Dealing with azoospermia?

[hulahoops04]

Hi everyone,
We had our first appointment at Reproductive Medicine Clinic today. After the urologist telling us we had a high chance of retrieving sperm with the SSR, my husband's FSH and LH have both come back high which may indicate testicular failure. Its like a rollercoaster!
Today she gave us a 25% chance of retrieving sperm and an 11% chance that this would be effective when used in IVF. At the minute we are clinging to that 11% chance!

There is a 9-12 month waiting list for the SSR operation. After a long talk I feel that I cannot take another 12 months waiting. I would have to quit working as a midwife as its just too hard. I've decided to do as much hospital agency work and extra shifts as possible to try and fund this privately. She said it would be about £2500, so I have a fair few shifts to do to cover this, but just can't wait a year! I am so worried that my PCT will pull funding as they have in lots of areas around Manchester if we hold out much longer.

So it was kind of a bitter sweet appoinment today. The consultant was excellent and I have total trust in her. I was worried about going today and coming out still confused and feeling like we had a long way to go!

 

[Flake-y]

Hi there; you know, I wouldn't bother too much about the hormone levels; my DH's both came out fine, in fact, the urologist said he was very pleased with the levels & he was very hopeful of finding sperm, but there wasn't any.

So you never know! I'm with you on going private too, we went private cause I couldn't stand waiting either! Cost was about £2500 too.

Lots of luck!

 

[Deb111]

Hi Hula

Sorry about your hubby's blood test levels - hubby's FSH is slightly high, but not much and his testosterone is very low! FS didn't seem bothered about either, but GP is not happy with testosterone levels and is referring us to endocrinologist. We're going privately for that initial appt as I'm hoping he will be able to shed some light on whether or not this could be connected to the azoospermia. The urologist didn't even mention getting it re-checked! I have very little faith in him

As Jo says, I don't think blood results tell you much, but I'm keeping everything crossed for you.

I'm so pleased that you have a lot of respect for your FS - it is so important to feel you have someone who knows what they're talking about on your side.

Sending you hugs xx

 

[Deb111]

Well today's appt with the urologist went much better than the last one. He was much more friendly and answered all of our questions. I have come away having more faith in him this time which is good.

I have lots of info about the different blood test levels / reasons for doing or not doing certain tests etc, which I will post here when I get a chance - who knows? It may help someone else to know what questions to ask.

Hope everyone is doing ok xx

 

[Flake-y]

Good news Deb!

 

[Deb111]

Just copied this across from my journal as I thought it might be useful for anyone going through this right now or in the future.

Right time to try and update with all the info we found out yesterday. I'm sure a lot of you already know this, but thought it would be a useful place to record it all for my own reference

The urologist was like a different person. Very helpful and supportive and understanding of our need to ask lots more questions.

Info from the urologist
- Pituitary gland makes FSH, LH and TSH (thyroid stim. hormone)

- Terry's FSH is 15 and normal is up to about 7

- The fact that his is higher than normal tells them that he doesn't have a problem with his pituitary gland itself

- If there was a blockage, the testes would be making sperm normally but they just wouldn't be getting through. This would mean that his FSH would be normal so the fact that his FSH isn't normal suggests that the body is struggling to make sperm rather than there being a blockage

- Therefore they haven't felt it necessary to do a scan

- Tamoxifen stimulates the pituitary gland to make FSH when it isn't making any / enough. The fact that Terry is making too much means that tamoxifen is not needed and would not solve any problems in our situation

- SSR can be done again in about 6 months IF necessary for whatever reason

- 90% of the tissue they take in the SSR will be used by the clinic to look for sperm, the other 10% goes to the hospital pathology dept to see if they can establish a cause etc. He said in some cases, the testes have pockets / small areas where normal sperm is being produced and that there is always a slim chance that when they take a sample, they will miss the pockets of sperm which is why they try a few places. He also warned us that there is a minute chance that they could take samples, catch the edge of one of these pockets of normal sperm production and that the part with healthy sperm in could be the 10% that goes to the pathology lab! From the way he was talking, that wouldn't be dealt with in the right way / time frame for those sperm to be recovered. I'm guessing that's when we would consider a possible further op in 6 months time?

If you've read this far I'm impressed! No wonder my brain aches! I feel like I could write a book about it at the moment! Whoever knew TTC would be so technical and indepth!


And now for the endocrinologist appt! (the one where we got to park right outside and had our parking refunded as we went private!!! )

He agrees it not a major problem with Terry's pituitary gland but says he needs testosterone replacement therapy as low testosterone can cause osteoporosis.

However, he wont give him that treatment now as it would trick the brain into thinking he was making enough testosterone which would mean his FSH level would drop and then sperm definitely wouldn't get made.

He wants us to go back and see him on the NHS when the TTC / SSR issues have been dealt with and will then do some more tests and start him on 12 weekly testosterone injections.

As we left he said "I will pretend I know you and reduce tonight's charge accordingly"!!!! We have no idea why?! Maybe he felt he couldn't / didn't really do much for us right now but it was a nice surprise so will be interested to see the bill when it comes.

Right, I think that's it for now .....

 

[april4jdg]

I feel like I already know what they are going to be in my heart... So does the urologist do the biopsy? Or the RE?

 

[Deb111]

Hi April

I really wish you all the best for tomorrow. If they tell you there are no sperm in this sample, make sure to ask them if it was centrifuged (I think I've remembered that right!) Apparently, even when a sample appears to have no sperm, if it is centrifuged, there may be a few present which will sink to the bottom. Worth asking?

It is our urologist doing the SSR

All the best xx

 

[Deb111]

Laura - Any news form your appt hun?

Stepmummy - I hope you had some good news regarding the follow up tests from hubby's op

Any more updates from anyone? It's been quiet in here lately. Hope everyone is doing well.

Hugs to you all xx

 

[Dancergirl]

Had IUI #3 last Monday (10/4) now just waiting to see if it worked. Feeling nervous and scared to get my hope up because I know how crushing it can be to find out it didn't work. I should know this weekend and will keep you posted. Wishing for the best.

 

[Flake-y]

Good luck dancergirl; keep us updated!

 

[april4jdg]

#2 Sa was a 0 again, they do centerfuge it and it was done at two different dr's offices...One at the RE and the 2nd SA at the urologist... So we have been referred to another urologist for a biopsy consultation this coming Wednesday...

This urologist works at the same hospital as our RE does... which is about 2 hours away from us...

 

[Deb111]

Sorry to hear your news April. I hope you can get an appt soon and get some answers xx

 

[Deb111]

Question for those women whose hubby's have had the SSR ...

We've been told Terry will need 'tight fitting, supportive underwear' after the op. Ironic when he spends all the time TTC wearing lose fitting, cool undies!

Anyway, I have no idea what to get and I know he wont - were your hubbies told to wear anythin specific or did they find one sort more supportive than other?

I don't know whether he needs 'speedo' type briefs (which look like they may be supportive but maybe a bit too confined if swollen,) or jockey shorts type with the support pouch at the front?

Any ideas girls?

 

[Flake-y]

K was given a supportive jockstrap after his SSR; he took it of the next day though & had a shower; he just out on his ordinary undies; you know, the tight boxers, like the Calvin Klein ones?

 

[lemongal7]

Hi ladies. Just stumbled onto this thread. Sounds like you all are going through some real cruddy situations. I just got hubby's SA back today and it was 0. How awful. I had hopes they were low, but 0???
Anyway, it's been helpful to see some of the things your hubbies have gone through, so I kind of know what to expect my hubby to go through next. We were told to see a urologist, so praying my hubby agrees to go. He hates DRs! Why does this have to be so hard???

 

[Deb111]

Hi Lemongal - welcome

So sorry you're going through this. It sucks big time - but there is hope. There are so many advances in medicine these days. If this had happened 10 years ago, we would all have ended up childless or having to adopt, but there are now options, which is reassuring and I think we have to cling on to that.

Have they requested another SA to be done? I hope hubby is open to discussing this with you and getting some help.

Keep us posted
Deb xx

 

[lemongal7]

Hi Deb111 - going to talk to hubby tonight. i know he's going to fight having to see a urologist...he just wants this all to happen naturally and is freaked about having a doctor examine his "stuff" , ya know? Poor guy. I think he eventually will come around to agreeing to it, but may take some time and lots of prodding.
The clinic where he had the SA suggested that when he sees the urologist to have another SA, so who knows. Maybe the next one will show us a couple sperm?? Anything, please!!

 

[MariaF]

Hia Deb! I've been following your thread and just wanted to wish you and hubby best if luck for the 28th. I'll be keeping everything crossed for you! Xxx

 

[Deb111]

Hi Deb111 - going to talk to hubby tonight. i know he's going to fight having to see a urologist...he just wants this all to happen naturally and is freaked about having a doctor examine his "stuff" , ya know? Poor guy. I think he eventually will come around to agreeing to it, but may take some time and lots of prodding.
The clinic where he had the SA suggested that when he sees the urologist to have another SA, so who knows. Maybe the next one will show us a couple sperm?? Anything, please!!

If it helps to convince your hubby - the urologist's examination was less than a minute long, but I know how it is for us women; the first time you have an examination it's awful but then with smears etc and all the poking and prodding with fertility tests, you soon lose your inhibitions! Hopefully, he will get used to it.

As far as the SA goes. Make sure to ask them if they centrifuge it. It's an important part of the process and can sometimes show the odd sperms that would otherwise have been missed.

xx