Dealing with azoospermia?

[Deb111]

Hugs to you all xx

 

[Deb111]

COPIED FROM MY JOURNAL - Ok here goes, so bear with me because this may be long lol but hopefully some of what we have been told may help someone else and it's a good record for me to keep of all the info too

So Dr Ramsay was such a lovely man. Very humble and says what he does is easy - he's not clever and just needs to know how to use a microscope! Well I guess a lot of people know how to do that, but I don't think Terry would let them cut his bits open!

He immeidately put us at our ease and although he was nearly 20 minutes late seeing us, he reassured us that we had plenty of time to discuss everything we needed to and our 30 minute appt ended up being nearly 50 minutes.

So here's what he told us

- testosterone level measured in a blood test will not be the same as testosterone level in testes. There will be about 20 times as much in testes and therefore even with Terry's low blood testosterone level, there should still be enough in testes for normal sperm production

- clomid doesn't raise testosterone, but will increase FSH in order to drive sperm production

- normal FSH is 10-12. Terry's is 15 so not excessively high, but body has already tried to boost itself and probably needs a helping hand

- in a few men he has treated with clomid where FSH has been normal before treatment, they have gone on to produce some sperm in the ejaculate

- however, with the small number of NOA cases in the UK, there are not enough cases to do random studies to give conclusive results on this kind of treatment

- serum oestradiol levels / ratios with other hormones will tell him which drug to use to condition Terry before the op (Clomid / Arimadex etc)

- as Terry has put on a lot of weight becuase of his thyroid problem, it is possible that his body is metabolising some of his testosterone in the fat (?)

- going to the gym, getting fitter and losing weight will increase his testosterone and will help the situation

- the op he will perform is mTESE where he will open the testicle and study it with a powerful microscope and look for the fuller tubules to remove for embryologist. Now I thought waiting 15 mins for the TESE procedure was hell, but this will be an hour and a half with a general anasthetic

- ICSI will cost about £7000 and Terry's side of things will be £3000 - £3500

- he would advise a donor back up, but doesn't insist on it

- he will want a SA doing and they will freeze anything they find - even if they only find one in SA, he definitely wouldn't feel any need for a donor back up

- could be NHS funded at Hammersmith, but it couldn't be a fresh, co-ordinated cycle there

- only place we can do a fresh co-ordinated cycle with him is at The Lister and would have to be privately funded

- Terry's prolactin levels are normal (so no hyperprolactinaemia)

- no need to do kidney tests as he's happy the cause has been identified so not looking for another cause

- not worried about lowering testosterone levels for Terry's future health by doing op as he will only do one side - the 3 sperm were all previously found in the one side, so he says he knows there are in there. He says it's highly likely there are some in the other side too, but will go for the definite side

So there you go lol and when asked "We know you can never be 100% with something like this, but how sure do you feel that you will find some?" His reply .... "Can't you tell by my reactions to your questions that I'm very happy about where we're at?"

"So you think you will find some?"

"Oh yes!"

So the plan now ...

Blood tests from GP - FSH, LH, Testosterone, SHBG (?), LFT, Thyroid Function Tests, Prolactin, Oestadiol

And then when we have those results, it's back down to Windsor for a follow up appt and plan of action

If you made it to the end of this ... I'm impressed! xx

 

[Pink Lolly]

Wow deb - glad you got on well with Dr Ramsay. That all sounds very promising xxx

COPIED FROM MY JOURNAL - Ok here goes, so bear with me because this may be long lol but hopefully some of what we have been told may help someone else and it's a good record for me to keep of all the info too

So Dr Ramsay was such a lovely man. Very humble and says what he does is easy - he's not clever and just needs to know how to use a microscope! Well I guess a lot of people know how to do that, but I don't think Terry would let them cut his bits open!

He immeidately put us at our ease and although he was nearly 20 minutes late seeing us, he reassured us that we had plenty of time to discuss everything we needed to and our 30 minute appt ended up being nearly 50 minutes.

So here's what he told us

- testosterone level measured in a blood test will not be the same as testosterone level in testes. There will be about 20 times as much in testes and therefore even with Terry's low blood testosterone level, there should still be enough in testes for normal sperm production

- clomid doesn't raise testosterone, but will increase FSH in order to drive sperm production

- normal FSH is 10-12. Terry's is 15 so not excessively high, but body has already tried to boost itself and probably needs a helping hand

- in a few men he has treated with clomid where FSH has been normal before treatment, they have gone on to produce some sperm in the ejaculate

- however, with the small number of NOA cases in the UK, there are not enough cases to do random studies to give conclusive results on this kind of treatment

- serum oestradiol levels / ratios with other hormones will tell him which drug to use to condition Terry before the op (Clomid / Arimadex etc)

- as Terry has put on a lot of weight becuase of his thyroid problem, it is possible that his body is metabolising some of his testosterone in the fat (?)

- going to the gym, getting fitter and losing weight will increase his testosterone and will help the situation

- the op he will perform is mTESE where he will open the testicle and study it with a powerful microscope and look for the fuller tubules to remove for embryologist. Now I thought waiting 15 mins for the TESE procedure was hell, but this will be an hour and a half with a general anasthetic

- ICSI will cost about £7000 and Terry's side of things will be £3000 - £500

- he would advise a donor back up, but doesn't insist on it

- he will want a SA doing and they will freeze anything they find - even if they only find one in SA, he definitely wouldn't feel any need for a donor back up

- could be NHS funded at Hammersmith, but it couldn't be a fresh, co-ordinated cycle there

- only place we can do a fresh co-ordinated cycle with him is at The Lister and would have to be privately funded

- Terry's prolactin levels are normal (so no hyperprolactinaemia)

- no need to do kidney tests as he's happy the cause has been identified so not looking for another cause

- not worried about lowering testosterone levels for Terry's future health by doing op as he will only do one side - the 3 sperm were all previously found in the one side, so he says he knows there are in there. He says it's highly likely there are some in the other side too, but will go for the definite side

So there you go lol and when asked "We know you can never be 100% with something like this, but how sure do you feel that you will find some?" His reply .... "Can't you tell by my reactions to your questions that I'm very happy about where we're at?"

"So you think you will find some?"

"Oh yes!"

So the plan now ...

Blood tests from GP - FSH, LH, Testosterone, SHBG (?), LFT, Thyroid Function Tests, Prolactin, Oestadiol

And then when we have those results, it's back down to Windsor for a follow up appt and plan of action

If you made it to the end of this ... I'm impressed! xx

 

[waitingginger]

wow deb that all sounds great!! he really knows what he is doing! which must feel great for both of you! x

 

[april4jdg]

Hey there! Just checking in... We have decided to use a sperm donor from European Sperm Bank here in the US- they have a branch in Seattle... They have to do a few blood tests on me in the next couple of weeks to prepare for the d-iui...

 

[Flake-y]

Hey there! Just checking in... We have decided to use a sperm donor from European Sperm Bank here in the US- they have a branch in Seattle... They have to do a few blood tests on me in the next couple of weeks to prepare for the d-iui...

That's good April, we used the European Sperm Bank too.

 

[april4jdg]

Did you have strictly MFI? We have been pleased with all the contact we have had with them so far. The free photomatching, etc. I hope you get your BFP!

 

[Flake-y]

Did you have strictly MFI? We have been pleased with all the contact we have had with them so far. The free photomatching, etc. I hope you get your BFP!

Yep, DH has sertoli cell only symdrome. I have mild pcos, but it's not really a problem, just irregular periods.

All the stuff from the ESB is great, I love the baby photo you get to see! Although some of them look a bit dubious!!!

 

[Step Mummy]

Hi ladies, me again, the one with the DH who has had 6 months of infection following his failed SSR!

Dh is doing better, now off the pain killers, his ball has shrunk and is now nearly twice the size of normal, still on antibiotics until Thursday, and back to see the specialist on Friday morning. We hope we will get sent away, I don't know why they would still want to operate, the only worry is that they say that the ball is dead.

We are wondering if this has all kick-started his other ball into working, he has got a lot hairier and his hair is darker which is strange, but we have been told this is virtually impossible - but you still have to hope and wonder as the end of the month comes closer! I don't think you ever stop trying naturally!

We are planning to start the donor venture in May-June this year. We just want a break and a bit of happiness before the next load of upset and I am still struggling to come to terms with not having my husbands baby, does any one else have this problem. I really wanted to look at our baby and see his features, his personality etc. and I know it will be his baby, but it's not the same - I guess after 11 years together and that was what you always wanted since you were dating - its hard to adjust.

We are getting preasure as well from some of our family - they can't understand why we want to wait and think we should just get on with it - I don't think they realise how hard it is do they! So this weekend I had to harshly explain the percentages of success and that at the end of it we could end up with dealing with never having a baby, and how upsetting and hard work each go will be - its easy for them - they have two beatiful little girls, both easily conceived - so they have no idea how hard it is, how stressfull and upsetting it will be for us and how horrible that two week wait will be!

I am glad to see we have had some good news while I have been away and that some are getting the BFP, however it is also sad to see that some of you have not suceeded and are waiting for the next go. Oh don't we all set ourselves up for a challange! Sometimes I wonder if we are all just mad or desperate - or both!!!

Anyway enough of me doing my bi-monthly ramble! Keep the hope up ladies, best wishes and good luck to you all!

P.s Flake-y - how are you doing - nervous and impatient I bet?

XXX

 

[Deb111]

Hi Angela

It's so nice to finally hear that hubby is on the mend

I can totally understand the 'scared to start the next step' feeling. We've all been through so much and the thought of setting yourself up for more disappointment is tough.

With regards to the extra hairiness etc, we have been told that when hubby has the one side operated on, the other side will help to compensate in making a bit more testosterone. If he's getting hairier, it sounds like maybe that's what's happening and who knows what effect that may have?

xx

 

[MariaF]

WOW, Deb. Im speachless.

It sounds like you've accomplished so, so much! It must be worth something and finally result in a BFP and a healthy bouncing baby

So which route will you follow? NHS or private? the private one sounds very expensive.....But I guess there won't be much of a wait?

Oh and SHBG is Sex hormone binding globulin. I think it's also something to do with testosterone and how it binds to something. I had to have it done for my PCOS.

You've come so far, I really believe you are so very close!!!!

 

[Deb111]

Thanks hun

I don't know much about the SHBG test, but from what I have read, it seems crazy that the NHS didn't do it when Terry's testosterone is so low - we've always felt theres a hormone connection with both his thyroid and testosterone being low.

I'm pretty sure we will go down the private route - yes it's expensive, but plenty of people spend £10K on a car and think nothing of it It wont be easy, but we can cut back and save a chunk of it and my parents have said they will lend us whatever else we need.

I just feel that if we try and cut corners and I don't get pregnant; we will always wonder "what if .....?" Although my side of things may well have to happen more than once, Terry will only be having this procedure once so we want to get it right and use what they find fresh

xx

 

[MariaF]

I agree Deb. They can freeze emryos for several tries in the future so it's best to have the first procedure done in the best possible way.

And I do believe going privately does make a difference - and not only from the shorter waiting list point of view. They do have better drugs, etc. And although it may be wrong, but I do genuinely believe they take more interest/care in you!

My parents have also helped with the IUI and if need be will help with the IVF and we are forever grateful.

The very best of luck to you

 

[waitingginger]

Jo! i am going to post on here because you have so many on your journal and it would be good for those of us who have been down!!!

Massive Massive Congratulations on your BFP!!!!!!!!!!!!!!!!!!!!!!!!

so happy for you!! you really deserve it!!
xxxx

 

[Flake-y]

Jo! i am going to post on here because you have so many on your journal and it would be good for those of us who have been down!!!

Massive Massive Congratulations on your BFP!!!!!!!!!!!!!!!!!!!!!!!!

so happy for you!! you really deserve it!!
xxxx

Thank you! We are so over the moon!!!

 

[Deb111]

Love the new avatar Jo! Off to update the front page xx

 

[Flake-y]

Love the new avatar Jo! Off to update the front page xx

Yay!

 

[loobylou_01]

Yay! had just come on to see if you'd updated the front page! great minds and all that! and also just realised Jo that our scans will have been exactly 6 months apart - our 1st scan was 23rd Sept! xxx

 

[Deb111]

We need another bump pic Linzie! and when's your due date?

 

[loobylou_01]

We need another bump pic Linzie! and when's your due date?

due n28th April Deb! And will try get a pic on this weekend, will get posing in the mirror!! Seen midwife today, baby behaving so far and is in the right position, head down!