A couple in Germany**, Max (46 years old) and Anna (41 years old) embarked on a challenging journey. They yearned for the joy of parenthood but had faced five long years of primary infertility. Their unwavering hope led them to a life-changing encounter in July 2021.

A Diagnosis of Nonobstructive Azoospermia:** Max was diagnosed with nonobstructive azoospermia, a condition that had cast a shadow over their dreams. To make matters more complex, his Johnson score was a mere 2. It was a journey that had already seen an unsuccessful testicular sperm extraction (TESE) in 2019, leaving them with dashed hopes and lingering uncertainty.

A Beacon of Hope:** Yet, they found a glimmer of hope. Their diligent examination revealed that Max's genetics and testicular volume were normal. The medical team devised a plan that included hormone therapy, consisting of HCG and clomiphene citrate. After six months of therapy, their persistence was met with disappointment as spermatozoa remained elusive in the semen analysis.

A Pivot Towards Micro TESE and ROSI:** The couple remained resolute, and a new path was charted. Micro-TESE, synchronized with IVF, was their next endeavor. Their hopes soared as they awaited the results. Unfortunately, the procedure yielded no spermatozoa, but it unearthed round spermatids, a tiny glimmer of hope in the vast darkness.

The Triumph of Resilience:** This was the juncture where IVF transitioned to ROSI. With maternal age pressing on, nine eggs were carefully collected from Anna, with seven maturing to perfection. In a display of sheer determination and resilience, five eggs found their match with the round spermatids (Sb2).

A Ray of Hope:** The journey was long and trying, but their faith was unwavering. In the end, two embryos made it to Day 3, a testament to their indomitable spirit. Those embryos were transferred during a fresh cycle, and their hope was rewarded as pregnancy took hold.

The Miracle of Life:** Their journey culminated in the most beautiful moment of all. A healthy baby boy arrived on time, filling their lives with boundless joy and a profound sense of fulfillment.

In the face of immense challenges, Max and Anna demonstrated that hope, resilience, and the unwavering pursuit of parenthood can triumph over even the most daunting obstacles. Their story is a testament to the miracles that can occur when determination meets medical expertise and unyielding hope.

**Disclaimer:** This is a true story reflecting the experiences of a couple from Germany who received treatment from Dr. Ahmet and Dr. Emra Pubuccu at Fertility Turkey. In order to safeguard the privacy of the individuals involved, their names have been altered.