How are Testicles Like Bottles of Wine?

Some wines cellar well and some don’t. Which ones do you keep and which do you drink? There aren’t hard and fast rules here. Just know that 99% of wines should be drunk immediately as only 1% of wines age well. One of the oldest wines every drunk was from a 1200-year old winery in Wurzburger, Germany: it was 421 years old when consumed, but quickly turned to vinegar after opening. In the works of Pope John XXIII; “Men are like wine – some turn to vinegar, but the best improve with age.”

A Good Vintage

I thought of this when my patient asked me: “How long will it last?” He was referring to the sperm FNA Mapping procedure that I had done that showed that he had testicular sperm despite having no ejaculated sperm (azoospermia).
From our early published experience, the average time from sperm FNA Mapping to sperm retrieval was 4.9 months with a range of 2 weeks to 13 months. More recently, we reported an average time of 7.5 months (range 4 to 21 months) in men who were Mapped after failed microdissection TESE before they proceeded with sperm retrieval. If you were to ask me what the longest time a couple waited from sperm FNA Mapping to sperm retrieval procedure, the answer is 14 years!  So the testicle is really like a good bottle of wine.

A Good Vinegar

But I fear that not all Maps fare well with time. In men with chronic illnesses such as diabetes and obesity, the stability of sperm production is not guaranteed. Remember, a healthy body is the best reproductive body. In addition, some men with azoospermia due to genetic causes involving the Y chromosome or other chromosomes may also not fare as well either. For example, the rate of finding sperm in men with Klinefelter syndrome decreases dramatically after age 35. So, there are situations in which I recommend that men not wait too long to proceed to sperm retrieval after Mapping.
All in, I generally recommend that Mapped men take their time, get things together and then circle back after at least 1-2 months to have a sperm retrieval. Often, I may suggest medical regimens to “optimize” sperm production for several months after Mapping, because I feel we have one good chance to get sperm for family building and I like to take my best shot. Just as wine has been called “bottled poetry,” to me, the author of Sperm Mapping, testicles are “spheres of hope.”