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Male Infertility Services

Surgical Sperm Retrieval

This procedure retrieves sperm from the testicle or epididymis for obstructive azoospermia (no sperm due to blockage after vasectomy) or for non-obstructive azospermia (no sperm on ejaculation with no prior vasectomy). PREG has an arrangement with a local urologist to perform the surgical sperm retrieval in PREG's surgery suite in Greenville with PREG's andrologist available to perform immediate sperm cryopreservation (if sperm suitable for cryopreservation is found). The cryopreserved (frozen) sperm can then be used later with the intracytoplasmic sperm injection (ICSI) technique in an IVF cycle to achieve fertilization of the woman's eggs obtained by transvaginal ultrasound follicle aspiration resulting in embryos.

Vasectomy Reversal

PREG does NOT perform this procedure. A urologist would perform a vasectomy reversal. Before vasectomy reversal is performed, evaluation of the female partner's reproductive potential is recommended. The alternative to vasectomy reversal - epididymal or testicular sperm aspiration or extraction and IVF with ICSI- should be presented and discussed. The prognosis for success after vasectomy reversal declines progressively as the interval between vasectomy and its reversal increases with significantly lower pregnancy rates when reversal was performed 10-15 or more years after vasectomy. The inverse relationship between success rates and the interval of obstruction may reflect progressive testicular damage. The age of the female partner has important prognostic value with women older than 37 having a progressive decline in fertility and IVF may be the better option. Other female factors such as tubal disease, anovulation, diminished ovarian reserve, or endometriosis may make IVF with ICSI the more preferred route to achieve a successful pregnancy. 

Evaluation of the Azoospermic Male

Azoospermia (No spermatozoa, or sperm) seen on 2 separate semen analyses, even after centrifugation of the semen sample in an attempt to concentrate the sperm if present in very low numbers (oligospermia). Azoospermia occurs in approximately 1% among all men and 10-15% among infertile men.

Semen Analysis (SA)

Semen Analysis (SA) should be performed in a qualified andrology lab for best evaluation of male infertility. Semen analysis should be looked at in a male to give the best indications of any sperm abnormalities. History of a pregnancy by the male does not necessarily equal a normal semen analysis. An adequately performed SA should include:

  • Sperm count (normal: >20 million sperm/ml semen).
  • Sperm motility (movement of sperm, usually >50% motility is normal)