Zero sperm shock

Adam (35) and his wife Hannah (30)  began to try for a baby about 12 months after they married.

“We were both fit and healthy so I thought all would be well,” explains Adam. “When nothing happened after a couple of years we went to see our GP and a sperm sample was one of the first courses of action.

“I was perhaps expecting it to be low, but I was shocked to hear it was zero. The doctor was surprised too and asked if I’d been unwell, which I hadn’t, but I had another test a month later and this also came back zero.

“I knew that when I was six or seven, I had surgery for an un-descended testicle, but I’d never thought that this would have implications for my fertility.”

The couple went for further tests where it was confirmed that there was no genetic cause for Adam’s zero sperm count. The couple were then referred to Bourn Hall Clinic for treatment. Adam initially assumed his fertility problems were due to a blockage that could be operated on and explains that he didn’t really understand the full implications.

“When we saw Oliver Wiseman at Bourn Hall Clinic, it was the first time that anyone really sat us down and explained the full situation. Oliver explained that he would have to retrieve tissue directly from the testicle, but couldn’t promise that any sperm would be found. The odds were about 50:50 really.”

A few weeks later in March 2011, Adam underwent testicular sperm extraction (TESE). TESE involves removing small pieces of testicular tissue and examining it carefully for sperm. (Bourn Hall now uses Micro-TESE which is less invasive.)

Many men with fertility problems do not have the opportunity to see a specialist in male fertility and therefore the issue is not fully investigated and counseled. Oliver Wiseman is unusual because he is a urologist who specialises in male factor infertility.

“Being a specialist and having the ability to offer a range of options for the patient is vital in male fertility treatment,” explains Oliver.“At Bourn Hall Clinic, the operating theatre is next to the embryology laboratory, so there is a dynamic interaction between the embryologist and the consultant during surgical sperm retrieval. I know immediately the quality and the quantity of the sperm that has been retrieved and can find sperm in 50 percent of patients for whom the operation is applicable.”

Adam’s admits that before the procedure, his expectations were low: “I think we were both prepared for things not to work out and we were looking into the possibility of using a sperm donor. At first I hadn’t been keen, but during those months I’d been receiving tests I’d had time to think about it more and had started to accept the idea.

“I was incredibly surprised when they found sperm, it was such fantastic news.”

Hannah started treatment in May 2011 and had IVF with ICSI, in which a single sperm is injected directly into an egg. The treatment worked first time.

She says:“We tried not to get too excited as we had been so disappointed in the past, but it really was a dream come true. We had a scan at seven weeks and it was absolutely amazing to see our little bean with a heartbeat, but it was still early days. It wasn’t until the 12 week scan that I felt we could finally breathe out.”

Baby Joseph was born on March 7th 2012, a year to the day after Adam underwent surgical sperm retrieval.

Mr Wiseman says that every day he meets men who have been told that they will never be biological fathers and there is often something that he can do to help.

He says:“The problem is that male factor infertility is not widely understood. But developments are being made all the time so men should be encouraged to talk about this subject more and investigate all the options.”

For Adam being a dad is still amazing.“It still hasn’t sunk in that I’m a dad yet”, he says. “I feel like we are baby-sitting for somebody. It’s quite scary thinking that one day Joseph will be looking at us for pearls of wisdom!”

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