Cared for by Dr William Akakpo
A male factor is involved in about half of couples who struggle to conceive, yet it is often assessed superficially. The work-up here is complete: semen parameters, hormones, genetics, imaging and clinical examination, so that a treatable cause is not missed. Varicocele, hormonal disorders, obstruction and previous surgery can all be addressed. Even in non-obstructive azoospermia — no sperm at all in the ejaculate — microsurgical testicular sperm extraction recovers usable sperm in around half of men. Surgery is scheduled with the IVF laboratory so that retrieval and fertilisation happen on the same day.
Performed under the operating microscope through a small subinguinal incision, preserving the artery and lymphatics. Semen parameters improve in roughly two-thirds of men, and spontaneous pregnancy rates rise significantly.
The testis is opened under high magnification and the rare dilated seminiferous tubules that may contain sperm are identified individually. This maximises the retrieval rate while removing far less tissue than conventional biopsy.
Where production is normal but the pathway is blocked, sperm is retrieved directly from the epididymis or testis, with excellent yields and immediate use or freezing for ICSI.
Hypogonadotropic hypogonadism, hyperprolactinaemia and iatrogenic causes (including testosterone therapy) can often be corrected medically, sometimes restoring spermatogenesis without surgery.
Around 40 to 60% in non-obstructive azoospermia, depending on the cause, testicular histology and hormonal profile. The individual estimate is discussed before surgery.
Yes. The consultation, work-up, surgery and laboratory work are coordinated with the fertility centre so the couple's schedule stays as short as possible.
No. Treatment is offered when the varicocele is clinically palpable and associated with abnormal semen parameters, pain or testicular growth arrest.