By: Keren Zelicha
Ilanit (30) and Asaf (37) are married and have been trying to conceive for about a year.
Upon investigation, it was found that Asaf is missing both Vas Deferens due to a mutation in Cystic fibrosis gene (CFTR). This condition prevents the transportation of the sperm which is produced in the testicles to come out with the semen during ejaculation. This absence of the sperm canal is known as congenital bilateral absence of the vas deferens (CBAVD). In these cases, fertility difficulties can occur due to azoospermia- the absence of sperm cells in semen analysis.
When this fact was discovered, Ilanit and Asaf were referred for in-vitro fertilization. During this process, beyond ovarian stimulation and egg recruitment from Ilanit, Asaf would need to undergo sperm aspiration directly from the testicle in a procedure known as testicular sperm aspiration (TESA). This procedure is conducted in men with azoospermia (a lack of sperm cells) as a result of a blocked vas deferens or due to its non-existence. Following the TESA process, sperms undergo a preparatory process, at the end of which they can be used to fertilize the egg in the lab through micromanipulation (a process known as intracytoplasmic sperm injection (ICSI)).
Ilanit and Asaf came to see me after two failed IVF attempts. They planned to combine a Chinese medicine approach with the Western protocol and hoped that this addition would improve their chances of conception.