Interactive FAQs Male Factor Infertility Question: My husband was recently diagnosed with spermatogenic arrest after a testicular biopsy. The urologist told us there was no known treatment for this. He first said there were no sperm being made, then he said that the ones there were so immature. I was totally confused. Are there germ cells or not? Can sperm production be restored or not? My husband's hormone levels were all normal and his testicles were of normal size. Ellen C. Illinois Answer In the absence of sperm on the semen analsysis, we have to ask 1) is the testicle is receiving appropriate hormonal stimulation, 2) is the testicle normal and capable of responding, and 3) is there an obtruction or congenital abnormality of the ductal system that creates an impediment to the semen on its course from the testicle to the penis. Your husbands medical history will provide clues as to the possibility of hormonal abnormality. The physical exam may indicate small, soft testicles and hormone testing for FSH, and testosterone suggesting that hormonal treatment may be beneficial. The biopsy can indicate whether the testicle is normally producing sperm that do not exit normally due to scarring from infection, injury or congenital abnormalities. The testicular biopsy should only be performed after arrangements are made for sperm cryopreservation by an IVF laboratory. This important step may avoid a second biopsy procedure should they find sperm and you choose to undergo IVF with ICSI. The biopsy must look at more than one location and even the opposite testicle if no motile sperm are found. Biopsy from a single site should not be considered conclusive evidence of testicular failure. Did they do a single biopsy? One side or both? If only one small biopsy, a repeat biopsy of the other side with cryopreservation of sperm if normal sperm are seen. There is no predictable way to treat this condition. Frequently, azospermia, the total absence of sperm may be associated with a chromosomal or DNA abnormality. Genetic testing for DNA microdeletions and chromosomal abnormalities should be performed to determine whether the abnormality may be passed to a male offspring. Dr. Perloe FAQ archives: IVF PCOS Clomiphene Ovulation Ovulation Induction Injections Age Related Infertility Endometriosis Donor Egg Donor Sperm Fallopian Tube Reanastomosis Tubal Infertility Unexplained Infertility Endometrial Factor Miscellaneous Return to the IVF Homepage This page, and all contents, are Copyright © 2003 by IVF.com, Atlanta, GA, USA.