Dealing with azoospermia?

[MrsG30]

Ladies,

Think IUI is always tried first as for obvious reasons its cheaper. They can overide your ovulation for IUI too.
think in the UK, we get 6 goes free, 3 unmedicated, then 3 medicated.or 6 medicated if you have ovulation issues.

Hope that helps.

xx

I have a question - if there is nothing found to be obviously wrong with me, and we are going to have to use a sperm donor - how do they decide between doing IUI or IVF? Because IVF is more successful isnt it? Or is it a cost thing?

I have a question - if there is nothing found to be obviously wrong with me, and we are going to have to use a sperm donor - how do they decide between doing IUI or IVF? Because IVF is more successful isnt it? Or is it a cost thing?

That is a question I have had too. I have read a lot of things but nothing conclusive. I would expect they could use IUI if they didn't expect ovulation problems with you. If there was NO chance of you ovulating on your own they might choose IVF because then your cycles won't matter. I am not positive. I am also curious if anyone else know anything.

 

[Mikihob]

I totally understand missMom. I saw two baby pic updates, a newborn and two pregnancy posts on Facebook in barely 5 minutes. Teared up after. Wanted to throw my phone out my window (it's a closed window).

 

[deafgal01]

MissMom it took me a very long time to be able to not get so mad or upset at anything baby related. Took me two years to bring myself up for attending baby showers again. You will get there, it just takes time and lots of answers. def can relate.

 

[MadCatLady]

Hi everyone..I am a long time lurker of the boards..here is a little into to me. https://babyandbump.momtastic.com/secondary-infertility/1858137-long-time-lurker.html

You ladies are so helpful and its so nice to be around people who understand. No one in our families know about us TTC or our troubles with it.

Just when I think that I'm strong enough and ok with everything I will see a pregnant lady or a baby and it hurts. I think you guys are the only ones that can understand what i'm talking about.

MissMom, hi! Yes it's nice to be around people who understand how this all feels, and to able to chat freely and ask questions that you cant talk to anyone else about. Totally understand where you're coming from re seeing babies etc - my job is working with kids from newborn to 18 years - used to love it but currently finding it quite difficult. Welcome MissMom!

 

[Rainbow123]

Just an update from me!
It turns out DH has high FSH (14.8 when normal is between 1-14), which confirms it's NOA. After filling out the usual forms and having the examination, the FS came in with the other doctor. After explaining NOA, she went straight into saying about donor sperm, as though mTESE wasn't even an option! She really was doing the hard sell on the donor sperm option! We let her say everything she wanted to tell us about donor sperm, then I asked about mTESE as I'd researched this was an option for men with NOA. She said that we wouldn't be eligible for it on the NHS, so I mentioned that it was something Dr Ramsay does in London for all NOA patients. She then said she would refer us to a urologist in Leeds who specialised in infertility in men, and that will take 2-3 months to get an appointment, then a possible 2 years to have the procedure! If he says there's a good chance then we go with the mTESE on the NHS, but if he doesn't think it's a great idea then apparently we wouldn't get it! It's RUBBISH! Anyhoo, if we go donor route we get 6 IUIs (3 unmedicated, then 3 medicated), then only 1 IVF. After that we would have to pay £4000 per cycle of IVF! We also wouldn't get NHS to cover a second baby, so that will have to be saved up for, if we get pregnant with number 1 baby that is!
To be honest, we were in there over an hour, got to ask the FS loads of questions and she didn't rush us at all. I came out feeling quite a lot more positive, thinking I could go with donor without being too stressed about it. DH came out feeling more stressed and is hoping for a positive appointment with urologist in Leeds. To be honest, I think the high FSH levels shows it's not great, so I'm not getting my hopes up for mTESE, but I think it's something DH needs to do and I will support him all the way.
Soooo... just wondering when our appointment is going to come through! I've booked an HSG scan for me on the 31st of May. We've both got to go for blood tests. DH has to get his so that they can see what blood type he is for if we go the donor route.. So much to take in, we're both feeling a bit numb!
Anyhoo, I completely agree MissMom, it's so difficult seeing babies and pregnant women all over Facebook and everywhere you go! But it makes it so much easier to be able to come on here to vent and read you lovely ladies' experiences. I've found it's a really helpful way of starting a conversation about it with DH as I can test the water a bit by saying "such and such is doing this.." and then compare it to ourselves.

XXX

 

[Hopeful Cat]

god sometimes I wish we were back in the UK. its the fault of the friggin UK NHS that my hubby and I are in this mess and we are having to pay for all our infertility treatment out of our own pocket! just want to call people from the NHS and yell at them to pay our expenses!

 

[MadCatLady]

Hi Rainbow 123 - we sound in very similar positions except we are going to Sheffield and not Leeds. It's interesting that we def go IUI then IVF, I was wondering about that as it kind of worries me that potentially going to have to spend another year doing IUI which has quite a low success rate and then I'll be over 35 which puts you in the "less successful" bracket for IVF!! Aarghh!

That is really pants that they might not even do an mTESE or that it could take two years! How can they justify that?! My DH has FSH of 33 so if they don't think it's worth doing on someone with FSH of 14 there is not much hope for DH! What frustrated me more is that you can't just pay for something to hurry up process and do rest on NHS, it's an all or nothing system which is so inflexible! I don't think they understand that we have all been waiting a long time already and don't really want this to go on and on and on even more!

 

[MrsG30]

Emma- I've answered your message so you know my thoughts but FSH of 148 i would be looking into, we got offered mtese with fsh of 35.1. Hopefully when you get to Leeds it will be more positive

MatCat- You ever know, they offered us it, however they did say the wait is about 12 month, and it has to be done with a fresh icsi cycle cos the chances of them being able to freeze anything from a NOA man are so small, they told me the 6 IUI'S we would try first would be monthly then if thy all fail straight onto IVF. It was like thy were asking u to choose time frame or Hubby being a biological Dad!!!They werent as our appointment was very informative and helped us make a decision but i felt that way.

xxx

Hi Rainbow 123 - we sound in very similar positions except we are going to Sheffield and not Leeds. It's interesting that we def go IUI then IVF, I was wondering about that as it kind of worries me that potentially going to have to spend another year doing IUI which has quite a low success rate and then I'll be over 35 which puts you in the "less successful" bracket for IVF!! Aarghh!

That is really pants that they might not even do an mTESE or that it could take two years! How can they justify that?! My DH has FSH of 33 so if they don't think it's worth doing on someone with FSH of 14 there is not much hope for DH! What frustrated me more is that you can't just pay for something to hurry up process and do rest on NHS, it's an all or nothing system which is so inflexible! I don't think they understand that we have all been waiting a long time already and don't really want this to go on and on and on even more!

 

[tulip11]

Hi we got two SA bottles via post for sperm analysis but I am wondering why did they send us two instead of one ?

 

[Rainbow123]

Hi Rainbow 123 - we sound in very similar positions except we are going to Sheffield and not Leeds. It's interesting that we def go IUI then IVF, I was wondering about that as it kind of worries me that potentially going to have to spend another year doing IUI which has quite a low success rate and then I'll be over 35 which puts you in the "less successful" bracket for IVF!! Aarghh!

That is really pants that they might not even do an mTESE or that it could take two years! How can they justify that?! My DH has FSH of 33 so if they don't think it's worth doing on someone with FSH of 14 there is not much hope for DH! What frustrated me more is that you can't just pay for something to hurry up process and do rest on NHS, it's an all or nothing system which is so inflexible! I don't think they understand that we have all been waiting a long time already and don't really want this to go on and on and on even more!

How many chances do you get at IVF MadCatLady? We were told 50% chance of one of the 6 IUIs would result in pregnancy. It is rubbish that everything takes so long. Especially when I know that I want at least 2 children (will have to pay for number 2) but I suppose as number 2 will be paid for by us it will probably be faster. Wouldn't your IUIs be done every month? So hopefully you would have them done over 6 months, then the next month surely you would go onto IVF? I'm not really sure, but that would make sense! How long until you're 35? I'm sure it won't make too much difference but I know what you mean about being in the 'bracket'. It worries me too! I always thought I'd have my babies by the time I'm 30, but I've been learning recently that even though I've planned things out it won't necessarily go the way I want it to! Doh!
I really don't know an awful lot about FSH levels, but I was surprised that DH's was only a tiny bit over the normal and they were talking about it like it was very high. I wish we could just ask the urologist about it now, get either a go ahead or told it's not likely, as then we could move on either way. I wouldn't mind waiting a little while for the procedures if at least we knew which road we are going to have to go down! It really is all down to what urologist says in 2-3 months. 33 isn't that dissimilar to MrsG30's hubby, and he was given a 40/50% chance of finding sperm. Do you know the reason for DH's azoo?
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[Rainbow123]

Hi we got two SA bottles via post for sperm analysis but I am wondering why did they send us two instead of one ?

My DH had to do 2 SA, about 1 month apart. But surely your DH has already done one? Are they being requested by a different doctor?
X

 

[Rainbow123]

Just found this research:
High serum FSH levels in men with nonobstructive azoospermia does not affect success of microdissection testicular sperm extraction.
RESULT(S):Testicular sperm were successfully retrieved in 60% of the men. Sperm retrieval rates in the groups of men with FSH values 15-30, 31-45, and >45 IU/mL was 60%, 67%, and 60% respectively; this was higher than the group of men with FSH < 15 (51%). Of those men who had sperm retrieved, clinical pregnancy and live birth rates were similar in the four groups (46%, 50%, 52%, 46% and 38%, 45%, 44%, 36%, respectively).
CONCLUSION(S):
The chances of sperm retrieval using micro-TESE is just as common, if not better for men with elevated FSH levels than for men with lower FSH. Micro-TESE results appear to differ from earlier series that report low retrieval rates with random biopsies for men with elevated FSH. High FSH is not a contraindication for micro-TESE.
Hmmmm....

 

[MadCatLady]

Hi Rainbow 123 - interesting piece of research! If the IUI's really happen every month then at least it would be done quite quickly? I am 34 in three days time so feel I have 12 months before my fertility starts plummeting, lol! (I know that might not really be the case but you can't escape all the stats that give 35 as the age where it starts going downhill! - makes me paranoid, esp as we too wanted at least two kids!). Think the frustrating bit is just not knowing when we'll get seen by Sheffield - my GP referred us but they wrote back asking for several other tests to be done first, these are done but when I spoke to the GP the other day she didn't know what was happening and if the results had gone to Sheffield or not! Useful!

Don't know yet what the problem is with DH - they said congenital and little chance of there being anything on biopsy, and looking stuff up I will not be surprised if they come back with Klinefelter's syndrome as he has a lot of markers for it - but that is totally me jumping to conclusions! DH is keen for biopsy/mTESE as he obviously would want a kid to be genetically his no matter how we would have to get it!

MrsG30 - I don't think Drs think at all how they phrase things - not good to imply choose time frame or biological child! I can't understand how the wait for a test can be that long - just ridiculous that hospitals think that is acceptable

 

[tulip11]

Hi Rainbow123
Well my hubby had 2 SA ordered by GP initially. But after the first appointment with urologist he ordered SA again and thus we got 2 bottles via post ordered by same doctor.

 

[BrandyRelax]

I asked my DR about the test nd it not somethin you automatically have in the UK, only if Dr thinks its needed, i guess its down to cost!!!
I have had ultrasound and lady said my womb and tubes were fine and had all bloodwork so god knows if i will go for further test?!?!?

Can i ask a maybe obvious questions on ovarian reserve or amh??? Im not sure if ive had mine checked, when my bloods came back she said "well your not going though the change of life early" is that what she could have been referring too? I remember bein motified at the time as that have never entered my head, this was before DH azoo diagnose.

Hope your all OK xxx

I'm not sure if anyone answered your AMH question, but from my experience, AMH speaks to the egg quality and quantity. If he's talking about "the change", it means that your FSH isn't too high. When you start going through the change, FSH gets really high. So you've likely not had your AMH tested. I'm from Canada, and we have to pay to do the AMH test, because it's not something that health care covers (but then we get no IUI or IVF free either).

Brandy

 

[Mikihob]

Hi ladies...status update.

DH's SA came back zero for the fourth time. We have an appointment made for May 29th with a urologist to check for a varicocele. My OB/GYN is also working on getting an appointment with an andrologist in Seattle and get DH setup for a biopsy. We have chosen to go the urologist route first because it doesn't require travel and will be less intensive for Dh (supposedly). I am hoping that we can DH a ultrasound before the appointment, but I think we have to wait until the urologist sees him, we will see.

I hope that it's a varicocele and we can fix it and get sperm production back. The lack of testosterone is REALLY getting to DH and me. Now we are waiting again. Even if he has a varicocele we have to wait for the correction procedure and then three months after that to see if any improvement in his SA. I keep thinking that it's going to be another six months and that we may have to do the biopsy anyway.

I am kinda of feeling good because we have the urologist appointment but also terribly sad because the length of time to getting pregnant is even longer PLUS DH has ZERO sex drive.

 

[MrsMo]

I started my drugs today, I'm on Norethisterone for nearly 2 weeks (due to my low AMH) before Prostap and then the daily injections.

I'm nervous, excited and terrified it won't work! We're very realistic about the fact they might not get any eggs and this could all be cancelled after my first scan to assess follicles on 12th June. If we get eggs, we've been told our chances spring way back up as the quality is likely to be good (low AMH just means chance of low quantity) due to my age so fingers crossed for eggs!!

Regarding some of the points about telling the child about DS (I've just been catching up on the last week of forum!), we have been doing research into this which was backed up by what our counsellor said last week. Basically it makes for a better family life if you're open and honest from the very beginning. There's LOTS of info about this on the DCN website which was founded by parents who used DS over 20 yrs ago and their experiences (and comments from their children) are very positive and very much towards not keeping secrets for many reasons. It's very interesting and helpful to read, in particular this letter. We've found it very useful and have decided to bring it up from at latest, the age of 3 so it's just something that's always been the case. I was so relieved when DH brought this up as he looked into it first as I hated the thought of living a lie and not knowing how to react in certain situations.

 

[MrsMo]

Hi MrsMo! Can I ask re buying sperm? (there's a sentence that I never thought I would be writing!). Did your clinic just give you donors to choose from, or did they give you companies to look at? DH and I are probably going to be going down donor route, (we've been told he is NOA and though they will do a biopsy they are not hopeful of anything being there). We are in UK too.

I agree it is like some horrible turmoil rollercoaster, I'm starting to worry about my sanity! I really hope that we all get what we hope for. I was reading a piece written by a guy who is a sperm donor and he said "I believe in karma, and I come from a broken home. I think if you have considered having a child enough that you're contemplating insemination, then you have put more thought into it than most parents". I liked that.

Stinas - I was so sorry to read your news, my heart goes out to you x

Hi MCL, I wrote a reply to this but it doesn't seem to have worked! Basically I said that our clinic had a few donors (much less than years ago as the new regulations re: anonymity mean there are fewer donors) but we had very specific characteristics we wanted to match so went to the European Sperm Bank for better choice. Definitely put in the UK before you search as it will change how many are available for the same reasons (some places can still use anon donors!). We were able to get lots of information using a password from our clinic without having to pay the extra fees. There is LOTS of info including medical and personal.

We were lucky and found one donor who matched pretty closely but due to my low AMH, we just bought 3 vials (didn't want to waste hundreds of pounds in case we don't get any eggs!). Hopefully they won't sell out if we have to use all 3 vials for lots of cycles and we can get more if lucky and can try for a sibling in future using the same donor. No point counting our chickens though as it was expensive enough and we might never use the ones have!

 

[MoBaby]

mikihob: the low sex drive is probably due to low testosterone. Hopefully the urologist can fix it easily with some injections (not testosterone though). Did they check that? I just see in your sig LH/FSH/Prolactin. If its just low testosterone its usually an easy fix (HCG injections alone or paired with other meds). I hope the urologist has some answers!

 

[Rainbow123]

I started my drugs today, I'm on Norethisterone for nearly 2 weeks (due to my low AMH) before Prostap and then the daily injections.

I'm nervous, excited and terrified it won't work! We're very realistic about the fact they might not get any eggs and this could all be cancelled after my first scan to assess follicles on 12th June. If we get eggs, we've been told our chances spring way back up as the quality is likely to be good (low AMH just means chance of low quantity) due to my age so fingers crossed for eggs!!

Regarding some of the points about telling the child about DS (I've just been catching up on the last week of forum!), we have been doing research into this which was backed up by what our counsellor said last week. Basically it makes for a better family life if you're open and honest from the very beginning. There's LOTS of info about this on the DCN website which was founded by parents who used DS over 20 yrs ago and their experiences (and comments from their children) are very positive and very much towards not keeping secrets for many reasons. It's very interesting and helpful to read, in particular this letter. We've found it very useful and have decided to bring it up from at latest, the age of 3 so it's just something that's always been the case. I was so relieved when DH brought this up as he looked into it first as I hated the thought of living a lie and not knowing how to react in certain situations.

Keeping my fingers crossed for you MrsMo!
Thank you very much for the web links, will definitely have a look at those!
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