For ICSI program, sperm selection is an important step since healthy sperm will increase the chance of pregnancy. However, there is a huge number of men who has a problem of no sperm so that they can’t proceed normal procedure of ICSI.

Please do not give up. Even if you have no sperm, there is still a way to retrieve your sperm by retrieving sperm directly from testicle.

In case of sterile men which has no sperm upon the ejaculation. There are many causes such as the blockage of epididymis, epididymal agenesis, ejaculation problem, sperm death, inflammation of testicle caused by mumps virus and others in the past. Those with these problems cannot have a baby naturally.

Apart from sperm donor, modern medical technology can help those with these problems have a baby by following methods:

– PESA (Percutaneous Epididymal Sperm Aspiration): This involves the same needle and syringe technique but the needle is placed directly into the epididymis. Then, retrieve the sperm, fertilize with 1 egg by using micromanipulator and proceed to ICSI.
– TESE (Testicular Sperm Extraction): This is an open surgical biopsy technique to remove a few testicular tissues and extract to find the sperm. Then, proceed to ICSI.
– TESA (Testicular Sperm Aspiration): This involves placing a needle attached to a syringe through the skin of the scrotum and simply sucking out the fluid inside the testicle. Then, proceed to ICSI.
– MESA (Microsurgical Epiddymal Sperm Aspiration): This is an open surgical sperm retrieval procedure that uses an operating microscopy to locate the tubules of the epididymis precisely, so that large numbers of sperm can be extracted. Then, proceed to ICSI.

In the case that the patient has already done with PESA / TESE with no sperm, it means that the patient is completely sterile. We recommend consult with the doctor for further treatment plan.

Reference: Prime Fertility Center Co., Ltd.

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ICSI (Intracytoplasmic Sperm Injection)

ICSI (Intracytoplasmic Sperm Injection) is an in vitro fertilization procedure with the laboratory technology. Both IVF and ICSI are comprising of similar procedures. But the difference is how sperm will fertilize an egg. In ICSI program, only one best sperm cell will be selected then injected directly into a fully matured egg. Patients will be prescribed some hormonal medications. Stimulating ovaries to produce several eggs. ICSI can make a pleasant fertilization rate. As well as reduces some fertilization problems or abnormalities caused from egg and sperm. For example: multiple sperm fertilize an egg, sperm cannot penetrate the egg. The combined egg will transform to be an embryo after fertilization. Next, the embryo will be raised and will grow up among the appropriate environment inside a laboratory. Finally, the embryo will be transferred to the uterine cavity in order to implant then develop to be the fetus later on.
Couples who should receive the infertility treatment with ICSI program:

1. Female’s age more than 35 years
2. Stenosis for both sides of the fallopian tube
3. Severe Endometriosis
4. Ovarian hormone dysfunction for examples: Chronic Anovulation, PCOS (Polycystic Ovary Syndrome)
5. Severe sperm abnormalities including sperm morphology, sperm count, sperm motility
6. Male who is sterile or had a vasectomy but the body can still produce sperm. To extract sperm under this limitation, a surgical procedure will be performed such as PESA, TESA, TESE.
7. Couples who have failed from previous IVF cycle
8. Couples who prefer screening the embryo’s genetic diseases
Semen Analysis

Infertility is caused by many factors as follows:
1. Male factor is about 30-40%
2. Female factor is about 30-40%
3. Male & Female factor about 30%
4. Unknown factor is about 10-20%
Semen analysis is a main fertility examination in male. However, in order to evaluate the cause of infertility, leading to the appropriate treatment, there are some necessary steps including history taking, health checkup as well as other laboratory tests.

The laboratory tests are consisting of various types of male infertility examination. What needs to be evaluated depends on an individual’s medical history and physical checkup. But semen analysis is compulsory to every case.
Sperm Collecting Instructions
1. Male should refrain from any sexual activity and ejaculation for at least 2-3 days but not longer than 7 days.
2. Wash your hands and penis with soap and water, be sure to rinse away all of the soap residue. Dry thoroughly before collecting the semen.
3. Collect the semen by masturbation.
4. Avoid touching the area inside the container while collecting the semen.
5. Condom is not allowed as it contains lubricants that can damage the sperm.
6. In case male cannot collect the semen by masturbation. It is possible to do sexual activity with his wife and collect the semen in the provided container.
7. Collect sperm in a clean and sterile container. You can request a container from the clinic and bring it to the clinic within 1 hour.
8. Do not put the sperm in the refrigerator or expose to the ice.