successful treatment of testicular failure type iv without micro-testicular epididymal sperm extraction: a case report

Objective: sperm donation and hormonal therapy with micro-testicular epididymal sperm extraction (tese) for infertility from testicular failure might not always be available in some contexts. we report a successful embryo transfer from the patient-by ‘cumulative sperm collection’ strategy. case report: a 42 year-old male presented with non-obstructive azoospermia from testicular failure. hormonal treatments were given along with the patient-initiated ‘cumulative sperm collection’ strategy, which eventually resulted in 17 sperms retrieved. twelve mature oocytes were selected for intracytoplasmic sperm injection (icsi) with the retrieved sperms, of which 8 oocytes were successfully fertilized but only two reached the early blastocyst stage; the first embryo transfer was not successful. another five eggs were thawed and fertilized with the remaining 5 sperms and 3 oocytes were successfully fertilized: seven cells were grade 3, 6 cells were grade 3, and 3 cells were grade 3. the second embryo transfer was successful, and the term female infant was successfully delivered by cesarean section. conclusion: at a center without micro-tese availability, successful embryo transfer for testicular failure type iv could be achieved by hormonal therapy plus a ‘cumulative sperm collection’ strategy.