Safe, New Ways to Make a Baby

Surgically extracting sperm from testicles is a safe and effective option for couples

(RxWiki News) For couples unable to conceive a baby on their own, technology has made tremendous strides in helping them. Even men who cannot produce sperm in their semen have good options.

A recent study found that surgically taking sperm from a man's testicles can be safe and effective for in vitro fertilization procedures.

In vitro fertilization, or IVF, is the process of fertilizing an egg and a sperm outside of a woman's body and then putting the fertilized egg into the woman. Babies have been born with this method since 1978, but the various ways the eggs and sperm can be taken out have been improving ever since.

In this study, the success rate for pregnancies and births varied according to the particular fertility condition a man had.

"Discuss your options for getting pregnant with a fertility doctor."

The study, led by Kenan Omurtag, MD, of the Division of Reproductive Endocrinology and Infertility at Washington University, looked at some of the factors that might influence how successful IVF is.

The researchers studied 130 men whose sperm was surgically extracted from their testicles for use in IVF, as well as 76 couples who underwent 123 total cycles of IVF.

The men all had different conditions that prevented them from providing sperm any other way other than surgical extraction. These conditions included the following:

  • 99 of them did not have any measurable sperm in their semen (60 from an obstruction and 39 for other reasons)
  • 14 had cancer
  • 7 were paralyzed
  • 10 had other conditions

An obstruction means the sperm's path from the testicles to the tip of the penis was blocked for some reason.

Among the men with obstructions preventing sperm from being in their semen, 22 were born without the vas deferens, and 37 had had a vasectomy or a failed vasectomy reversal.

The vas deferens are the tubes that carry sperm from the testicles to the tip of the penis.

The researchers were able to successfully extract useable sperm (at least 1-2 sperm per 0.5 milliliters) from 70 to 100 percent of the men who had obstructions preventing their semen from carrying sperm.

The researchers were able to extract useable sperm from 31 percent of the men whose sperm was not in the semen for non-obstructive reasons.

The distance between the surgical center where the sperm was extracted and the laboratory where the sperm was stored or used had no influence on the success rate.

The men whose semen did not contain sperm for non-obstructive reasons also had a lower fertilization rate (43 percent) during IVF. The fertilization rate for men with other conditions was 66 percent.

After fertilization occurred, the rate of the man's partner becoming pregnant was similar for all groups regardless of the men's conditions.

However, the rate of the pregnancy continuing to term differed based on men's conditions.

Men whose fertility difficulty had been no sperm in the semen for obstructive reasons had a rate of 38 percent for pregnancies resulting in a birth.

The rate of pregnancies resulting in a birth for the partners of men with cancer, paralysis or another fertility diagnosis was 16.7 percent.

Among the women with fertility conditions, 7.4 percent of the women with diminished ovarian reserve became pregnant, compared to 44 percent of women with other conditions.

The researchers concluded that extracting sperm from men's testicles was a " and effective option regardless" of the reason that sperm were not in the man's semen.

However, men whose sperm is not in their semen for reasons other than an obstruction "...have a lower chance of successful sperm retrieval and fertilization," the researchers wrote.

There are many different costs associated with IVF, depending on the specific procedures needed for each couple.

The average cost of a single IVF cycle tends to range from $10,000 to $15,000. The average cost of extracting sperm from a man's testicles ranges from $6,000 to $16,000.

Couples can learn more about how to estimate their costs for IVF, based on their circumstances and procedures needed, using the IVF Cost Calculator in the links below.

This study was published July 29 in the journal PLOS ONE. The research did not use external funding, and the authors declared no conflicts of interest.

Review Date: 
August 23, 2013