As an up and coming young couple, Matt and Clare Rood wanted nothing more than to cradle their very first baby.

Instead, despite three years of trying to achieve a pregnancy, they came up empty.

“We finally decided it was time for a checkup,” explains Matt, a 31-year-old network technician from North Liberty, Iowa. “We wondered if there could be something physically wrong.”

Clare made the first doctor’s visit and got a clean bill of health.

Matt’s subsequent visit to Cedar Rapids urologist Steven Wahle, MD, was more revealing. After three months of testing, he was diagnosed with azoospermia—a condition in which the patient has no sperm in the ejaculate.

Barring a remarkable turnaround, the couple’s dreams of pregnancy were beyond reach.

Wahle knew the couple’s only hope was to seek highly specialized care, so he referred Matt to a male infertility specialist in the Department of Urology at University of Iowa Hospitals and Clinics. The specialist was Moshe Wald, MD, an expert in microsurgical sperm retrieval procedures as well as the processing and freezing of harvested sperm (a semen storage method called cryobanking).

“Matt faced difficult obstacles but we believed there was a chance they could be overcome,” Wald says. “Our evaluation included specialized testing to identify treatable hormonal disorders or genetic problems that might have required genetic counseling before we would have made a sperm retrieval attempt.”

In addition, Wald’s team needed to make sure that Matt did not have a genetic disorder that would have made it impossible to find sperm in his testicles.

After confirming that Matt did not have any hormonal or genetic problems, Wald decided he was a good candidate for a procedure called micro-dissection testicular sperm extraction (TESE).

Micro-dissection TESE involves a meticulous search for possible areas of active sperm production in the testicles. It is performed under the operating microscope, and is an option for patients in whom the absence of sperm in the ejaculate is secondary to a problem with sperm production and/or maturation (non-obstructive azoospermia), and not with obstruction.

Specimens obtained are analyzed for the presence of sperm. Any sperm found is then further analyzed, processed, and banked at the hospital’s reproductive testing laboratory. Sperm obtained through this advanced technique can be used only for in vitro fertilization (IVF), and not other types of assisted reproductive techniques.

“Luckily,” Wald says, “we were able to find viable sperm during the micro-dissection TESE. This sperm was frozen for future IVF.”

Matt and Clare are thrilled and have taken the initial steps required for participation in the Assisted Reproduction program at UI Hospitals and Clinics.

“We are very excited about our prospects now and really looking forward to the opportunity for parenthood through IVF,” Matt says. “After what we’ve been through, the child we hope to have will certainly not be lacking for love or attention!”

Rood adds that Wald was an empathetic, understanding, and supportive professional in helping him and his wife rescue their opportunity for pregnancy.

“I would recommend Dr. Wald and the UI program in a heartbeat,” Rood says. “We couldn’t have asked for a better doctor or a better program.”

Infertility options

UI Hospitals and Clinics provides innovative, comprehensive, high-quality evaluation and treatment for men and women facing infertility issues. Urologists who specialize in male infertility evaluate and perform surgical procedures for sperm retrieval as well as other surgical and medical treatments (see attached article). Comprehensive services for women facing infertility issues include medical and surgical procedures such as robotically assisted surgery. Female infertility services are provided through the Reproductive Endocrinology and Infertility Clinic. Both the male and female infertility clinics are supported by the Reproductive Testing Laboratory. Additionally, couples who require assisted reproductive services can access the In Vitro Fertilization (IVF) program within the UI Center for Advanced Reproductive Care.

• For questions about male infertility: Call UI Health Access toll-free (800-777-8442) and ask for Moshe Wald, MD, call Wald directly at 319-356-1974, or visit www.uihealthcare.com/malefertility.
• For questions about female infertility: Call UI Health Access toll-free (800-777-8442) and ask for the Reproductive Endocrinology Clinic, call directly at 319-356-1767 or visit www.uihealthcare.com/repromed.
• For questions about advanced reproductive care including IVF: Call UI Health Access toll-free (800-777-8442) and ask for the Center for Advanced Reproductive Care, call directly at 319-356-8483, or visit www.uihealthcare.com/repromed.

—Michael Sondergard

Perseverence Pays
Matt and Clare Rood have taken the initial steps required for participation in UI’s assisted reproduction program.

A Skilled Expert
Male infertility specialist Moshe Wald, MD, performs microsurgical sperm retrieval procedures is an expert in processing and freezing of harvested sperm.