Extended Sperm Searches: Finding Rare Sperm Before Surgery
Why Standard Semen Analysis Misses Sperm
As mentioned earlier, a standard semen analysis reporting "0 sperm" doesn't actually examine your entire sample—searching the complete sample would take several hours. Some men literally have just a single sperm in their ejaculate, which, if found, can enable them to have biological children.
The Problem with Current Practice
Extended sperm searches are unfortunately not commonly performed on azoospermic patients, despite their potential value. This gap exists due to various factors including financial incentives, technical difficulty, insurance reimbursement issues, and misunderstanding of the procedure's benefits.
Urologists are surgeons by training, so they naturally default to considering surgery as the primary solution to fertility problems, even when a non-surgical option exists for some men.
Why You Should Get an Extended Search
If you were diagnosed with non-obstructive azoospermia and have the financial means, you should absolutely get an extended sperm search before considering surgery.
These specialized tests can find rare sperm in 10-40% of men who were initially diagnosed with azoospermia. The procedure should be considered a requirement for all azoospermic men prior to considering surgery, but should be considered especially essential if you have an FSH under 8 mIU/mL or have ever had even a single non-motile sperm seen on any previous semen analysis.
As only one individual sperm is needed to have a child, a successful extended sperm search can mean completely removing any need for surgery.
Available Extended Search Options
Most Promising Technology
STAR Test - Columbia University, New York City
This test uses advanced microfluidic and AI technology to find and isolate rare sperm. Their testing has successfully identified sperm that human technicians missed, which makes sense—finding sperm is difficult and time-consuming work that is likely better suited for computers than humans.
- Diagnostic only: $500
- With sperm freezing capability: $3,000
- No insurance coverage
Other Specialized Labs
Maze Labs - New York City
- Cost: ~$2,000
- No insurance coverage
- Additional fees for cryopreservation
Weill-Cornell Andrology Lab - New York City
- Cost: $570 (may be covered by insurance)
- Requirement: Must be a patient of a Cornell IVF doctor
- Freezing: ~$300 additional (refunded if no sperm found)
Bruce Gilbert, MD (Men's Reproductive Health) - New York City
- Cost: ~$700
- No insurance coverage
- Some people report this clinic has stopped offering extended sperm searches.
Jumeirah American Clinic - Dubai
- Director: Dr. Ramasamy (fertility expert)
- Uses AI technology from Neogenix Biosciences.
Outside US Options
MFC Lab - Israel
- Microfreeze technology (same technology used by Maze Labs)
- Contact for details
Unconfirmed but Possible Options
Note: These require verification but may offer extended searches:
- Pacific Fertility Center - San Francisco and Los Angeles (possibly when referred by Dr. Turek)
- Dr. Larry Lipschultz - Baylor, Houston, TX
- CCRM Colorado
Australia - Neogenix Biosciences
The company providing AI sperm search technology to Jumeirah American Clinic also works with several Australian clinics which may (unconfirmed) offer ai-enhanced extended searches:
- IVF Australia
- MelbourneIVF
- Virtus Health