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New technique could help infertile men

Courtesy:  Mail on Sunday

Men who are classed as infertile could become fathers thanks to a new procedure that gives one in five the chance of conceiving a baby.
Most of the estimated 300,000 British men with extremely low or zero sperm count are told they can’t have biological children, because they either don’t produce enough sperm or there is a blockage in one of the tubes along which the sperm travels.
The new technique, being offered at five specialist NHS hospitals across Britain, involves surgically removing a tiny section of the testicle – less than a millimetre wide – dissecting it, and then retrieving individual sperm cells ‘stuck’ inside.
Crucial to the success of the new procedure, called MicroTESE, is a specialised microscope that magnifies the tubes inside the testicles by 20 times, helping the surgeon to find the sperm.
Dr Channa Jayasena, consultant in reproductive endocrinology at Imperial College London, who performs the procedure, says: ‘Many of these men have been told they can’t have children, but this procedure sees between 10-30 per cent of them have a baby. It’s amazing.’
For men diagnosed with zero sperm count in the UK, there is no chance of natural pregnancy.
Surgical interventions are offered which can increase chances of sperm extraction by up to 25 per cent.
These involve recovering semen from inside the body using a fine needle or removing several 5mm pieces of the testicle, from which sperm is later extracted.
Not only is there a risk of serious complications – such as shrinkage of the testicles and blood clots – but any tissue retrieved must be sent off for biopsy, delaying insemination by up to a week and reducing the chance of successful pregnancy.
With the MicroTESE procedure, surgeons know if they have successfully extracted sperm within two hours, meaning couples do not face an anxious wait for results.
Two weeks before surgery, patients are given a dose of the sex hormone FSH to boost sperm production. Then, during the procedure, a urologist makes a tiny cut in the scrotum, allowing access to the testicles.
The surgeon then examines them under the super-magnifying microscope, identifying the tubes where sperm is made, called the seminiferous tubules.
Those that are swollen are most likely to contain sperm and are cut away using minute instruments.
The incision is stitched back up while a second urologist performs a biopsy on the removed tissue, and extracts any sperm ‘stuck’ in the tubes.
Any sperm found is frozen immediately and kept for use in IVF treatments later that week.
Patients are able to return home within three to four hours.
Lorry driver Adrian Barrett, 50, who has a very low sperm count, spent 30 years believing he’d never be able to become a father.
‘I had been through some very dark times coming to terms with the fact I would probably never be a dad,’ he recalls.
Then he and his partner, Michelle, 42, from Scole, Norfolk, were referred to fertility clinic Bourn Hall in Cambridgeshire, where the treatment has been pioneered by consultant Oliver Wiseman. Adrian was thrilled when surgeons explained fatherhood may be possible, even with a drastically low sperm count.
With Michelle’s eggs harvested and ready for insemination, Adrian had the MicroTESE procedure in September 2015.
Remarkably she became pregnant at the first attempt, but devastation quickly followed when she miscarried at ten weeks.
But then, on the third attempt at insemination, Michelle became pregnant again. She gave birth to son Michael on October 6, 2016.
Adrian says: ‘Being a dad has totally changed my life. There is only one way to describe what has happened to us – it is a miracle.’

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