New MicroTESE overcomes zero sperm

When Adrian gets in from work every evening the first thing he is greeted with is “Daddy!” and the outstretched arms of his toddler Michael.

Being a Dad was something which Adrian, aged 50, had always believed would never happen to him. He had been told as a child that he had a condition which would impact his fertility, and this was confirmed when he was in his twenties after a doctor told him that he had a very low sperm count.

Told at 20 would never be a dad

“Adrian told me when we met that he couldn’t have children,” says Adrian’s partner Michelle. “He actually told me before we started going out, I think that it was something which really worried him because it had caused problems in relationships before.  At the time it didn’t really concern me because I was still quite young and was focused on my job.”

The couple moved in together and Michelle’s priorities changed. “My sister had children and I used to spend a lot of time with them and it made me reflect on my own future. I was working long hours and my enthusiasm for my job had started to wane. I started to think about what else mattered in life.”

When Michelle turned 30 she stopped taking the contraceptive pill but Adrian was not optimistic that she would conceive. “In my mind I was thinking ‘miraculously I might fall pregnant,’” she says.

A woman’s fertility declines with age and at the age of 35 a woman’s chance of becoming pregnant naturally each month is just 10% (for a woman in her twenties it is 20-25%). Seven years after Michelle stopped taking the contraceptive pill she was still not pregnant and she knew that, at the age of 37, time was not on her side. She realised that she had been avoiding a conversation with Adrian for far too long.

“In the end I said to him, ‘I really want to do something before it is too late. We don’t really know why you can’t have children and science might have moved on since you last sought advice and there might be something which can be done.’”

Eligible for NHS funded treatment at Bourn Hall 

The couple went to see their GP and were referred to the James Paget Hospital for tests. “By this point Adrian was in his 40s and I was in my late 30s,” says Michelle, now aged 41. When tests confirmed male factor infertility Adrian and Michelle were told they would be eligible for NHS-funded fertility treatment and they chose to go to Bourn Hall Clinic, which has clinics across the East of England.

“I really had to push Adrian to take a leap of faith,” says Michelle. “There was that fear of disappointment again, being given hope and then possibly losing it. In the end I had to say to him, ‘I really want to try something, can we see if we can do it together?’”

Told there was hope – MicroTESE can overcome zero sperm

The couple went along to Bourn Hall Clinic and were given the stark news that Adrian was producing no sperm at all. “We sat there and thought, ‘oh, well there is nothing that can be done for us,’” reveals Michelle.

Specialists at Bourn Hall, however, explained that even a zero sperm count doesn’t have to mean that it is impossible for a man to father a child.

Adrian admits that he was emotionally quite thrown by this revelation. “ 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.”

MicroTESE (micro-surgical testicular sperm extraction) involves using a surgical microscope to identify tiny tubules most likely to contain sperm – and then removing them for analysis in the laboratory. If sperm are found they could injected directly into an egg during IVF treatment.

Oliver Wiseman, Consultant Andrologist and male infertility specialist at Bourn Hall Clinic explains: “It is important that men with no sperm in their ejaculate or with very low numbers ask to see an andrologist who can undertake this surgery if it is indicated, as this will give them the best chance of being able to proceed with treatment using their own sperm.

Most men with low testosterone levels are given Clomid to try and boost their body’s own testosterone production, as normal levels of this are important for sperm manufacture and may increase the chances of finding sperm with microTESE.”

Adrian was prescribed Clomid for three months and then went back to Bourn Hall Clinic for the MicroTESE procedure. The couple were told that Adrian had responded to the medication and sufficient sperm were then found at surgery for the couple to have IVF treatment.

Slim chance 

“Our specialist at Bourn Hall was very honest with us and told us that he had found some sperm, but not very much,” says Adrian. “He was very honest with us about the risk of failure and the chances of success.”

“It is such an upheaval in your life,” says Michelle. “You feel like you are constantly in limbo. I stopped work, I didn’t want to put myself under any addition stress and we focused purely on achieving our goal.  Adrian said that until he was holding a baby in his arms he wouldn’t let himself believe it could happen, so much could go wrong. He said he just wasn’t going to count on anything happening.”

Michelle had been told during her treatment that one of her ovaries had stopped working and when the couple decided to go ahead with a third cycle of treatment they felt as though it was their last chance.

“We were down to our last sample of Adrian’s sperm which had been extracted and we decided to throw everything at this treatment,” says Michelle. “I had an endometrial scratch and intralipids before transfer because they are thought to reduce the risk of miscarriage.”

The couple were delighted when Michelle’s treatment worked and her pregnancy went to full term. On October 6, 2016 she gave birth to son Michael, who they named after Adrian’s own father who had sadly passed away some years before.

Michael is now a bubbly toddler and ‘a real little character’ laughs Michelle. “I am so glad that I did insist we sought help because if I hadn’t Michael wouldn’t be here. I didn’t want to end up an old lady asking myself if I could have had a child. My one regret is that I didn’t push for us to get help a little sooner, or had my eggs harvested when I was younger, as we might have had the opportunity to have a second child. But that is with the benefit of hindsight and you don’t think about that at the time.”

Adrian is a doting Dad. “Michael is a carbon copy of me,” he laughs. “Being a Dad has totally changed my life. To have been told from an early age that there was very little possibility that I would father a child and then to be 50 years of age and have a young son is just incredible.

The procedure used to retrieve my sperm is relatively new and so didn’t exist as an option for me when I was younger. I am just so grateful that we put our faith in medical science. There are no words to describe what has happened to us, it is a miracle.”

More information about MicroTESE

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