A pre-marital health checkup at Tam Anh Cau Giay General Clinic revealed the fiancee's reproductive health was normal. However, Minh's semen analysis twice found no sperm. Ultrasound showed both testicles were atrophied to half their normal size, and FSH and LH hormone levels were double the normal range, indicating potential spermatogenesis impairment.
Dr. Cao Tuan Anh, Specialist II, from the Fertility Support Unit (IVF Tam Anh), noted Minh had mumps at age 7. Following the illness, he experienced painful swelling in both testicles, which went untreated, though he maintained normal sexual activity. Doctors diagnosed non-obstructive azoospermia, likely a complication of orchitis after mumps. They advised micro-surgery to find sperm, but Minh initially declined the procedure.
Feelings of infertility led Minh to repeatedly suggest breaking up, despite his fiancee's encouragement for treatment. Their wedding, planned for late 2025, was postponed. Nearly one year later, Minh returned to IVF Tam Anh for another examination, but his condition remained unchanged. This time, he agreed to undergo micro-TESE surgery to locate hidden sperm in his testicles.
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Dr. Tuan Anh (second from right) and his team perform micro-TESE surgery to find sperm for a patient. Photo: Tam Anh General Hospital Hanoi
Under a microscope with 25x magnification, Dr. Tuan Anh meticulously dissected and examined each testicular tissue region, searching for active seminiferous tubules. These were then transferred to the lab. Embryologists further separated tissue fragments, scanning each microscopic field. After two hours, 35 normally shaped, motile sperm were found. The sperm sample was processed and cryopreserved in liquid nitrogen at -196 degrees C, awaiting use for an in vitro fertilization cycle after Minh's wedding.
Dr. Tuan Anh stated that male infertility accounts for about 40% of causes for difficulty conceiving. However, men often hesitate to seek examination, fearing judgment or believing reproduction is primarily a woman's issue, which can lead to misdirected or prolonged treatment. Azoospermia affects about 1% of men in general and accounts for 10-15% of infertility cases. Patients often have normal sexual activity and painless ejaculation without obvious abnormalities, making late detection common.
Doctors recommend men undergo reproductive health checks before marriage or when planning to have children. This is especially important if they have a history of mumps with testicular swelling and pain, small testicles, previous genital surgery, a history of male reproductive infections, or unusually low semen volume. Some male reproductive issues can be detected with simple tests such as semen analysis, testicular ultrasound, hormonal tests, and genetic testing when necessary. Early examination helps assess reproductive potential, detect potential risks, and choose appropriate treatment, sperm cryopreservation, or assisted reproductive options.
Van Anh
*Patient's name has been changed
