Dealing with azoospermia?

[Soili]

Chickensoup, if you feel unsure and rushed, my honest opinion would be to take a bit of time to figure things out. If you're going private, you should have a bit more flexibility with scheduling things. Talk to your husband, do your research, talk to the doctor about your doubts if needed as well. A month or two won't make a difference. But do also know that in this TTC business there will always be doubt and uncertainty and questions will be coming up along the way. You make the best decision you can at the current time and circumstances. And just hope that things will work out. There's nothing more you can do.

 

[Chickensoup85]

whats the difference? and can you have both done if need be? im totally confused

I always thought mTESE was less invasive, and in a way it seems to be because they take smaller amounts of tissue asthey able to be more precise. However, instead of going through the skin, the peel back the skin to expose the testies. I think this is correct, read some many conflicting things on google!

I think I am just worried for my husband and his recovery really because I feel like he is only doing this for me, as he is happy to use donor sperm.

 

[Chickensoup85]

Thank you Soili. I think it's just an attack of nerves but I will email the urologist with my concerns.

 

[jokerman]

Did anyone's OH eat anything special or take any vitamin before the TESEto make sure if they found anything it was better quality? Or does it not work like that for azoospermia?

I will begin a dose of doxycycline (100mg twice a day for 7 days leading up to the procedure) prior to the mTese. This is a common anti-bacterial medicine and its purpose here is to destroy any sperm antibodies which may be damaging sperm. Other than that, and the clomid that I have been taking for the past 4 months, I have not been instructed to take anything else.

 

[Jojo27]

whats the difference? and can you have both done if need be? im totally confused

I always thought mTESE was less invasive, and in a way it seems to be because they take smaller amounts of tissue asthey able to be more precise. However, instead of going through the skin, the peel back the skin to expose the testies. I think this is correct, read some many conflicting things on google!

I think I am just worried for my husband and his recovery really because I feel like he is only doing this for me, as he is happy to use donor sperm.

I am assuming my DH had mtese! He had tissue removed from each testical. And a few stitches.
Don't worry re recovery, he will be fine. Mine had op on Monday morn and was back in work on the wed, however they do advise 7-10 days off work, but I suppose it depends what they do job wise. He was in quite a bit of pain and badly bruised but was ok x x

 

[jokerman]

Me again, having a minor (aka major) freak out about mTESE.

Should we have gone with the TESE? It seems less invasive... Have we made a mistake??

At the same time as mTESE OH is having transurethral resection of ejaculatory ducts to unblock his tubes. Is this too much is one go? What if normal sperm production occurs after the unblocking and mTESE wasn't needed? If OH went through so much when it wasn't needed...

And, my biggest worry, what is any sperm they find doesn't survive the thaw? I asked the urologist if we should do a fresh cycle and he said no because there is no evidence of fresh sperm being more successful at fertilisation than frozen sperm but neglected to mention it probably won't survive the thaw!

I feel like I have been duped and that I have jumped in feet first without getting a second opinion first. We have had to go private because, due to our age, we are not eligable on the NHS; of course he is going to tell us to go ahead with all this, he stands to make a fortune from us!

I thought that mTese was less invasive from most of my readings on the subject. I can't post a link as I have less than 10 posts but here is a copy of some text from the US National Library of Medicine website:

The total complication rate following mTESE was 10% in the early phase and none in the long-term follow-up compared to 24% of FNA side. It is concluded that mTESE is superior to FNA as regards sperm retrieval rate and lower incidence of complications in NOA patients.

I know it's a comparison to FNA and not TESE but I am clinging to the bold part! As far as I know, mTese has a much higher chance of finding sperm versus TESE, and removes a lot less testicular tissue. I'm sure I read somewhere that TESE can remove up to 30% of testicular tissue(!). Can you imagine going for an operation on your arm and having up to 30% of your arm removed?! TESE scares me a little bit to be honest.

I was also concerned about testicular sperm not surviving the thaw, but our RE has assured that they have a very high survival rate. For now, we've just decided to go ahead with the mTese to find out if there is any sperm or not. If there is, then we can decide on whether the urologist will need to be on standby to perform a new mTese during IVF, or whether we will scrap IVF and move to DIUI.

I feel your pain regarding the costs of this. We're also paying for all this out of pocket. It's very easy to be sceptical of our doctors' intentions when the advice they give you stands to line their pockets. You are their client so have no hesitation in asking whatever questions you wish, or getting a 2nd opinion either. It's your money and your health.

 

[Jojo27]

I assumed it was too but when I asked the urologist, he said that he wouldn't tell us the results that day because the samples of the biopsy needed to be sent off to have closer look under a more powerful microscope. I can't remember what he called it.

That's what we were told. Have to be taken back to the lab x

 

[MrsG30]

whats the difference? and can you have both done if need be? im totally confused

I always thought mTESE was less invasive, and in a way it seems to be because they take smaller amounts of tissue asthey able to be more precise. However, instead of going through the skin, the peel back the skin to expose the testies. I think this is correct, read some many conflicting things on google!

I think I am just worried for my husband and his recovery really because I feel like he is only doing this for me, as he is happy to use donor sperm.

whats the other procedure called? i just want to feel clued up when we go on thursday?
is one where they take a piece of skin and the other where they try to extract with a needle? sorry if im sound dumb xxx

 

[CanadianMaple]

The other one is the TESA. That's what my DH is getting on Thursday before my egg retrieval. The TESA is more for a blockage, but my DH didn't want to spent the $4000 for a 40% chance and miss a few weeks of work; he had been through so many surgeries in the past. We have a donor backup since we only have a 20% chance of finding sperm.

I had my day 8 appointment for IVF today. There are so far 14 follicles and my lining is triple stripe and over 10. My circulation to my uterus is good again. I get to skip tomorrow's appt and them go in on Wednesday. That could be the day of the trigger shot. After waiting for over a year, this part of the process has been going so fast! Cross your fingers for us; I'm nervous for the TESA and the ER.

 

[MrsG30]

The other one is the TESA. That's what my DH is getting on Thursday before my egg retrieval. The TESA is more for a blockage, but my DH didn't want to spent the $4000 for a 40% chance and miss a few weeks of work; he had been through so many surgeries in the past. We have a donor backup since we only have a 20% chance of finding sperm.

I had my day 8 appointment for IVF today. There are so far 14 follicles and my lining is triple stripe and over 10. My circulation to my uterus is good again. I get to skip tomorrow's appt and them go in on Wednesday. That could be the day of the trigger shot. After waiting for over a year, this part of the process has been going so fast! Cross your fingers for us; I'm nervous for the TESA and the ER.

CM- why do diff men have different procedures and can you have both?

i bet your mega excited- keep us informed and i will nipping on and off for your updates. xx

 

[Chickensoup85]

Good luck CanadianMaple! You must be so excited that things are finally happening (and nervous)!

Thanks for the reply Jokerman, I feel so much better. I thought that's what I had originally read so that why we went for mTESE but then made the mistake of doing more research which threw up conflicting posts and confused me.

MrsG30, I thought a PESA is the one where they used a needle... so if that's the TESA, the PESA might be the one which the urologist descibed as randomly firing a gun thing which grabs bits of tissue...

There are so many acronyms! Still, least we have options haha.

 

[MrsG30]

Good luck CanadianMaple! You must be so excited that things are finally happening (and nervous)!

Thanks for the reply Jokerman, I feel so much better. I thought that's what I had originally read so that why we went for mTESE but then made the mistake of doing more research which threw up conflicting posts and confused me.

MrsG30, I thought a PESA is the one where they used a needle... so if that's the TESA, the PESA might be the one which the urologist descibed as randomly firing a gun thing which grabs bits of tissue...

There are so many acronyms! Still, least we have options haha.

ill ask on thursday when we go what the difference is and who gets what etc ha!
yes your right hun at least there us a few things to try.

the select friends we have told have all in turn said "can we help" "can we donate" i never thought in my lifetime my friends would be offering would be sperm
if i didnt laugh i would cry

 

[CanadianMaple]

TESA and PESA is about the same, it just depends on the area they search at. https://www.drkarenboyle.com/spermretrieval.html

 

[CanadianMaple]

The other one is the TESA. That's what my DH is getting on Thursday before my egg retrieval. The TESA is more for a blockage, but my DH didn't want to spent the $4000 for a 40% chance and miss a few weeks of work; he had been through so many surgeries in the past. We have a donor backup since we only have a 20% chance of finding sperm.

I had my day 8 appointment for IVF today. There are so far 14 follicles and my lining is triple stripe and over 10. My circulation to my uterus is good again. I get to skip tomorrow's appt and them go in on Wednesday. That could be the day of the trigger shot. After waiting for over a year, this part of the process has been going so fast! Cross your fingers for us; I'm nervous for the TESA and the ER.

CM- why do diff men have different procedures and can you have both?

i bet your mega excited- keep us informed and i will nipping on and off for your updates. xx

TESE is quite invasive. They actually open the testicles and look with a microscope and take out portions of tissue and examine it under a microscope.

TESA/PESA is where they use a fine needle into areas that are known to have sperm if there is a blockage. Someone who had a vas wouldn't need a TESE so they would recommend this less invasive procedure. In DH's case, they said that 50% of men with testicular failure still have patchy areas that produce sperm. We are hoping that since the urologist felt his epiditimis, there could be sperm in there that is blocked since it's usually flat if there is none in there. If they don't find any there, they will take random samples from the other epiditimis and then around the testicles.

 

[Stinas]

Canadian - Good luck!!!!

 

[Verity Belle]

Hi, hope you don't mind me joining the group, my Hubby and I got the azoospermia diagnosis on Thursday and are devastated. He has kind of shut down at the moment so I am trying to be the strong one but I keep having a little cry in secret. Glad I have some where others are going through this too but really sad that others are going through this
Verity xx

weve just known over a week- its heartbreakin i know- dont give up hope xx

Thank you sorry you are going through this too

are you in the uk? what the next step for you? we have our 1st specialist appointment on thursday xxx

Yes we love just outside London. My Hubby has to go have blood rest to check hormone levels I guess and then do another SA at the beginning of April. Then we go from there depending on our options. I have had blood tests and been poked and prodded since Oct when we first went to the Dr so now it's his turn

we are in the north east- its will be good to keep up to date as its sounds like were at very similar stages, plus the NHS worries me- mainly waiting times! xx

I would love to know how you get on hun, I agree that we seen to be at similar stages in this so far. it's taken us from October to get where we are now so am trying to prepare myself that this is just the start of a long process. Have you had all your tests ?

 

[Verity Belle]

Dear Canadian wishing you lots of luck x

 

[maybeBmommy]

HELP.
I need some stories on how your husband handled the idea of using donor sperm....it hasn't been confirmed yet, but I'd bet my life my husband has klinefelters syndrome.

 

[SunUp]

Wow,so many new people! Sorry to 'see' you all on here, but its nice knowing how, in reality, we are not alone. It definitely makes you feel lonely, when you get the azoo diagnosis.

Just for some 'quick' clarification:

TESE is a surgical procedure where the doctor takes a piece of tissue and stitches the area up. The tissue is examined under a microscope, and often biopsied afterwards.

mTESE is more invasive of a procedure, where they open the testicle up more to look under a high powered microscope to try and find areas with sperm. They will often take a few tissue pieces at this time.

Both are invasive and usually require some form of sedation.

DEPENDING on where you have your procedure done, you will get your results back. At our clinic, we got the microscope results right away and the biopsy results later.


Deb- hope things are going well. AFM for the front page:
Pregnant with baby #1, Due in June.

 

[SunUp]

HELP.
I need some stories on how your husband handled the idea of using donor sperm....it hasn't been confirmed yet, but I'd bet my life my husband has klinefelters syndrome.

There is a whole thread dedicated to that diagnosis - if you get diagnosed with that, I would suggest checking it out.