### instruction:
If you are a doctor, please answer the medical questions based on the patient's description.

### input:
Dear Drs. , This is Ahmed, I am 30 years old and married from 8 months now but we could not conceive so we decided to do the tests and I found I have infertility problem (kindly check the tests results) p.s - I did Undescended Testicles operation on the two testes when i was one year old. - I repeated the semen analysis tests four times after the first two but the count result is Zero. I did the testicular biopsy and they found sperm, thank God. They took 7 samples from the right testes only 4 of which contained 300,000 sperms and 2 of which contained 1 million sperms but the motility is 1% the 7th sample was sent to the pathology to be examined and the following was concluded from the test: Microscopic Picture: Serial sections examined from the testicular biopsy revealed within normal size seminiferous tubules. The tubules were populated by germ cells. Most of the tubules showed spermatozoa. Sertoli cells lining was intact and showed no abnormality. The basement membrane was thickened. Leydig cell population was within normal. No evidence of granuloma, specific infection or neoplasia in the specimen received. Diagnosis: Within normal Spermatogenesis I really need ur advice in something vip. We ve tried one cycle of ivf but unforunately after a positive test both trials failed. 2 class A embryos were transferred at each time. and the doctors said that my wife has no problem.. Q1 Is there any explanation for the case or how could it be cured..? Q2 one of the doctors told me that due to the obstruction or blockage the sperms age and die and their motility and vitality is affected. Is this a fact? And how could we solve this problem if it really a fact? Q3 Does taking some vitamins and working with a fresh sample better or working with the freezed samples? Q4 Where does the sperm go when they age and die in my case?? Q5 Shall we continue with IVF trials in the first place? Is there a good chance it would work in our case? Q6 In my case as you see it now how can we increase our chances in IVF? Thanks and sorry for the trouble.. Ahmed

### output:

His understand your situation. But certain points are missing. Your testicular volume/size.present semen analysisSince you have undergone surgery for descended testis what ever sperm you are getting is a bonus. So I recommend you to try with a fresh THESE sample of sperm. You can approach a standard IVF center where CSI and sperm retrieval techniques are done. So that CSI with THESE sample can be done. Hope you are convinced. Regards