Answer from: Raúl Olivares, MD
As long as we have one sperm per egg, that’s enough to go ahead with the IVF. The prognosis may not be very good because these severe male factors tend to have a lot of problems afterwards, but we can even do a surgical removal of sperm from the testicles, so even in cases of azoospermia, in which the patients may not produce a single sperm, IVF can be done.
Sometimes it’s being discussed if ICSI is always needed or if the sperm is good enough, you can carry out a conventional IVF in which you place the egg along with 100,000 sperm just to let them fertilize the egg. We do ICSI in 100% of our cycles. When you do conventional IVF, you are assuming a risk of having a low fertilization rate or even a complete fertilization failure, and we think that these procedures are too expensive. The cost is really high, and we feel that if we do ICSI, we save like 5% of cases in which you were going to have a fertilization issue that later would have been solved using ICSI. For us, it does not make sense to do that. When you do ICSI, as long as I said at the beginning, as long as you can have any motile sperm, and you can pick it up, you can inject that sperm into the egg and go ahead with IVF, so in almost all cases.
What is the minimum value of low sperm count, and how can we deal with it?
Poor quality sperm can still be used to fertilize the eggs and perform IVF treatment by placing both sperm and egg in a special dish in the lab. What is the minimum sperm count that is needed for IVF?