Infertility has historically been viewed as a woman’s issue, but recent studies reveal a shift in understanding, showing that male infertility is just as significant a factor. In fact, male infertility is responsible for 60% of infertility cases, with 1% to 2% of men experiencing azoospermia, or the absence of sperm in their ejaculate. Another 1% to 2% have cryptospermia, where sperm count is too low for assisted reproduction like in vitro fertilization (IVF).
October marked the fifth anniversary of a groundbreaking procedure in the United States, offering new hope for men struggling with severe sperm issues. Known as the Extended Sperm Search and Microfreeze (ESSM) technique, it has already resulted in 36 live births and 50 pregnancies for couples with men who previously had no viable sperm.
Originally developed in Israel, ESSM has gained widespread acclaim for its success rate in retrieving sperm from men with azoospermia or cryptospermia. Maze Men’s Health, located in Harrison, New York, is the only U.S. practice offering this innovative procedure. The clinic has performed over 750 sperm searches since adopting the ESSM method.
The results speak volumes:
- ESSM boasts a 40% sperm recovery rate for men with azoospermia.
- For men with cryptospermia, recovery rates soar to over 90%.
- A total of 23 IVF cycles have been initiated using sperm retrieved through ESSM at Maze.
- ESSM has led to 36 live births, with 51 men successfully providing sperm for IVF.
Chaya Rothschild, a senior andrologist at Maze, oversees the sperm recovery process, which is intricate and precise. ESSM involves dividing a semen sample into tiny microdroplets, which are then meticulously examined under a powerful microscope for sperm. The search can take up to eight hours, after which any viable sperm is isolated, frozen, and preserved for use in intracytoplasmic sperm injection (ICSI) during IVF.
The foundation for ESSM was laid by a 2017 study at the Male Fertility Center in Tel Aviv, which found that examining concentrated semen samples yielded a 40% success rate in locating rare sperm. This technique, combined with microfreezing, has significantly improved outcomes. Unlike traditional sperm freezing, which can result in lower sperm survival rates, microfreezing allows for better preservation and a higher likelihood that sperm will survive thawing when needed for IVF.
The microfreezing component also addresses the time constraints of IVF cycles. Traditional freezing methods require thawing large samples and conducting a second search for sperm, a process that can delay IVF procedures. With ESSM, sperm are preserved in smaller volumes, ensuring greater survival rates and faster access during IVF.
One 37-year-old patient shared his experience, describing how multiple fertility clinics had diagnosed him with azoospermia before he turned to Maze. After undergoing ESSM, 42 sperm were successfully recovered and frozen. This resulted in seven healthy embryos being created, allowing his wife and him to pursue parenthood.
Maze’s doctors recommend ESSM as a first step before considering more invasive procedures like testicular sperm extraction (micro-TESE). While micro-TESE is an option for sperm retrieval, it is invasive, carries the risk of testicular damage, and can only be performed a limited number of times. In contrast, ESSM is noninvasive and can be repeated as necessary.
While the cost of ESSM is lower than surgical sperm extraction, it is not typically covered by insurance, as it is a relatively new procedure. However, the costs are transparent: $2,000 for the sperm search and $100 per vial for freezing. Maze’s billing team works directly with insurance providers to explore coverage options for patients.
ESSM has significantly changed the landscape for treating male infertility. With less invasive intervention and higher success rates, this breakthrough technique is offering renewed hope to men struggling to father children and is transforming the IVF journey for countless couples. As this method continues to evolve, its potential to help even more families grow is boundless.
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