Doctor Nguyen Cong Danh, from the Center for Reproductive Support at Tam Anh General Hospital Ho Chi Minh City (IVF Tam Anh TP HCM), stated that Hung contracted mumps a decade ago, which resulted in inflammation and bilateral testicular atrophy. Tests revealed his pituitary hormone levels, FSH and LH, were 3-4 times above normal. This indicated the pituitary gland was consistently signaling the testes to function, but the organs were severely damaged, having almost lost their function.

Doctor Danh explained that the mumps virus directly attacked the testes, causing inflammation and damage to the seminiferous tubules. This also obstructed blood flow essential for tissue nourishment. Spermatogenic cells were destroyed and replaced by fibrous tissue, causing the testes to shrink, impairing sperm production, and leading to infertility.

Hung also had a deletion in the AZFc region of the Y chromosome, a common genetic abnormality in men with azoospermia or severe oligozoospermia. Furthermore, he presented with bilateral varicocele, which had reduced his testes to about one-third of their normal size. Untreated, this condition would continue to degrade testicular function.

"The likelihood of finding sperm was very low compared to cases with a single pathology," Doctor Danh stated, recommending a "2-in-1" surgical approach.

Using a microscope magnified 30 times, microsurgeons performed micro-TESE to retrieve sperm from the testes. Any viable seminiferous tubules were then transferred to the lab. Concurrently, the patient underwent varicocele ligation to enhance the testicular environment.

Doctor performs sperm retrieval and varicocele ligation for the patient. Photo: Tam Anh General Hospital

Most of Hung's seminiferous tubules were fibrotic and non-functional. After nearly 190 minutes, the team retrieved just enough sperm for one IVF cycle, with no surplus for cryopreservation. Embryologists then directly injected individual sperm into oocytes for fertilization, successfully cultivating seven good quality day 5 embryos.

Hung's wife received one good quality embryo transfer into her uterus and successfully conceived on the first attempt. She is now over 12 weeks pregnant.

Embryologist injects sperm into the oocyte cytoplasm (ICSI). Photo: Tam Anh General Hospital

Doctor Danh recommends that men who have experienced genital inflammatory diseases, particularly mumps, seek early medical evaluation for intervention or sperm cryopreservation before complete testicular atrophy. Individuals who have not contracted mumps should get fully vaccinated as advised.

For cases of oligospermia or azoospermia, AZF testing is crucial to predict the likelihood of sperm retrieval and to provide genetic counseling before treatment, given the potential for transmission to male offspring. Any male child born would also require reproductive health monitoring upon reaching adulthood.

Dinh Lam

*Patient's name has been changed