Having been through two cycles of IVF earlier this year and talking to plenty of other women doing the same - this situation is relatively common, there are plenty of men that for a variety of reasons cannot ejaculate sperm. Often it's a problem with an ejaculatory ducts but of course it can be PC.
Anyway these men go to an andrologist and have their sperm removed from the testes at the IVF clinic. Which apparently is not much fun for the man, a lot less pleasent than providing sperm the standard way. It is for this reason that my IVF doctor had Paul my husband bank two lots of sperm prior to the op so that if we wanted to do more cycles we could.
It does add another layer of complexity in an already complex situation, because for IVF to go right there are so many steps that have to go well - from a good response to the hormones, to even and steady egg growth, to a good crop of eggs at harvest, to a high % of eggs fertilising, to good cell division, and even if this happens then the blastocyst has to implant. And it's not cheap - each cycle costs about
$4K out of pocket in Australia per cycle but people in the US often pay $15-20K (andrologist sperm removal is likely to be extra) and it isn't covered by many insurance policies. Each cycle has about
20-30% success rate at a good IVF lab.
Hope this helps.
Husband's age: 52. Sydney Australia.
Family history: Mat. grandfather died of PC at 72. Mat. uncle died of PC at 60. He has hereditary PC.
PSA: Aug07 - 2.5|Feb08 - 1.7|Oct09 - 3.67 (free PSA 27%)|Feb10 - 4.03 (free PSA 31%) |Jun10 - 2.69. DRE normal.
Biopsy 28Apr10: negative for a diagnosis of PC however 3 focal ASAPs “atypical, suspicious but not diagnostic” for PC. Review of biopsy by experienced pathologist, 1/12 core: 10% 3+3 (left transitional), 1/12 core: ASAP (left apex)
Nerve sparing RP, 20Aug10 with Dr Stricker. Post-op path: 3+4 (ISUP 2005). Neg margins, seminal vesicles, extraprostatic extension. Multifocal, with involvement in the peripheral, apex, fibro-muscular and transitional zones.
Post RP PSA, Sep10 – 0.02
Post Edited (An38) : 10/7/2010 6:14:40 AM (GMT-6)