Mr. Minh, 40, and Ms. Thao, 36, had been married for eight years without children. Four previous attempts at sperm retrieval via aspiration and surgery for in vitro fertilization (IVF) at various hospitals resulted in two miscarriages for Ms. Thao and surgical site infections for Mr. Minh.

The couple sought treatment for the infection at Tam Anh General Hospital, Ho Chi Minh City, intending to abandon their dream of parenthood. However, Doctor Nguyen Cong Danh, from the Center for Reproductive Assistance, assessed that Mr. Minh still possessed sperm and a chance to become a father. The four prior IVF failures, he noted, might have stemmed from poor embryo quality.

The doctor prescribed antibiotics for Mr. Minh's surgical site infection. After one week of treatment, the infection was well-controlled. The doctor then scheduled sperm aspiration for him on the same day his wife's eggs were retrieved.

The doctor used a fine needle to retrieve sperm directly from the epididymis, avoiding surgery or scrotal incision. The sample was immediately transferred to the adjacent lab for processing. The procedure yielded enough sperm for one IVF cycle, with additional sperm cryopreserved for a backup cycle.

Doctor Danh (center) performs percutaneous epididymal sperm aspiration for a patient. *Photo: Tam Anh General Hospital.*

For Ms. Thao, doctors redesigned an ovarian stimulation protocol to obtain a better quantity and quality of oocytes. Specialists injected sperm into the oocyte cytoplasm, then cultured and assessed the embryos in an ISO 5 laboratory with strict environmental controls. A monitoring system, integrated with artificial intelligence (AI) technology, continuously observed the embryos, allowing specialists to evaluate each one thoroughly.

Mr. Minh and his wife successfully created two day-5 embryos and two day-6 embryos of good quality. Given the wife was over 35 and had a history of two miscarriages, embryo biopsy was performed before uterine transfer. Three embryos showed normal genetic test results.

The doctor transferred the best embryo into the wife's uterus, resulting in a successful pregnancy on the first attempt. The pregnancy is now over 12 weeks.

The time-lapse embryo culture system features continuous observation cameras integrated with artificial intelligence (AI). *Photo: Tam Anh General Hospital.*

Years of infertility can stem from various causes originating from either the wife, the husband, or both. These causes include abnormalities in eggs, sperm, embryo quality, and factors affecting embryo implantation and fetal development.

For men who have undergone multiple sperm retrieval surgeries or experienced post-procedure infections, doctors must assess the inflammatory status and sperm retrieval potential before selecting an appropriate method. Wives with a history of miscarriage or repeated embryo transfer failures may undergo checks for related factors and, in some cases, embryo genetic testing to detect chromosomal abnormalities and aid in selecting suitable embryos.

Dinh Lam

* Character names have been changed.