No sperm? No problem!

Tests for success
In all cases, it is vital to know whether sperm is being produced in the testes. That way, the man is not subjected to a surgical procedure when there is no hope of finding any sperm. The couple can also be appropriately counselled about their chance of success with ICSI.

About five years ago, a new endocrine hormone was identified called inhibin B. In women, inhibin B is a marker of ovarian reserve, but in fertile males it is produced by the Sertoli cells (the site of sperm production). Other 'male' hormones such as testosterone and follicle-stimulating hormone (FSH) are also useful guides to an azoospermic man's fertility potential. It has been found (after measuring the inhibin B levels in over 100 azoospermic men undergoing PESA or TESE) that the level of inhibin B accurately predicts whether or not viable sperm will be found.

Irrespective of the cause of the azoospermia and the level of FSH, it has been found that if the man's inhibin B level is greater than 80pg/ml, sperm will be retrieved at PESA, TESE or open biopsy. All azoospermic men are now routinely offered the inhibin B test at MFS (and all men would rather have a blood test than a fruitless testicular biopsy!).