Hall’s  team have particular expertise in performing.

Consultant Urologists Oliver Wiseman and Nimish Shah are two of only a small number of urologists in the country to specialise in male fertility treatment. In the last nine years at Bourn Hall they have operated on more than 500 men needing surgical sperm retrieval.

“It is amazing that we have reached 500,” says Mr Wiseman. “We have a fantastic team of nursing staff, embryologists and admin support and it is so rewarding being able to help men who might have thought that nothing could be done to help them become fathers”.

Reasons for zero sperm count

The two main reasons why Mr Wiseman, Mr Shah and their team perform sperm retrieval are in men with a low or zero sperm count caused by:

• Non-obstructive male infertility – causes can include genetic conditions, testicular problems, toxins (some drugs including steroids used in weight training and chemotherapy, may damage the testicles’ ability to manufacture sperm), a previous illness (such as measles) or a hormonal problem;
• Obstructive male infertility (blockage to the tubes which transport the sperm) – reasons can include patients with cystic fibrosis, infections (such as mumps, chlamydia or gonorrhoea), a previous vasectomy or a failed vasectomy reversal and cysts blocking the flow of sperm.

Mr Wiseman says that the team’s success rates for retrieving sperm caused by a blockage is exceptionally high. “It is as close to 100 per cent as you can get,” he says. “And for those men with a zero sperm count caused by poor production we successfully retrieve sperm from around 50 per cent of them”.

Finding sperm in tissue

A common procedure used with patients who have poor production is MicroTESE (micro-surgical testicular sperm extraction) which involves using a surgical microscope to identify tiny tubules most likely to contain sperm – and then removing them for analysis in the lab. If sperm are found they can injected directly into an egg during IVF treatment.

At Bourn Hall the embryologists have considerable expertise in semen analysis (andrology)  and the lab is in close proximity to the operating theatre.  This is particularly beneficial when performing Micro-TESE.

Mr Wiseman says: “I know immediately from the embryologist the quality and quantity of the sperm which has been retrieved and when a sufficient sample has been achieved. This means that we can find sperm in around 50 per cent of patients for whom the operation is applicable”.

Bourn Hall patient Adrian underwent Micro-TESE after tests revealed that he was producing no sperm at all. “To sit at Bourn Hall and be told that even with a zero sperm count I might be able to father a child using my own sperm came as a complete shock,” he says.

Adrian and his partner Michelle are now parents to son, Michael, aged 2, following IVF treatment (with ICSI) at Bourn Hall using Adrian’s sperm retrieved using Micro-TESE.

Finding sperm in tubes 

For men who have no sperm in their semen because of a tube blockage, the team mainly employ a procedure called PESA (percutaneous epididymal sperm aspiration) which involves inserting a fine needle in to the epididymis, one of the tubes leading from the testicle, and collecting samples of tissue containing sperm using gentle suction.

Tom underwent PESA after tests had revealed that the reason his sperm count was zero was that he was a carrier of cystic fibrosis which meant that he had no vas deferens (the tubes which transport the sperm from the testicles to the penis). The procedure was a success and he produced two vials of high quality sperm which was frozen for use in future IVF treatment cycles.

Tom and his wife Rachel now have three children – daughter Amalie and twins Margot and Teddy – after IVF treatment at Bourn Hall using Tom’s frozen sperm.

The opportunity to undergo sperm retrieval, whatever the outcome, offers renewed hope to many men who might have previously thought that they would never have the opportunity to father their own biological child.

“Being told that the reason that you are not conceiving is down to a low or zero sperm count can be extremely distressing for a man,” says Mr Wiseman. “The procedures we use ensure that for men who are producing viable sperm, no matter how little there is, we should find it and help them on the journey to become dads.”

Get good advice 

The opportunity to undergo sperm retrieval, whatever the outcome, offers renewed hope to many men who might have previously thought that they would never have the opportunity to father their own biological child.

“Being told that the reason that you are not conceiving is down to a low or zero sperm count can be extremely distressing for a man,” says Mr Wiseman. “The procedures we use ensure that for men who are producing viable sperm, no matter how little there is, we should find it and help them on the journey to become dads.”

Research by Bourn Hall showed that many people found it difficult to discuss infertility with their GP and were often told that nothing could be done until they had been trying for three years.

With fertility issues every month counts. After all, there are only 12 chances to become pregnant each year.

Free fertility consultation

Bourn Hall is offering free consultations with a fertility nurse specialist to talk about your fertility concerns and provide expert advice.  This tailored advice will include ways to boost your natural fertility, recommendations for tests and explanation of what the results will tell you and discussion of the treatment options that are relevant to you.

The advice will be appropriate to you and your circumstances. You don’t have to be trying to get pregnant or need fertility treatment to have a free consultation.

Half price fertility health and wellbeing checks

If you suspect that you may have an issue with your fertility then a fertility check-up is advised.

NHS testing is available for those who have been trying to conceived for over two years, but if you want to have a semen analysis, or other tests faster, without a GP referral then Bourn Hall is currently offering a mini fertility health check for both partners (male and female) half price for just £200 or if you just want a semen analysis its only £130.

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