"This is the first case the hospital has received involving a solitary kidney and multiple congenital abnormalities of the reproductive system leading to infertility," said Dr. Nguyen Cong Danh from the Center for Reproductive Support at Tam Anh General Hospital in TP HCM.

Cuong, who is generally healthy, discovered his infertility, caused by a lack of sperm, after two years of marriage without children. He underwent testicular sperm extraction (TESE) for in vitro fertilization (IVF) with his wife's eggs, but three embryo transfers were unsuccessful.

In early 2025, the couple visited the Tam Anh IVF Center in TP HCM for a comprehensive reproductive and general health check-up. Dr. Danh discovered that Cuong had a congenital absence of his left kidney, along with the absence of the vas deferens and seminal vesicle on the same side. The remaining seminal vesicle was underdeveloped, resulting in an incomplete sperm duct, and his semen analysis showed no sperm.

The patient has congenital unilateral absence of the vas deferens (CUAVD), a condition affecting only 0.5-1% of men, Dr. Danh explained, adding that most cases of this condition are accompanied by renal agenesis on the same side, due to a defect in the mesonephric duct during fetal development.

The couple pursued IVF to conceive. Dr. Danh performed percutaneous epididymal sperm aspiration (PESA) on Cuong's left side (the side without a vas deferens) and retrieved two sperm samples, without damaging the testicular tissue.

The first sample was processed by an embryologist, who selected suitable sperm for intracytoplasmic sperm injection (ICSI) into the wife's oocytes. This resulted in the fertilization and cultivation of seven good quality day-5 embryos. The remaining sample was cryopreserved to preserve their future reproductive potential without needing further sperm retrieval procedures.

Tam Anh IVF embryologists perform specialized techniques in the "lab-in-lab" system. Photo: Nguyen Thang

Cuong's genetic testing revealed he carries the heterozygous gene for Thalassemia, a type of inherited blood disorder. His wife carries the heterozygous gene for Wilson's disease, meaning one copy of the gene is faulty but she does not exhibit the disease. Although the couple carries two different disease genes, there was a risk of passing on the recessive genes to their child without causing the disease, so preimplantation genetic testing was not necessary.

In early May, Thao's uterine lining was prepared, and a high-quality embryo was transferred, resulting in a successful pregnancy. The fetus is currently 9 weeks old and developing well.

Dr. Danh recommends that couples who have not conceived after one year of marriage seek early consultation for appropriate treatment, to increase their chances of conception and minimize costs. Unmarried men and women should prioritize general health or reproductive health check-ups for early detection of any conditions and consider sperm or egg freezing to preserve their fertility if necessary.

Tam Anh IVF offers comprehensive infertility treatment for both men and women, incorporating an ISO 5 cleanroom for embryo culture, along with advanced technologies to improve success rates. Genetic techniques enable accurate diagnosis and optimize treatment effectiveness for couples with complex genetic conditions.

Hoai Thuong

*The patient's name has been changed