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Can I father a child despite suffering from azoospermia?

Q: I am a 31 years old male suffering from azoospermia since long. In childhood, I had a severe pain in my left testis and after consultation; I was operated by a surgeon. Left testicle measured as 29 x 20 mm, but situated in left inguinal canal. Right testicle measured as 46 x 34 mm enlarged with altered echo pattern, multiple hypoechoeic area inside, along with this, hernia also removed same time. Four years back, I got married and underwent certain tests, which showed no sperms, fructose – positive, left testis – 31 x 18 mm with hypoechoeic pattern, undescended at opening of the internal inguinal ring with 8 mm cyst and right testis – 15 x 10, small atrophic with altered echo pattern with 3.5 mm cyst. After one year, I again underwent same test, which showed no sperms, fructose – negative. Same result showed for another two years. Last year, I again underwent same surgery for my left testis and now it is in its proper place but right testis is found non homogeneous with echogenic periphery and echogenic areas in its substance measured 1.8 x 1.3 x 1.4 cm (volume 1.7 cc). We have also undergone IUI with donor's sperm thrice followed by IVF but still not get positive result. Can I father a child?

A:It sounds like you have a complicated surgical history. If you want to father your own child, then you would need to undergo microdissection testicular sperm extraction, a procedure that uses a microscope to find areas of sperm production. The chances of finding sperm in your case would be between 40 - 50%. I don’t think it is performed in India. It sounds like you have already resorted to getting donor sperm and you have failed IVF cycles. It is unclear why this is the case. If you are not successful with this, you need to try with a different IVF centre or think about adoption as the last resort.

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