My husband has no sperm. I have PCOS. How can I get pregnant?

A couple dreaming of a baby is a beautiful thing. Many factors have to coincide together for this beautiful dream to be realised. Thanks to the development in the field of reproductive sciences, we have a thorough understanding of what works and what causes issues. With an optimistic view, there are many solutions available for problems in either of the couples. 

The couple should also know when to consult a fertility specialist. If the female’s age is below 35 years, then the couple can try for at least a year before thinking of consulting a fertility specialist. However, when the age of the woman is above the age of 35, the couple can try for six months, and if they still do not conceive, then they should consult a fertility specialist. 

Any fertility specialist will start with understanding your pattern of trying and past medical history followed by a physical examination. Blood tests, scans, ultrasound, and sperm testing are a part of routine analysis to figure out fertility issues. If the result of the analysis and diagnosis shows that your husband has no sperm and you have PCOS, then this is not a reason to panic. Surprisingly, many couples face this situation, and many options are available to you.

A known fact is that around 20% of women have polycystic ovary syndrome (PCOS), and in half of couples facing conception issues, the cause of infertility is sperm-related.

Know the relation between PCOS and what it means for fertility?

PCOS is a medical condition affecting a woman’s ovaries. PCOS means that there are a large number of harmless ovarian cysts that have undergone “follicular arrest.”

Under normal conditions, a follicle is where the egg develops and gets released from. In women affected by PCOS, the follicles are underdeveloped, so an egg cannot be released, which means ovulation does not happen. As a result, women suffer from hormone imbalance and have irregular menstrual cycles and difficulties in conceiving. Women with medical conditions such as PCOS can benefit from guidance from fertility experts and improve their ovulation, which can result in natural conception.

If the conservative methods and medical treatments are not improving the PCOS symptoms, then there is good news, and that is, women with PCOS generally respond well to IVF treatment. They respond too well to stimulation so they could be at risk of Ovarian Hyperstimulation Syndrome (OHSS). At ZIVA Fertility clinics, many PCOS patients are treated with our Mild Stimulation protocols, which means only 5-9 days worth of stimulating drugs are given as opposed to the 4-5 weeks worth used in traditional IVF. By adopting Mild Stimulation protocols, we largely avoid the severe risks of OHSS, and an added advantage is that women experience less bodily stress and are more receptive to implantation.

Effect of having no sperm on fertility

When there is no sperm in the ejaculate, that condition is called Azoospermia. An Obstructive Azoospermia is a blockage preventing the sperm from entering the ejaculate.

Non-obstructive Azoospermia means issues with sperm production caused by the testis. Either type of Azoospermia reduces the chances of conception. Male infertility problems contribute to 50% of infertility problems and are the sole cause in around 30% of cases. However, this is most commonly overlooked or overshadowed by conversations surrounding female infertility. In the last couple of decades, shockingly, male sperm counts have dropped by as much as 50%.

Every one in ten infertile men has Azoospermia. Medical treatments such as chemotherapy or radiation, genetic conditions such as Klinefelter’s syndrome, anatomical abnormalities such as varicoceles or absence of the vas deferens on each side, and recreational drugs such as some narcotics could lead to Azoospermia. Men could have had poor testicular development as a foetus/child or were exposed to environmental toxins.

My husband has no sperm. I have PCOS. How can I get pregnant? 

Though rarely do both conditions exist, it’s not unheard of. But there are options available to have a child even if your husband has no sperm and you have PCOS. Do not wonder how I can get pregnant. Below are the options one can try if your husband has no sperm and you have PCOS:

Mild IVF: In a mild IVF, lower doses of fertility drugs over a shorter period are administered as compared to the standard IVF. The treatment time is reduced by about two weeks, and women get to avoid a lot of the unpleasant side effects of the drugs.

Standard IVF: Ovarian stimulating hormones are given to produce more than one egg. Blood tests and ultrasounds are used to determine the timing of egg retrieval. The eggs are retrieved using an aspiration needle under ultrasound guidance. After egg retrieval, they are combined with sperm in a culture dish. Upon successful fertilisation, a zygote or pre-embryo will begin to develop, which is kept in the incubator for two to five days while it continues to grow and divide. On the healthy embryos, Preimplantation Genetic Screening (PGS) is done to check for chromosomal abnormalities. The embryos that have been created during the preceding steps are transferred to your uterus through a thin tube called a catheter. During this procedure, your doctor will insert the catheter through your vagina and cervix and advance it to place the embryo into your uterus.

Intrauterine insemination (IUI):  In an IUI procedure, sperm is artificially placed inside the female’s uterine cavity with the help of a catheter, which enables it to reach the uterus directly without getting killed in the way, thereby making its union and fertilization with the egg more feasible and easier. Before this process is done, the sperm is thoroughly washed, a process in which the sperm is separated from the seminal fluid. It’s because some of the substances in the seminal fluid can irritate the uterus and lead to complications such as cramping and pain. However, the process itself is utterly painless and takes only a few minutes to complete. 

Fertility treatment with sperm donation: Since the male has no sperm, one has to depend on donor sperm. There are authorised sperm banks from which one can obtain sperm. 

Combined IVF with ICSI: ICSI is performed in the lab whereby a single sperm is directly injected into the egg. The rest of the procedure follows the IVF protocol.  

However, one has to remember that modifying their lifestyle and including a fibre-rich, protein-based diet full of minerals and vitamins gives the best results for women with PCOS. Maintaining a healthy weight is essential, too. 

We at ZIVA Fertility Clinics have helped couples in similar situations. For more information, please visit our website or contact us at +91-9100002737 or +91-9392834024.