Kien, 42, said on 9/9, "My sexual function is normal. I never thought I would be infertile." He explained that his wife's sister had undergone fertility treatment to conceive, leading him to believe the issue lay with his wife. For years, his wife underwent infertility examinations alone. The couple experienced frequent conflicts and separated, only reconciling earlier this year. They then traveled from Vinh Long to Ho Chi Minh City, hoping to have a child.

Doctor Le Dang Khoa, Head of the Assisted Reproduction Department at Tam Anh General Hospital - District 8, discovered that Kien had absent vas deferens, a congenital condition also known as bilateral absence of the vas deferens. Genetic testing revealed he carried a CFTR gene mutation associated with cystic fibrosis. This condition causes mucus to block and damage the vas deferens during fetal development, preventing them from forming properly.

Men with absent vas deferens can still produce sperm, but it cannot be ejaculated, preventing natural conception. They can still have normal sexual function and experience pleasure during intercourse. This often leads to a delayed diagnosis, as many only seek medical attention after years of trying to conceive without success. According to Doctor Khoa, prolonged male infertility can also negatively impact the woman's reproductive health due to her increasing age, making treatment more challenging.

Doctor Le Dang Khoa performs a reproductive health ultrasound on a male patient. Illustrative photo: Nguyen Thang

Doctor Le Dang Khoa performs a reproductive health ultrasound on a male patient. Illustrative photo: Nguyen Thang

Kien's wife, Hien, experienced a decline in her ovarian reserve (AMH) from a healthy level (4.7 ng/mL) to near depletion (0.7 ng/mL), along with irregular menstrual cycles. She was also diagnosed with endometritis.

Doctor Khoa prescribed a couples therapy approach, involving percutaneous epididymal sperm aspiration (PESA) for Kien and multiple-cycle egg retrieval for Hien. After two cycles, Hien had 6 eggs frozen. In the third egg retrieval cycle, doctors collected 3 more fresh eggs.

Doctor Le Dang Khoa (left) and the surgical team perform a sperm retrieval procedure for a male infertility patient. Photo: Hoai Thuong

Doctor Le Dang Khoa (left) and the surgical team perform a sperm retrieval procedure for a male infertility patient. Photo: Hoai Thuong

Simultaneously, in the adjacent operating room, Kien underwent PESA, yielding two fresh sperm samples. Embryologists selected suitable sperm to inject into the fresh and thawed eggs, cultivating them in a time-lapse incubator to produce 5 high-quality day-5 embryos.

Before embryo transfer, Hien's endometritis was treated with antibiotics. At 42, she conceived for the first time, and her 12-week-old fetus is currently developing healthily. Kien's remaining sperm sample was frozen for future use.

"Our greatest joy is that we finally have a child," Hien said, adding that she no longer blames her husband for the years of misunderstanding.

According to Doctor Khoa, women were often previously considered the primary cause of infertility. In reality, male infertility accounts for about 40% of cases, equal to female infertility. Approximately 20% of cases are due to issues with both partners or have unknown causes. Male infertility can result from injuries causing blockage of the vas deferens, infections in the reproductive system, complications from mumps, hypogonadism, erectile dysfunction, genetic abnormalities, or gene mutations causing absent vas deferens, like in Kien's case.

At Tam Anh IVF - District 8, doctors employ a couples therapy approach, evaluating and treating both partners' reproductive health. This includes assisted reproductive technologies like intrauterine insemination (IUI) and in vitro fertilization (IVF). This approach allows for early detection and treatment of male reproductive issues, improving quality of life.

Hoai Thuong

*Patient names have been changed.