Dealing with azoospermia?

[april4jdg]

Sounds like your husband has given up. My husband- he said- well atleast I know how you felt for 11+ months of ttc... That wasn't the best, but I understood what he meant... after he saw me going through the upset, he felt it too now...

I have read it is better to talk to men while they are doing something like fishing, or on a walk-they will open up more...
You can rarely just sit them down for a chat, like us women do...

anyway-let him now there are different types of azoo, that have successes...
you said there was one dead sperm, right? So he is atleast producing some.

it may be obstructive, with a variocele, or anything- that surgery corrects. it is very early for you all now... You cannot let it eat you up- it will put a strain on your marriage...

It can be hormonal-and they get put on meds for a few months and it corrects itself-
It is too early to write it off as - you will never have kids-

I told my husband, I married you-unconditionally, and even if I knew about it before we got married, I would have still married you. This changes nothing- for love is unconditional.

I am surprised your doctor didn't give you any of the other results-
ours told us volume was good- everything was good- except fsh was slightly elevated at 17.5, ph level etc...
Our RE told us of the azoospermia- then had DH do another sample with a local urologist and a physical exam-and the results there were 0- then we got referred to another urologist for a biopsy.


Dh is probably going through a range of emotions-like, embarrassment- which most guys turn it to anger when they are embarrased.
Shock, and other things...

My DH just clammed up (and I am a talker...lol But I had to remember that is how some guys deal) when I confronted him, he said- what do you want me to say-this is the hand we have been dealt- I'll do whatever I need to do to see if I can have a baby- biopsy- SA, whatever. But for now this is the hand that we have been dealt. We will be parents- one way or the other- we will do IVF-ICSI, if possible, or we will adopt.

 

[Deb111]

Nayla - as far as the IVF / ICSI is concerned, we were told that if it was a blockage, they would probably not repair it, just get the sperm out and use if for ICSI. We were told the success rate of correcting a blockage which is on a very small scale is not very reliable.

I know it's hard and you have to respect your hubby's wishes, but it is a real shame that he wont let you go with him. Could you write down a list of things for him to ask, or try to get another appt for you so that you can go and get the information that you need. You need some answers and some information too. My experience is, that with the best will in the world; men come away having listened to 50% of what they are told and remember about 10% of that!

Whilst I think about it (and hopefully others here will add to the list), some of the tests that you need to be asking about are

- FSH, LH and testosterone level blood tests
- blood test for Y chromosome micro-deletion
- test for presence of fructose in sperm sample as the absence of this indicates a likely blockage
- karyotype blood test
- blood test for cytstic fibrosis carrier

The results of these will tell you a lot about the cause, although we were told the only sure way to know if there are sperm is to do the SSR. Until those tests are done, there is no way of knowing whether it is obstructive or non obstructive

xx

 

[april4jdg]

Nayla - as far as the IVF / ICSI is concerned, we were told that if it was a blockage, they would probably not repair it, just get the sperm out and use if for ICSI. We were told the success rate of correcting a blockage which is on a very small scale is not very reliable.

I know it's hard and you have to respect your hubby's wishes, but it is a real shame that he wont let you go with him. Could you write down a list of things for him to ask, or try to get another appt for you so that you can go and get the information that you need. You need some answers and some information too. My experience is, that with the best will in the world; men come away having listened to 50% of what they are told and remember about 10% of that!

Whilst I think about it (and hopefully others here will add to the list), some of the tests that you need to be asking about are

- FSH, LH and testosterone level blood tests
- blood test for Y chromosome micro-deletion
- test for presence of fructose in sperm sample as the absence of this indicates a likely blockage
- karyotype blood test
- blood test for cytstic fibrosis carrier

The results of these will tell you a lot about the cause, although we were told the only sure way to know if there are sperm is to do the SSR. Until those tests are done, there is no way of knowing whether it is obstructive or non obstructive

xx

I agree! Men don't think to ask that stuff- maybe you can send a list of questions with him!

 

[Flake-y]

As far as we were told, there are 2 types of azoo; obstructive, or non-obstructive. I don't think either one or the other is more likely.

The obstructive is caused by a blockage, and as Deb said, they won't repair it, they would do an SSR, then do ICSI. I think in obstructive azoo there is the highest chance of sperm retrieval.

The non-obstructive can be caused by lots of different things; a hormone imbalance, a birth defect, or in (possibly) my DH's case, a severe case of mumps. I know there are some guys who are given meds & they start producing sperm again, although from what we were told, there is less chance of getting sperm if the problem is non-obstructive.

I think, apart from blood tests, the only way of knowing whether there is sperm is to do the SSR op. I think each case is different though, hope your urologist gives you some more answers when you go!

 

[Nayla82]

Thank you again for your very helpful answers

Deb- I just jotted down all those questions, really I thank you again, as I dont know what to be looking for or asking for? Those questions are safe in my diary when needed i will ask ASAP.

Jo- Thank you for your msg, You have cleared it up for me, I need to get it in my head that either way i will have to have ICSI or IVF Ouch in typing that, never ever did I feel it would get this far Im still in my little bubble thinking if i secretly have sex with him this week i will get pregnant as im in my fertile window... I just need to WAKE UP.. I have been so used to timing sex and around Ovulation going to be feel weird not charting opking and everything else. (im so in denial thinking his will get to me naturally sooner or later)

What topped it off for me, An hour ago i got a phone call from the nurse confirming my IUI for tomorrow and to come early, I told her the Gyno cancelled it and told me she would have informed you? really just adding salt to the raw cut. I keep thinking if hubbys Sample came back ok, we would have had IUI tomorrow as i type i feel strong Ovulation pains and i have been having alot of EWCM (sorry TMI) but my body was more than ready for IUI, but here I am a whole new situation. Im sure many more periods will come and go, I need to sit tight as its a longggg road ahead of me.

On a positive note my husband opened up to me for the 1st time since getting the results, His words were we might need to do IVF bless him on the little he knows. Told me hes very scared and he knows how much being a mom means to me etc etc. I said dont worry we will overcome this lets take each day as it comes, i said you are my superman and we will overcome it. His reply was i might as well be your superwomen! its really got him questioning his manhood?? I told him if i didnt have breasts or had no eggs? I would not say im less of a women! I said its a problem that will be fixed we have to unite as 1. (I thank the Lord hes talking to me)

I told him about this forum than a million questions he was asking me! (i was secretly happy about the fact he wants to know) he was like theres other people also? how long were they TTC? whats happened? what have they done? do they have kids? etc etc.. I just told him theres a handful of us and its a supportive group and were all in the process. Didnt want to scare him.

I told him ICSI does not mean it will be done than im pregnant, i said it can not work and mayb 3 or 4 times is needed. His words were every time they do ICSI will they have to slice my balls? I honestly dont know? unless 1st ssr they freeze whatever they find? But it was a valid question? Do any of you ladies know with every IVF and ICSI will SSR be NEEDED? Hes so scared when it comes to surgery.

April- The hands that we have been dealt. I really love that saying and its so so true either way we will have kids and im open for adoption also, but the baby has to be NEWBORN, I know beggers cant choose much in life, but I just want a baby fresh from the womb which I can raise and love from day one. I also heard its very difficult to adopt newborns as theres a waiting list, usually there much older when it comes to adoption. Again i will not jump that far, and try to concentrate on the present.. So many things are whizzing in my head

Also April you are correct, Even though it was a ZERO COUNT and 1 DEAD you are correct he must be producing something deep within? and i told him some results are ZERO ZERO and women have gone to have pregnancies I said hold on to that 1 DEAD SPERM must be more hidden inside? it will be 1 week tomorrow since we found out, been a very weird week and very blurry indeed.

Im feeling a little stronger today, mainly because hubby chatted to me and hes willing to learn and prepare for the worst or the best situations?.

I cant believe the weight thats has dropped off me was 7ST.5 last week and I weighed myself this morning and im just hitting 7 stones. This is not healthy at all and if i have to prepare my body for IVF and drugs maybe a multiple pregnancy, I need to gain weight. the problem is that when im stressed i find it difficult to even nibble. I need to keep thinking my bits have to be 100% last thing I need is that if they find sperms than my eggs start playing up...
That will not be the case fingers crossed.

over christmas i will eat everything around that should do the trick. I have to hang in there now and see what 2nd semen sample says.. im very very nervous.

Has anyones read or seen the 1st sample to be zero than the 2nd sample to have a few hundreds or millions? or is it usually a fact that the 2nd semen analysis will always be identicle to the 1st?? Again I just dont want to have my hopes high that there will be a few 1000 next week? will be better if i know for a FACT another ZERO will be on the cards??

Hope you all have a lovely week and thank you in advance for your kind and warm replies

 

[april4jdg]

I can't speak for others, but just for me and DH. His 2nd SA was a zero as well...
Then he had an appointment for a urologist- that did the physical exam and the 2nd SA.
That is when we got scheduled for the biopsy. They will put him under and do the biopsy. They then immediately rush the tissue to the embryologist and they examine it under the microscope. If they find any sperm cells, then they will freeze them to later do he ICSI-IVF.

It is tough for guys- There are a lot of good books- I have a TON! and webstes like this one, and another one I go to called www.thebump.com I am on the infertility board there- they have a check-in on Thursdays with azoospermia.

 

[Deb111]

Hi Nayla,

It is really good to hear that your husband is taking some small steps towards accepting this and that this is helping you too. You come out of the hospital feeling very alone and like you are the only ones going throught this. It will take a lot of time, but even small steps are good and the fact that he's asking questions is great.

Maybe he will reach the point where he is happy to let you go to the appt with him. Perhaps telling him that you are feeling helpless in all of this and need to be able to be there to support him may help. I'm glad he is more open to you being on sites such as this because you do need to arm yourself with information and support from others going through the same. I think it's pretty fair to say that none of us are likely to meet someone in 'real life' who is going through the same so this group is a god-send.

With regard to the sperm sample; our second one came back the same as the first. But we didn't have the worry at that stage, because we'd mistakenly been sent a letter saying the first sample was 'normal' but that they always did a second one for comparison, so we were unaware until our appt when we were shocking asked "so you know there's a major problem with your husband?"?!?!?!? We were totally unaware because of their error. I think it's quite probable to assume that the 2nd sample wont show anything very much different, but that doesn't mean there's not things that they MAY be able to do to help, depending on the outcome of other tests.

With the SSR, they will do the procedure and if they find any they are likely to freeze them (unless you time your cycle and egg collection with the SSR - in which case they would freeze any excess sperm). If they have enough, they will use it for additional cycles, if not, he may have to have the surgery again.

With regards to your weight, you need to see what your BMI is, which you can do if you google it. Most hospitals will not do IVF / ICSI if your BMI is too low or too high and so it may be something you need to look into now rather than 'wasting time' further down the line. I know I have to get my BMI down and I'm working on that now.

I'm really sorry about the IUI phonecall - that was really bad organisation on the part of the clinic and I'm sure it was very hard for you xx

 

[Nayla82]

Thank you a million Debs for your honest and warm responses really appreciate it xx may the lord reward you for your sweetness xx

I read your msgs over and over again so i don't miss anything it all makes perfect sense. I must inject in my head that it may also be a ZERO so i don't upset myself more than I am.

It makes perfect sense, i will try and make sure his SSR is the same time when I'm ovulating so we can kill 2 birds with 1 stone and do ICSI at the same time. I know it will never be that straight forwRd.
that would be ideal

Can frozen sperms live for along time? Just thinking how long they can store them for?

I have not read much on IvF but i think i need to educate myself on this now
my BMI is under, I'm sure I'll get rejected if i don't put weight on, i don't want to hinder any chances of getting pregnant I need sort this out asap . My husbands words earlier were soon the boat will be in your court so you better look after yourself and be popping those eggs if it makes him feel better, no pressure on me

April- thank u so much for your quick answer x will definitely have a nosey in that link, it makes sense everything will have to be done very fast and of course with professional medics, as its a very sensitive procedure getting those little sperms safely from A-B. I'm definitely getting all my information in here rather than spending hours googling

I'm so happy the fact that my husband does not mind me online now, as he knows I'm talking to "real women" as its so true deb what are the chances of meeting someone in real life that has the same problem?? Its so crazy this time last week i was a happy camper did not even know Zero sperm really existed it all changed last Tuesday, 1 week almost over , the pain has to get better, just has to

So sorry if I'm ranting on like a crazy women on this thread I really have no where else to go, you really are my angels

I have faith in the Lord that this will all be a thing of the past health and happiness is what i want for Christmas x

You are all lovely women with beautiful souls and hearts i so pray we all get to be mothers soon.

Thank you again Ladies for cooling of the heart x

 

[Deb111]

One thing I said to my husband when he had his diagnosis - and I think this kind of helped us to focus on the way ahead - is that nothing changed on the day we were told. The azoospermia had been there for a long time, maybe since birth, who knows? but it wasn't as if the day we were told, he stopped producing sperm. The only thing in reality that changed is that we found out. When we were oblivious to the problem, there was no way we could have had a child (little did we know) but now you know, you can start getting tests and answers and hopefully find a way forward.

Lots of love to you both xx

 

[waitingginger]

your messages are starting to sound more positive Nayla thats good!!

Once you come out of these dark times you will be so much stronger ready to face anything!! i would always say me and my OH were super close and in love and couldnt be anymore but since we found out we have actually just got even stronger and more in love! we face things together! yeah we both get upset i balled my eyes out the other day because my brother in law had put on facebook 'me and harry chilling on the sofa having cuddles and watching in the night garden' it just got me!! my OH cant sleep and is having nightmares every single night its taken him a long time to come to turns with it and i dont think he fully has still but he knows i love him! he always says he doesnt want to discuss anythign until we know if there is any sperm in there! and to be honest i am not going to force the issue because i know he will have to talk about with the doctor at the fertility hospital so i am just going to leave it for now!! i dont want him thinking about it all day because i know it is all i think about!! to go from obsessing about TTC and charting and to still be ovulating is like a kick in the teeth but i try to stay positive that at least we shouldnt have a problem with whichever treatment we have to have!!

Now i just keep thinking well atleast when our baby gets here it will be the most longed for baby and will be spoilt to death and we will love it so much because of all we went through to have him. some babies are more special and ours will be even more so because there must be a reason why we had to work so hard for them right??!

My OH still says to me now you could go and find someone who would get you pregnant tomorrow. i think its just when he is feeling a bit down anyway like when i moan when i have PMT all you can do is keep reassuring him you are doing it together its not just his results its 'your results'. my bloke actually felt loads better once he started to tell his brothers and mom and things because everyone was concerned and caring and are actually really interested in the treatment and where we are up to and things and i think it makes him feel better plus nobody asks when we are going to have children any more!!!

I will log back on wed afternoon to let you all know how the appointment goes!! Just writing my list of questions for the consultant and am so annoyed with myself that i havent pushed for any answers before now i think my brain had just been in a premanent muddle about it all since april!!! because you have no answers and no reasons you cant move on!!

Much love x x x x

 

[Deb111]

I will log back on wed afternoon to let you all know how the appointment goes!! Just writing my list of questions for the consultant and am so annoyed with myself that i havent pushed for any answers before now i think my brain had just been in a premanent muddle about it all since april!!! because you have no answers and no reasons you cant move on!!

Much love x x x x

Wishing you all the best with your appt on wed xx

 

[Flake-y]

Nayla, so glad your DH has started talking to you & opening up. Hopefully he is coming to terms with it all & will be feeling a bit more positive now.

With regards to the SSR, we were told that the urologist will try to get as much sperm as possible from the op; this can either be done from aspiration of the fluid from the tubes that carried the semen, or from testicular biopsies, depends on what the problem is. I think they freeze what are called 'straws' of sperm, each straw is used in one cycle of ICSI. How many straws they get depends on how many sperm are found but if it's just a blockage, then you'd probably get plenty of sperm so your DH wouldn't have to go through the op every time.

Then, they will freeze it & thaw it when you are getting your ICSI. You don't need to worry about timing the SSR for when you are ovulating, during ICSI the clinic will control your cycle with medications so you won't have to worry about timing.

I think some clinics will time the egg collection part of the ICSI with the SSR, so that the sperm is used straight away, although if they don't find any then donor sperm would need to be on standby so that the cycle of ICSI is not wasted.

It sounds really complictated but you will find out so much information on your journey you will end up a sperm expert!!!!!

 

[Nayla82]

Good Morning Ladies

Thank you ever so much for your reply Jo wow your really cleared it up, and your right im sure with the whole timing thing they know what they are doing and what ever they find they will be stored in a very safe place

I really hope and pray they find something next week

Cant believe its been 1Week today that we got the news, What a dark and depressing week its been! But i will get a grip and the show must go on! whether i like it or not, there is a problem and there MUST be a solution

WaitingGinger- Looking forward for the news that they will give you and what your next course is? I really hope 2011 will be magic for you

My husband 2nd analysis is next tuesday, vry vry nervous, How many days should he wait? i want the maximum sample that he can give? 2 days 3 days? how many days did your partners wait before their semen analysis?

I really want this weekend to go quickly, sad as it is as i love christmas! need to see whats happening x

take care and thank you again xx

love and hugs

 

[Deb111]

We were told hubby should abstain for 2 - 4 days before giving a sample, but when I said "oh maybe our timing was out" when we got our second result, we were told it really wont make THAT much difference in cases like this. xx

 

[april4jdg]

Yeah- same here! The first SA DH did, it had been 7 or 8 days-because we had timed sex so much ttc, I was disgusted, and didn't even want to try anymore...When the nurse called back and said, it was 0, I said, "well, I know you are supposed to abstain, but it has been a while, like a week... " and she said "yeah, but he should have had some in the sample."

So, on 2nd SA it was 3 days...but it was 0 too...

But like I said earlier-they said he had one dead sperm, sooo, that mean they are getting made,they just will have to find out what is happening...

 

[Nayla82]

Thank you ladies I think i will let him abstain 4-5 days just to see.

The sad thing is that we have been talking to each other openly as if they will DEFINITELY find sperms and we will go on and have kids and live happily ever after. I think were both in denial and were chatting away like they have already found sperms and when will i be ovulating next for IVF?? Its crazy we need to know it will take more time and more heartache to get my I just love that were chatting away with that feeling it will be ok

I dont know why today I had a panic attack? Im feeling very over whelmed with it all, its all i eat breath and sleep Azoospermia Last week didnt even know what it was...

Please keep me in your Prayers I just feel I dont have 1% of the strength that you women have.. im thinking also fingers crossed they find something than with ICSI we have to wait again... alot of patience is needed in this very long journey of TTC

 

[Nayla82]

Morning Ladies

Hope everyone is well and ready for Christmas, Not long left! Well the best we can be anyway

Waiting ginger- I really hope it goes well today and you get good feedback Looking forward to see what was discussed. I hope it works our for you Hun

I just feel like im getting myself so worked up cant seem to shake off my panic attacks? . Ladies sorry for being a pain but in regards to the Semen Analysis when you got both results back was it ZERO ZERO? or were there dead ones in there? I mean was it black and white NOTHING in the sample?? So sorry for asking?? or when they saw the dead ones they didnt bother to mention them and say that they were ZERO SAMPLE?

I have just read the full thread all morning (God bless you women your all tough cookies, it scares me to think I have a longggg road ahead of me!) It seems that SSR isnt that Magical?? It seems like they either find nothing? or when they do there not really any use? or they just find a couple that NHS will not entertain??

Deb I have read alot on dr Turks clinic and ive read it over and over again! please do fight again as im more than certain if they were healthy i know it was just a couple they can still use it in ICSI! No way 100 is minimum as it just takes that 1, I hope and pray you will get the anwsers you need, im 100% Certain within time you will have your own baby just question them till your blue in the face! xx

Im so sorry again for being the dull one on this thread but i so wish and pray next weeks sample will be a good one so i can start 2011 on a high

Imagine next christmas we all have babies or pregnant!! Also does ICSI mean you will have twins? or will you have to ask them put 2 eggs in?? Im just thinking I would love twins than repeat this all over again... Again im jumping ahead of myself will cross that bridge later!

Love and hugs xx Thank you in advance for your replies especially the Semen Analysis results? xx

 

[Deb111]

Thanks for your kind words Nayla.

As far as our samples were concerned they found nothing at all. We asked about dead sperm but they said there weren't any dead ones in them.

ICSI doesn't mean you will have twins and I think if you have an NHS cycle and are under 35, they will only put one back (I'm sure someone who's been there will correct me if I'm wrong). I think the chances of twins are higher but it's not guaranteed.

There is a girl on the forums that must be either nearly due or had her baby already, whose hubby was diagnosed with azoospermia and her hubby had SSR. I can't remember her name right now, but there are success stories out there xx

 

[waitingginger]

Hi Ladies
Well our appointment today not really any further along...

Apparently the blood test we had back in August wasnt comprehensive enough and so OH has given more blood today for the Kerotype test, think thats how it spelt! you mentioned it to be before Deb! and for FSH and something else!! i cant believe they werent done last time! apparently all that was done was testosterone! which doc says was low and so i eveident that there is a problem with the testicles 'functioning globally'. not obstructive!! although every case of azzospermia i have read nobody ever seems to have obstructive!!

And so we have to wait for a month for the blood test results and then he said we go from there. I asked about the SSR and he said would you want to go ahead with it despite whatever comes up on the blood tests and we both said yes! so hopefully we will get that doen anyway!

I asked about the dead sperm he couldnt explain why it was there but that every mans sample will always have dead sperm amongst the fresh ones. maybe there is no answer for why the sperm is dead or maybe something is killing it i dont know! but looks liek doc thinks the testicles arent working. He also said his testicles were on the small side and this is eveident again of the testicles not working.

And so there we go doesnt sound like good news does it? pretty much born like this? and now a wait for more blood results that we could of done whilst we were sitting here waiting for 8 months being messed around by the other hospital then sent here!

Owell not much we can do about it!! i was so hoping they might turn round and say oh evidence of dead sperm thats good there is prob some behind there but nope! and the outlook doesnt look good for his biological babies!

He said oh atleast this guy knows what he is talking about and its the first person who does i think he is going to find some!! i am just going to leave OH with the hope because no point putting a downer on it until we have to. I did hear him say to his brother before 'got to have an operation and if they cant find any sperm then will have to have a sperm donor' so atleast he is thinking abit ahead.

Chippy for dinner and break up from work tomorrow so going to focus on something good!
x x x x

 

[Deb111]

How frustrating for you hun. I would consider putting in a complaint letter. We had many, many issues and these 'experts' need to consider how they are treating vulnerable people going through this kind of stuff. You shouldn't have to put up with it.

My hubby's testosterone level is low and testicles are slightly small apparently but they found 3 live, healthy, motile sperm when they did the SSR.

Some things to consider talking to them about before your SSR (going on our experience)
- do they have a cut off point for how many sperm they need to find during the SSR before they will freeze them? Our 3 were just discarded as they said it didn't meet their criteria

- if you are prepared to consider using a sperm donor as a back-up, would they prepare you for egg collection on the same day as your husband's SSR so that at least if they did find some they thought they could use, they could use them fresh without having to freeze. When I had previously asked if freezing damaged them; I was told no, but now we are told that 25-50% are lost during various thawing processes!

- thirdly, talk to them about clomid for your HUSBAND. We have done some research and spoken to Dr Turek who says that clomid will boost his testosterone naturally and may increase the small number of sperm found. You may really have to push the issue or do some research yourself to show them , as UK NHS Dr's seem to just fob you off and say it's a drug for women. Testosterone replacement therapy would not be a good option as it would increase his levels unnaturally and would trick the body into thinking it didn't need to make any testosterone and so would make no sperm

Hope you manage to have a lovely christmas xx