Men's fears in infertility clinics

Hanoi – Upon receiving the diagnosis of infertility due to the absence of sperm, Mr. Dung was shocked and demanded that his wife immediately take their first child for a DNA test.

Dr. Cao Tuan Anh, a specialist at the Center for Reproductive Support, Tam Anh General Hospital, Hanoi (IVF Tam Anh), shared on December 28th the unforgettable reaction of this patient upon receiving the news of infertility. Mr. Dung and his wife had a 5-year-old daughter and had been trying to have another child for two years without success, so they went for a reproductive health check-up. He was diagnosed with secondary infertility, meaning infertility after already having children.

"I don't believe I'm infertile, so whose child is my daughter?", he reacted upon receiving the results, Dr. Tuan Anh recounted, adding that the patient immediately insisted his wife take their child for a DNA test.

"Mr. Dung contracted mumps three years ago, which caused his testicles to become fibrotic and gradually shrink, resulting in the absence of sperm and leading to infertility," explained Dr. Tuan Anh.

The patient then underwent micro-TESE sperm retrieval surgery, successfully fertilizing in vitro fertilization (IVF), and fathered a son. Mr. Dung confessed that during his infertility treatment, he remained skeptical and secretly took a strand of his daughter's hair for DNA testing to confirm that she was indeed his biological child.

Another patient, named Khang, came to see Dr. Tuan Anh alone, his face covered with a mask "because he was afraid of meeting acquaintances." The examination revealed that both of his testicles had shrunk to the size of a peanut, weighing only 2.8g (testicles weighing less than 3g have a very low sperm retrieval rate). Khang had undergone medical treatment in many places without success and was considering micro-TESE surgery to retrieve sperm.

"But I'm scared of having a tooth pulled, I faint at the sight of blood, so will testicular surgery be painful, and will I be given anesthesia?", he asked.

Dr. Tuan Anh reassured the patient that the micro-TESE procedure, performed under spinal anesthesia, would be painless, take only 1.5-2 hours, and allow for discharge after 24 hours. He stated that 80-90% of infertile men with mumps can have sperm retrieved using this method. The patient agreed to proceed with the procedure.

Men also face many fears when undergoing infertility examinations. (Illustrative image: Freepik) — Men also face many fears when undergoing infertility examinations. (Illustration: *Freepik)*

In another case, Mr. Dang, 38 years old, was the only son in his family, married for three years without children. Every day, he was asked why he hadn't sought infertility treatment, causing him immense stress. Afraid of losing face, he asked his wife not to reveal the reason was him. His wife had to endure the stigma of being a "single woman without children." He procrastinated for another two years before finally going to Tam Anh IVF Center for examination.

"Mr. Dang has poor sperm quality, but 1% of his sperm are still motile, so he can still have children," said Dr. Tuan Anh.

The patient was prescribed sperm collection and storage for a small number of sperm cells for IVF. In October 2023, his family welcomed a new member after 5 years of hoping for a child. "This year I finally have a real Lunar New Year celebration," the father said.

According to Dr. Tuan Anh, men are often considered the stronger sex, but when undergoing infertility examinations, they often become shy or withdrawn. When they receive diagnosis of infertility-causing conditions such as varicocele, retrograde ejaculation, undescended testicles, azoospermia, infections, etc., they sometimes lose their composure.

"Men don't cry immediately like women, but changes in voice and facial expression, along with other unusual symptoms, are only noticed by doctors who are very observant," said Dr. Tuan Anh.

Men also face many fears when seeking treatment for infertility, such as fear of pain, fear of losing face, and fear of not having their own children. "Therefore, let's allow men the right to be vulnerable and show them empathy," added Dr. Tuan Anh.

According to statistics from the World Health Organization (WHO), Vietnam is one of the countries with a high infertility rate in the world. Data from the Ministry of Health indicates that approximately 1 million couples experience infertility or subfertility each year. Infertility due to the wife accounts for 40%, with a similar percentage for the husband; 10% is due to both partners, and 10% is of unknown cause. Notably, the majority of male infertility cases are related to sperm quality.

According to Dr. Tuan Anh, methods such as epididymal sperm aspiration (PESA) and testicular microsurgery for sperm retrieval (micro-TESE), combined with intracytoplasmic sperm injection (ICSI), can help patients with non-obstructive azoospermia conceive, minimizing treatment time and costs.

Doctors recommend that men proactively undergo premarital reproductive health checkups or, after six months to a year of marriage without conceiving, to identify the cause early, facilitate easier and more effective treatment, and avoid the need for sperm donation.

In 2022, Tam Anh IVF Center recorded a sperm retrieval rate of over 90% in patients using the PESA method. This rate was approximately 42% for the micro-TESE method. Specifically for patients with azoospermia due to mumps complications, the sperm retrieval rate after micro-TESE reached 100%. The average success rate of in-vitro fertilization (IVF) was 68.5%. For couples aged 28-35, this rate reached 74.4%.

Thanh Ba

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