silverbell
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I hope that the appointment with Dr Ramsey today goes well, Deb. 
Thanks so much, looby x
Thanks so much, looby x
Dealing with azoospermia?
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silverbell
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Hi all - I hope you guys don't mind me kind of butting in; Azoospermia hasn't been officially diagnosed for us yet, but it is very much on the cards and I'm really looking for a bit of info/advice/support...
DH had his first SA last month and unfortunately between the stress and a bit of stage fright he missed the target and returned a sample too small to test - so we had to reschedule and his 2nd test has come back last week with no sperm. We have a consultation tomorrow and at the same time he'll take a 3rd test. We've been trying for 2 years and we are realistic about the results of the 2nd test....
So, I've been doing my research and I'm terrified of what this means for us. I know that in the majority of cases they do find sperm in the testis; but when you've already found yourself in the 5% of people who don't conceive in 2yrs and the 1-2% of people that have no sperm it's difficult to find comfort in the statistics.
I'm also frustrated because I've been reading up on azoospermia and there's lots of interesting stuff about less invasive ways to diagnose it and how to identify and potentially treat the cause - but looking at our clinic's website it seems to me that they will just want to biopsy and move to ICSI if they find anything.... and for DH sake I don't want him to have to go through a horrible procedure only to hear more bad news! But DH is being so amazing and is willing to go through whatever he has to in order to make this happen for us...
Actually DH's putting me massively to shame! Since we got the news on Thursday I've been a wreck! Crying at every little thing (my fear being that we're about to come to the end of the road TTC). And this is obviously not the best thing for me to do when this is his issue - I've had a text book bad reaction! And instead of getting angry at me he has been picking me up and supporting me!
We'll be asking about our options on diagnosis and treatment at the clinic tomorrow. It's a private clinic and I'm kind of wondering if we are lucky enough and ICSI turns out to be an option for us is it possible to go ahead with ICSI private but seek a longer term solution through the NHS (if the cause is a treatable one) - I know this sounds completely selfish, but if we could start our family sooner rather than later and then potentially 'correct' the issue causing azospermia for the future wouldn't that be amazing? But is this even possible?
*This is a far cry from the girl who spent the last 4 days crying at the thought of never having an ultrasound/hearing my baby's heartbeat/receiving a mother's day card.... hope is creeping back in, but that is scary too! The potential disappointment is so great & even if it turns out ICSI is an option success is not guaranteed.... How do you handle the fear/stress/disappointment?
DH had his first SA last month and unfortunately between the stress and a bit of stage fright he missed the target and returned a sample too small to test - so we had to reschedule and his 2nd test has come back last week with no sperm. We have a consultation tomorrow and at the same time he'll take a 3rd test. We've been trying for 2 years and we are realistic about the results of the 2nd test....
So, I've been doing my research and I'm terrified of what this means for us. I know that in the majority of cases they do find sperm in the testis; but when you've already found yourself in the 5% of people who don't conceive in 2yrs and the 1-2% of people that have no sperm it's difficult to find comfort in the statistics.
I'm also frustrated because I've been reading up on azoospermia and there's lots of interesting stuff about less invasive ways to diagnose it and how to identify and potentially treat the cause - but looking at our clinic's website it seems to me that they will just want to biopsy and move to ICSI if they find anything.... and for DH sake I don't want him to have to go through a horrible procedure only to hear more bad news! But DH is being so amazing and is willing to go through whatever he has to in order to make this happen for us...
Actually DH's putting me massively to shame! Since we got the news on Thursday I've been a wreck! Crying at every little thing (my fear being that we're about to come to the end of the road TTC). And this is obviously not the best thing for me to do when this is his issue - I've had a text book bad reaction! And instead of getting angry at me he has been picking me up and supporting me!
We'll be asking about our options on diagnosis and treatment at the clinic tomorrow. It's a private clinic and I'm kind of wondering if we are lucky enough and ICSI turns out to be an option for us is it possible to go ahead with ICSI private but seek a longer term solution through the NHS (if the cause is a treatable one) - I know this sounds completely selfish, but if we could start our family sooner rather than later and then potentially 'correct' the issue causing azospermia for the future wouldn't that be amazing? But is this even possible?
*This is a far cry from the girl who spent the last 4 days crying at the thought of never having an ultrasound/hearing my baby's heartbeat/receiving a mother's day card.... hope is creeping back in, but that is scary too! The potential disappointment is so great & even if it turns out ICSI is an option success is not guaranteed.... How do you handle the fear/stress/disappointment?
silverbell
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Bookworm, I could have written most of that myself. We're in very similar situations in that we only found out DH had no sperm in his samples 1.5 weeks ago. It seems like a lifetime already with all the emotions, research and discussions that have taken place since.
I'm sorry you've found yourself here too. The ladies on this thread are lovely and I'm sure will be here to give you lots of encouragement and advice. Obviously I'm very new to it all as well, so probably won't be too much help.
DH and I have already accepted that he'll probably need an op or 2 to see if there are sperm and he's happy with this. We want to know we've done everything we can before going down the sperm donor or adoption route. We have also tried to counsel each other to be prepared for further bad news and that we may well end up having to use a sperm donor.
My DH is being amazing too. I think us ladies really struggle quite a bit more, as we're so emotional and think of so many different things and over-analyse everything.
When DH and I found out on the Wednesday afternoon we went home from work early as DH felt physically sick. He told me the news in the car on the way home and I thought I was going to throw up. Later on he left home to get another sample pot from the docs and I just burst into uncontrollable floods of tears. Fast forward to the Thursday and all morning at work I was falling apart. I just couldn't cope. I kept breaking down in the loos and tearing up all the time. DH was apparently having a really tough time too. We were definitely in shock and devastated at that point and shouldn't have been at work. After I completely fell apart in front of my colleague, we both went home and took the Friday off work. We needed a few days to get our heads straight and lean on each other and just be together.
It has gotten easier now, but is still utterly heartbreaking. It's different from lots of other forms of infertility because you're basically being told there's a high possibility you may never have biological children with the man you love. It's a MASSIVE thing to deal with and understand and you're probably still in some shock now.
You're very lucky to get a private appointment so soon. I don't think it's at all selfish to want to start your family sooner rather than later. You've waited long enough already and the thought of loads of waiting lists wouldn't be helping your current emotional state either. In fact, DH and I are considering getting a loan in order to get any treatment done privately as we just can't bear the thought of waiting on the NHS, especially when you only get one try at IVF where we live.
As I say, I'm still very new to the world of azoospermia, but I don't think a longer term solution is possible for the majority of men unfortunately. I sincerely hope it is in your case and I believe it is possible, though the chances are low.
In answer to how to handle the fear, stress and disappointment ... I still don't know. Just take each day as it comes and more than anything talk, talk, talk to each other. Tell each other every little thing that's crossing your minds. You've got to be so strong for each other now more than ever and if you're anything like my DH and I, you'll become counsellors for each other.
We've decided to just take it one step at a time and see what each step reveals, though we are prepared for the possibility of yet more heartache and extremely difficult decisions in the future.
I wish you all the very best x
I'm sorry you've found yourself here too.
The ladies on this thread are lovely and I'm sure will be here to give you lots of encouragement and advice. Obviously I'm very new to it all as well, so probably won't be too much help.DH and I have already accepted that he'll probably need an op or 2 to see if there are sperm and he's happy with this. We want to know we've done everything we can before going down the sperm donor or adoption route. We have also tried to counsel each other to be prepared for further bad news and that we may well end up having to use a sperm donor.
My DH is being amazing too. I think us ladies really struggle quite a bit more, as we're so emotional and think of so many different things and over-analyse everything.
When DH and I found out on the Wednesday afternoon we went home from work early as DH felt physically sick. He told me the news in the car on the way home and I thought I was going to throw up. Later on he left home to get another sample pot from the docs and I just burst into uncontrollable floods of tears. Fast forward to the Thursday and all morning at work I was falling apart. I just couldn't cope. I kept breaking down in the loos and tearing up all the time. DH was apparently having a really tough time too. We were definitely in shock and devastated at that point and shouldn't have been at work. After I completely fell apart in front of my colleague, we both went home and took the Friday off work. We needed a few days to get our heads straight and lean on each other and just be together.
It has gotten easier now, but is still utterly heartbreaking. It's different from lots of other forms of infertility because you're basically being told there's a high possibility you may never have biological children with the man you love. It's a MASSIVE thing to deal with and understand and you're probably still in some shock now.
You're very lucky to get a private appointment so soon. I don't think it's at all selfish to want to start your family sooner rather than later. You've waited long enough already and the thought of loads of waiting lists wouldn't be helping your current emotional state either. In fact, DH and I are considering getting a loan in order to get any treatment done privately as we just can't bear the thought of waiting on the NHS, especially when you only get one try at IVF where we live.
As I say, I'm still very new to the world of azoospermia, but I don't think a longer term solution is possible for the majority of men unfortunately. I sincerely hope it is in your case and I believe it is possible, though the chances are low.
In answer to how to handle the fear, stress and disappointment ... I still don't know. Just take each day as it comes and more than anything talk, talk, talk to each other. Tell each other every little thing that's crossing your minds. You've got to be so strong for each other now more than ever and if you're anything like my DH and I, you'll become counsellors for each other.
We've decided to just take it one step at a time and see what each step reveals, though we are prepared for the possibility of yet more heartache and extremely difficult decisions in the future.
I wish you all the very best x
mumanddad
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Hay ladies sorry i havent been around.
Well we started the ball rolling for adoption on friday... So im excited about all that and we are going to save for ivf
but guess what im 2 days late... One minute i think af is on its way but next minute i have the same pregnancy symptoms j had with my angel
ahhhhhhh why cant my body make its mind up. Surely im not pregnant because of azoospermia!?!
Well we started the ball rolling for adoption on friday... So im excited about all that and we are going to save for ivf
but guess what im 2 days late... One minute i think af is on its way but next minute i have the same pregnancy symptoms j had with my angel
ahhhhhhh why cant my body make its mind up. Surely im not pregnant because of azoospermia!?!
Deb111
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Welcome Bookworm and I'm glad you've found us. What you are experiencing is perfectly normal - you are in shock. You are grieving for how you thought things would be and for the time being you have to just go with it - cry, scream, shout, stamp your feet because it's NOT fair.
What you said about hoping but being so scared is exactly what I said to my husband's urologist on Saturday - qhilst you're in limbo and waiting, nothing can go wrong but as soon as you start doing something to try and get where you want to be, you will hopefully get some success but are also setting yourself up for disappointment and he couldn't have put it better. He said "If you don't cross the road, you can't get run over can you?" But I guess if we never try, we will never know.
Silverbell is right - you just have to take each day as it comes. Some will be ok, some might be good and some will be dreadful right now, but your bad days will start to feel less bad and you will strat to look forward to what you can do.
Will be thinking of you both tomorrow xx
What you said about hoping but being so scared is exactly what I said to my husband's urologist on Saturday - qhilst you're in limbo and waiting, nothing can go wrong but as soon as you start doing something to try and get where you want to be, you will hopefully get some success but are also setting yourself up for disappointment and he couldn't have put it better. He said "If you don't cross the road, you can't get run over can you?" But I guess if we never try, we will never know.
Silverbell is right - you just have to take each day as it comes. Some will be ok, some might be good and some will be dreadful right now, but your bad days will start to feel less bad and you will strat to look forward to what you can do.
Will be thinking of you both tomorrow xx
Deb111
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Lots happening for you hun! Will keep everything crossed that things work out for you one way or another xx
silverbell
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OK, ladies, I need to pick your brains! Deb very helpfully suggested that I could check on here to see what questions we should be asking the Urologist when we eventually get to see him (hopefully soon).
I thought I'd ask now and start writing them all down because Deb is right and I will forget once we're in there face-to-face.
Just to bring you all up to speed, DH has had 2 SA and both show absolutely zero sperm. He's had an ultrasound (apparently shows smaller testicles than normal and an epidydimal cyst) and he has had his hormone blood tests done (will get results from GP next Monday).
What should we ask the Urologist when we see him?
I thought I'd ask now and start writing them all down because Deb is right and I will forget once we're in there face-to-face.
Just to bring you all up to speed, DH has had 2 SA and both show absolutely zero sperm. He's had an ultrasound (apparently shows smaller testicles than normal and an epidydimal cyst) and he has had his hormone blood tests done (will get results from GP next Monday).
What should we ask the Urologist when we see him?
Hi Silverbell - I'm really green here so I'm afraid I might jump in here and embarrass myself... but here's my thought anyway and please forgive me if these are silly/redundant:
If tests all come back OK what way do they test to see if there is sperm in the testis: ie biopsy/PESE/etc At my clinic there is a tendency to go straight to biopsy but apparently the PESE is less invasive but only some of the consultants do it at the moment;
Will he have to have more than 1 procedure? so if they go in once can they try to get as much as possible and try to freeze and thaw some to test that it will work - if so job is done and move straight to cycle1;
Will you need more tests?
Good luck - FX for good test results
If tests all come back OK what way do they test to see if there is sperm in the testis: ie biopsy/PESE/etc At my clinic there is a tendency to go straight to biopsy but apparently the PESE is less invasive but only some of the consultants do it at the moment;
Will he have to have more than 1 procedure? so if they go in once can they try to get as much as possible and try to freeze and thaw some to test that it will work - if so job is done and move straight to cycle1;
Will you need more tests?
Good luck - FX for good test results
Deb111
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Ok here's a few things off to top of my head - I'm sure others will add more (and don't feel that anyone will think you're making silly comments Bookworm - we were all new to this once and are still learning)
- did they centrifuge the sperm sample? (as apparently, centrifuging it can sometimes find one or 2 at the bottom)
- get a note of his FSH, LH, oestradiol, prolactin and testosterone blood test results and also see if they have done / will do a thyroid test
- needs karyotype test, cystic fibrosis carrier test and blood test for y-chromosome microdeletion
- ask if NHS find sperm, is there a minimum number they need to freeze them?
(they got rid of our 3 very healthy ones because it didn't meet their criteria of 100!)
- did they centrifuge the sperm sample? (as apparently, centrifuging it can sometimes find one or 2 at the bottom)
- get a note of his FSH, LH, oestradiol, prolactin and testosterone blood test results and also see if they have done / will do a thyroid test
- needs karyotype test, cystic fibrosis carrier test and blood test for y-chromosome microdeletion
- ask if NHS find sperm, is there a minimum number they need to freeze them?
(they got rid of our 3 very healthy ones because it didn't meet their criteria of 100!)
Flake-y
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Hey Bookworm, welcome to the thread, you will find lots of support here.
My DH has already had a surgical sperm retrieval done, thought you might be interested in exactly what he had done.
All his blood tests came back normal, testes were normal sized, the urologist waid the only way to know for sure if there was sperm in the testes is to do the SSR. He suggested a PESE first, which aspirates fluid from the epididymus, then if there was no sperm found there, to go straight to the TESE which takes multiple testicular biopsies. These were both done at the same time under a GA.
I think it would depend on the blood results, if the bloods come back with something treatable then they would do that before doing any surgery.
Wishing you lots of luck!!!!
silverbell
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Bookworm, I think Flake-y has answered far better than I could have and I'm still so new I'm just going by what I've researched at the moment. Hope you're doing as OK as you can be
Deb - thank you so much! Some great questions there and I've written them down. Adding them to the first page would be fabulous and, I agree, very helpful indeed for newbies.
I have one more question that's been bugging me.
I believe that at some point (as we'll be using donor sperm if no sperm is found on SSR for DH), I will need to be checked to ensure I'm OK to have IVF? Who does this? Is this a Gynaecologist or a Fertility Centre? The reason being is that I live on an island with no Fertility Centre. Going across to the mainland is fine for the IVF/ICSI side of things, but will mean lots of days off work and travelling/money if I have to do everything there (such as scans, blood tests, examinations etc - I don't know exactly what a workup for me would entail, so forgive my ignorance).
Therefore, is it worth me requesting a referral to see the Gynaecologist here so that I can get fully worked up and checked so we're all ready to go once DH has had investigations? Or will they not do that?
We're just trying to save time and cut corners and speed things along and if I can get in the system and fully checked out then that would certainly help.
Any ideas? Sorry for all the questions, but still very clueless.
Deb - thank you so much! Some great questions there and I've written them down. Adding them to the first page would be fabulous and, I agree, very helpful indeed for newbies.
I have one more question that's been bugging me.
I believe that at some point (as we'll be using donor sperm if no sperm is found on SSR for DH), I will need to be checked to ensure I'm OK to have IVF? Who does this? Is this a Gynaecologist or a Fertility Centre? The reason being is that I live on an island with no Fertility Centre. Going across to the mainland is fine for the IVF/ICSI side of things, but will mean lots of days off work and travelling/money if I have to do everything there (such as scans, blood tests, examinations etc - I don't know exactly what a workup for me would entail, so forgive my ignorance).
Therefore, is it worth me requesting a referral to see the Gynaecologist here so that I can get fully worked up and checked so we're all ready to go once DH has had investigations? Or will they not do that?
We're just trying to save time and cut corners and speed things along and if I can get in the system and fully checked out then that would certainly help.
Any ideas? Sorry for all the questions, but still very clueless.
waitingginger
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hi bookworm!
so sorry you have had to join us! but so glad you have found us!! seems to be more and more people joining every week! scary to think how many people there are out there dealing with this!
Our process so far has been:
2 SAs
ultrasound scan
numerous examinations
Blood tests
because OH blood tests have come back as having practically no FSH or LH, we arent going to be considered for a SSR at this time because his bloods point to the problem being hormonal or something with the paturity gland, which is something that may be fixable with drugs!! so we are just waiting at the moment whilst OHs bloods are checked over a 6 month period!
I think if you have chance to read any of the pages or our journals you see not that none of our journeys seem to of been the same! we have had different tests in different orders! i hope you can make some sense from it and ask your fertility consultant about all of it! so nothing is missed out!! would be great to hear on your OHs blood test results when you have them!!
Silverbell- yes i saw a gyno seperately but i got reffered quicker then my OH and now i just have to get copies of my test results for the fertility clinic! think it would speed time up! i told our fertility specalist i had had day 21 bloods, ultrasound, internal scan and HSG and she said that was everything and it made it easier she knew she was only treating one issue! depends if your Doc is prepared to refer you too
Hope everybody else is well!!
xxxx
so sorry you have had to join us! but so glad you have found us!! seems to be more and more people joining every week! scary to think how many people there are out there dealing with this!
Our process so far has been:
2 SAs
ultrasound scan
numerous examinations
Blood tests
because OH blood tests have come back as having practically no FSH or LH, we arent going to be considered for a SSR at this time because his bloods point to the problem being hormonal or something with the paturity gland, which is something that may be fixable with drugs!! so we are just waiting at the moment whilst OHs bloods are checked over a 6 month period!
I think if you have chance to read any of the pages or our journals you see not that none of our journeys seem to of been the same! we have had different tests in different orders! i hope you can make some sense from it and ask your fertility consultant about all of it! so nothing is missed out!! would be great to hear on your OHs blood test results when you have them!!
Silverbell- yes i saw a gyno seperately but i got reffered quicker then my OH and now i just have to get copies of my test results for the fertility clinic! think it would speed time up! i told our fertility specalist i had had day 21 bloods, ultrasound, internal scan and HSG and she said that was everything and it made it easier she knew she was only treating one issue! depends if your Doc is prepared to refer you too
Hope everybody else is well!!
xxxx
Flake-y
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Silverbell, if you go thru the NHS, it'll be a gynocologist that'll do all your tests. I'd say it doesn't do any harm to get referred & get all your tests done. They'll def do them before any IVF anyway, but getting them done now might save a bit of time!
silverbell
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Waitingginger and Flake-y - thank you so much That's made me feel so much better. I will definitely ask on Monday now that you've said that and leave it up to him. Hopefully he'll agree and I can at least get my part all sorted and in tip-top shape ready for any treatments. It's great too, waitingginger, as our processes are the same at the moment (2 SAs, USS, exams and blood tests). We're just waiting to find out the results of the scan and bloods on Monday and review with a Urologist in July.
I have noticed that no 2 stories seem to be the same and lots of different things done in different orders. It makes it very confusing and frustrating for a newbie, as you can't figure out what on earth will happen next.
That's such great news about them thinking yours might be a hormonal problem that may be able to be fixed. I really do hope this is the case and am keeping everything crossed for you!
That's made me feel so much better. I will definitely ask on Monday now that you've said that and leave it up to him. Hopefully he'll agree and I can at least get my part all sorted and in tip-top shape ready for any treatments. It's great too, waitingginger, as our processes are the same at the moment (2 SAs, USS, exams and blood tests). We're just waiting to find out the results of the scan and bloods on Monday and review with a Urologist in July.I have noticed that no 2 stories seem to be the same and lots of different things done in different orders. It makes it very confusing and frustrating for a newbie, as you can't figure out what on earth will happen next.
That's such great news about them thinking yours might be a hormonal problem that may be able to be fixed. I really do hope this is the case and am keeping everything crossed for you!
Thank you so much everyone for the welcome, answers & advice - unfortunately we've had it officially confirmed & are 'dealing with azoospermia'
I think I will cruise by some journals if you don't mind - it's all so new and it'd be great to have an idea of what's in store... Though I'd echo Silverbell; having just read some of this thread it's a minefield!
We're trying not to pre-empt anything but we know there has been another case of obstructive azoospermia in DH's family which led to 2 ICSI babies. The couple were very open & have said that the cause of the obstruction was unknown.... When we mentioned that the consultant indicated a strong suspicion that we could be looking at DH being a CF carrier. I'd love to talk to the other couple to ask what tests they had etc but DH is unwilling to tell people yet.
The other couple went through this some years ago (their oldest is almost 10) - do you think it's possible that the testing/investigations weren't as thorough/developed then? The dr seemed quite sure that CF is a possibility but I believe that if the couple knew he was a carrier they would have told the rest of the family - particularly when they were so open about everything else...
I suppose it doesn't much matter though; we have to go through the process anyway & we'll get answers eventually. Strange I feel like I'm finally coming to terms with the news & now DH seems to be flagging!
Thanks again
I think I will cruise by some journals if you don't mind - it's all so new and it'd be great to have an idea of what's in store... Though I'd echo Silverbell; having just read some of this thread it's a minefield!
We're trying not to pre-empt anything but we know there has been another case of obstructive azoospermia in DH's family which led to 2 ICSI babies. The couple were very open & have said that the cause of the obstruction was unknown.... When we mentioned that the consultant indicated a strong suspicion that we could be looking at DH being a CF carrier. I'd love to talk to the other couple to ask what tests they had etc but DH is unwilling to tell people yet.
The other couple went through this some years ago (their oldest is almost 10) - do you think it's possible that the testing/investigations weren't as thorough/developed then? The dr seemed quite sure that CF is a possibility but I believe that if the couple knew he was a carrier they would have told the rest of the family - particularly when they were so open about everything else...
I suppose it doesn't much matter though; we have to go through the process anyway & we'll get answers eventually. Strange I feel like I'm finally coming to terms with the news & now DH seems to be flagging!
Thanks again
silverbell
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I'm sorry it has been confirmed, Bookworm
My DH doesn't want to tell anybody either.
I imagine testing is better these days - I think tests and investigations are constantly improving.
It's the waiting that is hard. I've found that out already and we only found out he had AZ 2 weeks ago!
Don't worry about your DH flagging. If you're anything like my DH and I your emotions will be up and down for a while yet. One day you might be fine and the next in pieces. Some days things will get to you and another they won't. You'll both feel a bit up and down for a while I would think. It's so much to take in and think about and hope for. I don't think you'd be human if your emotions weren't all over the place.
My DH doesn't want to tell anybody either.
I imagine testing is better these days - I think tests and investigations are constantly improving.
It's the waiting that is hard. I've found that out already and we only found out he had AZ 2 weeks ago!
Don't worry about your DH flagging. If you're anything like my DH and I your emotions will be up and down for a while yet. One day you might be fine and the next in pieces. Some days things will get to you and another they won't. You'll both feel a bit up and down for a while I would think. It's so much to take in and think about and hope for. I don't think you'd be human if your emotions weren't all over the place.
Deb111
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Sorry you've had confirmation Bookworm
The first ICSI treatment wasn't done until 1992 and we were told that surgical sperm retrieval has only been around for something like 10 years, so I'm sure medically, things have progressed an AWFUL lot since then.
10 / 12 years ago none of us would have had any other option but donor sperm / adoption. Medical research is progressing every day. Don't know much about the CF carrier thing though sorry.
Thinking of you both xx
