A New Procedure to Expand Reproductive Choices for Transgender Women

A New Procedure to Expand Reproductive Choices for Transgender Women

Retrieving viable sperm from men with low fertility and those who have used estrogen therapy for years has been a challenge. Transgender women take medications to suppress testosterone production and increase estrogen, which tends to decrease sperm production and often diminish it completely Now with advanced technology, there is a new, less invasive technique with promise.

A new procedure called Extended Sperm Search and Microfreeze, or E.S.S.M., makes retrieving that sperm possible  unless sperm production has stopped altogether).

Dr. Arie Berkovitz, an obstetrician and gynecologist and Male Fertility Expert at Assuta Hospital in Rishon LeZion, Israel, created the E.S.S.M. technique as a treatment for men with low sperm counts.

What is E.S.S.M?

The revolutionary new procedure, the Extended Sperm Search and Microfreeze (ESSM), finds and freezes small numbers of sperm in 44 percent of men with azoospermia. This groundbreaking procedure is performed by dividing the entire semen sample into five micro-liter droplets and carefully scanning the drops under a high-powered microscope. Any sperm located are placed on a specialized device, called SpermVD, and cryopreserved for use in intracytoplasmic sperm injection (ICSI-IVF).

The SpermVD’s innovative design allows individual sperm to be transferred to a microdroplet for freezing. Because the sperm are successfully frozen in such a small quantity of fluid, over 90 percent of them survive the freeze and thaw process, and the individual sperm can easily found when thawed on the day they are needed to inject into their partner’s egg (ICSI).

The advantage over traditional sperm sample freezing and thawing are:

  • It is much more likely that sperm will be found than when the sperm are frozen in conventional vials.
  • Finding sperm is faster, so that they can be injected as soon as possible after the eggs have been retrieved from the partner, which optimizes fertilization and pregnancy outcome rates.

Candidates for E.S.S.M

Sperm production requires consistent testosterone production. E.S.S.M. does not increase sperm production but it allows doctors to find and freeze small amounts of sperm from the ejaculate without more invasive techniques. Invasive techniques involve removing sperm through a needle inserted into the testicle. The process can be painful and can damage the testes.

If you have been diagnosed with one of the following, you may be a candidate for ESSM:

  • Azoospermia: no sperm observed in the ejaculate in a conventional semen analysis; 44 percent of azoospermic men will have sperm found and successfully frozen
  • Cryptozoospermia: where only a very few sperm can be found, even after centrifuging and concentrating the specimen; almost all these men will have a successful ESSM and be able to proceed with IVF/ICSI.
  • Severe Oligozoospermia: sperm concentration less than one million/mL

To learn more about these topics and speak to one of our physicians about fertility treatment, you can request a consultation here.



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