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zero sperm advice on next steps needed

6K views 43 replies 23 participants last post by  gillyc1 
#1 ·
We've been TTC for over 4 years (we're 33 and 32) and went to see our GP a couple of weeks ago, he said that the first step was for my OH to produce a semen sample.
We've been for the results today and he said that there was no sperm present - oligospermic sample (looked it up and this is low, not azoospermic which is none?!).
He is referring us to a fertility specialist - we were that numb that we didn't ask how long this would take.
He said he wasn't an expert but he didn't think that we'd be able to conceive together and that the specialist would be able to discuss options such as a donor. I've loads of questions now since going home and looking into it more......
- Only had one sample tested, not asked to do another?
- He didn't mention trying to find out why? Blockages / reason why / etc.
- My OH has a varicocele but this wasn't mentioned / questioned - seems to be the most common cause and possibly treatable.
- Is this it? Has anybody any advice or similar situations etc?
Thank you in advance!
 
#2 ·
Hi. Sorry to hear u didn't get good news from ur gp. Remember when we went it was like a punch in the stomach. We were told to take the donor route too.  What I would say is that gps aren't usually very good woth info on ivf. Deffo have a few sampless a few montgs apart, if ir dh had a cold or something that can affect the sample.  Hospital always do much more in depth analysis than gps too. . Also taking supplements n changing lifestyle (there are some very good sections regarding this on this site) helps. Id get dh on wellman now as takes 3 months to take affect. As u can see in my sig it helped with dh. Am no expert but just thought I'd put in my 2p as there's always hope. Good lick with everything.x (am on my phone so sorry if this msg is a bit confusing! )
 
#3 ·
Very sorry to read your news and in particular your reaction from the GP . We have been in a similar boat. I'd encourage you to reach out to ladies on this thread for partners with azoospermia ( no or very few sperm) http://www.fertilityfriends.co.uk/forum/index.php?topic=323562.480

Best of luck, the ladies on here will look after you.
 
#4 ·
Hi, my DH has azoospermia caused by missing vas deferens.  We were told they cannot fully diagnose a man with azoospermia unless 2 different samples are taken and they have to be a certain number of weeks apart, sorry can't remember now it was a while ago for us.
I remember when we found out, my DH was due to start chemo so we were told to go and bank his sperm as it could affect him long term. So off we went, we got the results about 30 mins after giving the sample and they just said there's no sperm present. We couldn't believe it, they said it may have been caused by the cancer and to come back after treatment to see of it comes back. We came out and I cried and cried I felt like someone was playing a cruel trick on us that in the midst of my husband nearly dying, and trying to muddle through everything, we find out he may be infertile. I rang my mum.sobbing saying I wish I was one of those girls who had just got pregnant at 19 when I first met him.
Anyway i suppose by the time we got an official diagnosis we had already got used to the idea. The pain when your first hear those words is awful though.
You're not alone, so many of us have felt how you have xx
 
#5 ·
Hello, sorry to hear this. We were in your position this summer. My advice is generally don't listen to GPs too much about fertility, my partner's was crap and unsympathetic. Your GP is right, he is NO EXPERT. You'll need a further semen analysis done. You're head is probably spinning right now. We've still not had confirmation yet of what the plan is for us (having further tests done as azoospermia) but having read so many posts on here I've realised that despite such a crappy situation something possibly CAN BE DONE. Definitely agree with getting your OH on supplements and doing all the other good stuff (which you probably are doing, sorry) ie diet, alcohol etc if any of those are issues. You're in a good place here, I'd be lost without this site xxx
 
#6 ·
Depending on how approachable your GP is, I would suggest going back and asking to see the SA report and check it says on it it's been centrifuged. Also ask for a repeat SA and basic hormone tests on him (FSH, LH, testosterone, Oestrodial, prolactin, thyroid). Then ask who he's referred you to, as you want him to be sent to a urologist in the first instance. If you can take all those results to the urologist appointment it should help speed up the process. There's a long way to go yet before looking at options such as donor sperm. It's a shame GPs generally know so little about this, but it's such a specialised area so the least they can do is get things moving so you're seen by someone knowledgeable. There's many of us on this board in the same position who understand how you feel, so please ask any questions that you think we can help with.
 
#7 ·
Thank you all for your positive replies and giving us some hope!
We both came away pretty devastated yesterday as he was so direct saying that we wouldn't be able to conceive together, I don't understand why as a non-specialist he would say it like that? It's only from looking on the internet and these forums that we realise that there is still hope! We feel more positive today, OH has made an appointment to go back and ask some questions this morning!
- are missing something to make him be so direct, is there something on the analysis that we don't know?
- doctor said no sperm present but comments say oligospermic, which is low?
-will specialist send for tests to find out why, or is that just it, full stop, underline?
- second sample?
- OH has varicocele - this hasn't been discussed but is on his records
- how long until specialist appointment?
 
#8 ·
You've probably read about this by now, but the general process should be that the specialist looks for underlying reasons (make sure it's a specialist in male fertility issues so either a urologist or andrologist. Most fertility specialists have a gynae background which isn't enough with severe male factor issues). This should involve a full history (any hernia/undescended testicle ops or mumps etc), physical examination including ultrasound and hormone and genetic blood testing. I think opinion can be divided on the benefits of operating on varicocele depending on the size, but I don't know much about that. Hopefully the GP will be a bit more enlightening - certainly even really, really tiny numbers of sperm are significant as with ICSI it really can only take 1.

Not sure where you are in the country, but if you can get to the south east it may be worth considering seeing Mr R who is the urologist you'll see mentioned a lot on these boards. Whilst it may well come to donor sperm ultimately, if that's being mentioned in initial appointments as your only option I think you deserve to see someone who will explore and explain in more detail.
 
#9 ·
Thank you all for your replies :)

We're feeling much more positive thanks to the replies that we've had, the research we've done ourselves and OH returning to see a different GP. Not only did we have the shock of the results but the double whammy was the GP being so direct with what he said, we left originally thinking that the only options we had were a donor or adoption! Now we know that there's a lot more in between before it might get to that stage. We know that we're at the start of a long journey but we're going to get our family one way or another!
 
#10 ·
So thought I'd update on where we are at..... I have blood tests tomorrow - we've seen another (much more helpful) GP who was quite annoyed that I hadn't been told to have any tests yet! We have our fingers and toes crossed that everything is fine with me - not sure how we'll be if there are issues with both of us  :-[
Hubby has a urologist appointment early in January so hopefully we'll start to find out more and move forward with whatever our options may be. We're feeling much more positive and are back in the zone that we'll be pregnant one way or another! Hoping by next christmas but until the January appointment we're not too sure on how long this will take.....
 
#11 ·
Glad to hear things are moving and you've found a more proactive doctor xx
 
#12 ·
We have been in a similar boat to you for the last 4 years.

We have been ttc for 6 years and went for fertility investigations after 2 years. Hubby's two SA came back very vague as less then 10000 and zero. we had no explanation or investigations for a cause other than karyotyping to check DNA (done by fertility consultant). The doctor was as useless as yours and the consultant told us we had no chance of natural conception either.
that was the end of the fertility journey for us as i had to lose weight and stop smoking to qualify for treatment.

fast forward to 2014 and i achieved what we needed so returned to the doctor (a new one this time) and hubby went for another SA, we received another zero count but finally got our referral to Oxford fertility unit.
Things have changed enormously here and the treatment received has been amazing.

hubby has now had three sperm analysis with freezes (and test defrost) in preparation for our cycle (he will provide fresh on the day too).
We now have a few hundred sperms frozen ready :-D
it turns out that these previous investigatory sperm analysis are not centrifuged (spun to remove all debris and concentrated), they are only assessed under a microscope and only a small amount of the sample is looked at. so my husband has been stressed, depressed and upset at his counts for the last 4 years for no reason at all, all because they don't do the full procedure to investigate sperm unless you are actually committing to a cycle! Really disappointed in this treatment of him and for the upset he's gone through.

The andrologist at OFU explained to us that the numbers being so low will affect our ability to conceive as there needs to be millions to enable the one lucky sperm to reach the egg. She explained that they sort of surf on top of each other to get carried up to the egg, and while lots will die/fail along the way, the stronger ones use these to carry them there then do the final stretch by themselves. When your numbers are really low, this 'surf' isn't available which makes the journey harder for them, hence the lack of success. So while never impossible when you have low numbers, its just a lot lot harder for them.

So i guess what i'm trying to say is tell your partner not to beat himself up, that nothing is impossible and there is a big chance that there still are lots of sperm present, just that perhaps they haven't been looked for properly yet!
Stay positive and keep this in mind, don't let anybody tell you what can and can't be done until you're in with the experts and being investigated properly :-D

vba2010 said:
So thought I'd update on where we are at..... I have blood tests tomorrow - we've seen another (much more helpful) GP who was quite annoyed that I hadn't been told to have any tests yet! We have our fingers and toes crossed that everything is fine with me - not sure how we'll be if there are issues with both of us :-[
Hubby has a urologist appointment early in January so hopefully we'll start to find out more and move forward with whatever our options may be. We're feeling much more positive and are back in the zone that we'll be pregnant one way or another! Hoping by next christmas but until the January appointment we're not too sure on how long this will take.....
 
#13 ·
Hi all,

Hope you don't mind me joining in, but we're in a similar situation. We had our second appt with the fertility specialist today, following more tests and more waiting. my FSH is 6 which is ok apparently, although this will be need to be done again as it will be too out of date soon (crazy!)

DH's second sperm test came back same as the first; occasional motile sperm seen. He had an external physical examination and then a blood test which they're going to do chromosome testing with, so another 4-5wk wait! Was never going to be a straight road! However, then he said that as long as we meet the criteria then he will refer us.

A lot of people on here seem to have had lap & dye tests but I've not had any of them, is that only if they know there's female problems? So far most of the tests have been for him.

Vba: ignore the doctor, they have no idea about fertility! When we first got our first sperm analysis back, the doctor read 'occasional motile sperm count' as being slightly less than normal!! They really have no idea! So you're not alone :)
 
#14 ·
Hi there,

I'm quit new on here too, after 3 years TTC we finally got a diagnosis of azoospermia in March this year. We had spent about 18 months investigating me for problems because OH has a daughter from a long time ago. Anyway, whatever caused it, we then had a plan and OH went for Surgical Sperm retrieval in July. For a variety of reasons (including saving up!) we are due to start our treatment at Lister London in January. We saw Mr Ramsay who was wonderful urologist, very caring and as the partner, he was wonderful to me too on the day of the SSR. I couldn't recommend him enough.

We will start ICSI soon so although I can't tell you a wonderful success story, we are a lot further along and have some hope it will all be ok. You have to push push push though IMO, don't just let things tick along. Ask as many questions as you want of the specialists, that is what they are there for. Forget the GP - it's better to pay IMO to see someone even for an hour's consult than faff about for months with your GP if they aren't helping.

Good luck!
 
#15 ·
Hi i'm feeling a bit numb at the moment got married 2 years ago me and my wife are 31 and we had no luck trying for a baby, then I noticed my testicles appeared to be shrinking which was very distressing so decided to have a fertility test, me and my wife was extremely upset when the result came back zero twice, the last result coming a week ago.

My hormones and other bloods are all normal, testosterone is actually on the higher side, had ultrasound which came back normal but agreed my testicles are on the smaller side.

My younger brother who is 30 also came back with a zero sperm count and has smaller than normal testicles am curious as to whether cause could be genetic? , am confused and for some reason feeling immense guilt and sadness over the fact that I may not be able to provide my wife with a baby.
 
#16 ·
Hi Dcaine
first of all massive  ^hugme^

you are absolutely NOT ALONE

zero sperm count is, sadly, pretty common. you will need to go for some further testing to determine whether you have a chromosome abnormality, a blockage, or something else.
these days medics are able to perform microsurgery that can obtain sperm from testicular tissue, which can then be used for ICSI, and there are many members on here who have had success and had babies .
they also, on some occessions can prescribe medication such as clomid and tamoxifen that have been known to kick start sperm production in men with zero sperm.
hope is not lost.
as you will see from my signature my hubby has the same thing
sadly we were unsucessful,
but we had an awful  hospital that really messed up.
we are moving foward with a donor now

all the best
xxxxxx

 
#17 ·
Hi dcaine- I just wanted to come on and say im sorry about your diagnosis. You are not alone as you will see from this forum there are lots of us in the same boat. There are so many things it could be as Kayla said you should have some karyotype and genetic bloods done. The fact that your brother has the same issue would lead me to think it may be genetic but i have read stories on here from woman whos hubbys had azoospermia caused from genetics and had success with sperm retrival. Have you seen a uroligist? It could be that you and your brother are carriers of the cystic fibrosis gene and are missing your vas defrens. A uroligist will usually have a feel around to see if he can feel them.

Good luck in whatever your next step is and this site is a god send for advice and information so im sure there will always be someone on here who can help you out.

dede
 
#18 ·
Hi dcaine,

Sorry you have found yourself here.

There are many things which can cause zero sperm count. It may well be something genetic but could also be a coincidence.  My husband was adopted because his parents couldn't have children. When we found out that my husband had a zero sperm count we told his parents and they were very shocked because his dad also had exactly the same problem. It is a huge coincidence that two people in the same family who are not genetically related could have the same problem but this shows it can happen.

Happily, unlike 30 years ago, there are more options available to us and it is by no means a hopeless case. Have you seen a urologist? They would be able to give you a better idea of what the problem may be and the solutions that may be open to you.
We see the amazing mr R down in windsor - he gave my husband some medication and last month we found out we had motile sperm in his sample for the first time ever.

Depending on the nature of the problem there may also be the option of surgically extracting sperm which can then be used in ICSI treatment.

There is lots of support and information available on this site.

I wish you lots of luck in your next steps xx
 
#20 ·
Hi Dcaine,
We had our shock back in October, we're now awaiting an appointment for assisted conception. I don't know if that's what caused a small improvement but my OH has been taking Wellman conception since October and his latest results, whislt not ideal, were better than the original results.
 
#21 ·
Hello, sorry you had to join.
We have jut found out also that my husband has no sperm count.
We will have our first fertility appointment next month and see where we stand and what the next step is.
Its such a horrible and devasting thing, we don't know anyone who is in the same or even similar situation, I think that makes it harder as no one understands and don't know how to reply when you tell them etc.
Wishing you the best of luck at this sad time :(
 
#23 ·
DCaine100 is my hubby

Thank you all for commenting...we are in the process of waiting for a urology appointment 6 weeks and counting the wait is beginning to frustrate us as we want to know wat to do next...we are now both on Pregnacare Conception tablets we were wondering if anyone was using the same an had good results?

Many thamxs
 
#24 ·
Hi MrsCC
I have just been reading your thread as my boyfriend of 16 years has also just found out after two tests that he has no sperm.  We have been trying to concieve for 2 years and 7 months now.  He has been doing all the usual since his first test results; no hot baths, cut down on smoking massively, no drinking, no tight underwear, right foods and he has also been taking the Wellman tablets.  Unfortunately they haven't made any improvement.
We are waiting for a date to see a Fertility Clinic but have been told it will be 4/5 months. Our local hospital did not mention any possible treatment or further investigation as to why my DP has no sperm and instead just kept referring to a sperm donor.  I'm wondering whether we should speak to our GP and push for him to see a Urologist. I'm not sure whether the Fertility Clinic will do this but I'm so confused and feel like every next stages takes so long. May I ask whether you are seeing a Fertility Clinic or just waiting for a Urologist appointment. I'm trying to understand the process and wondering why a Urologist hasn't been mentioned to us.
I wish you and your DH all the luck in the world xx
 
#25 ·
Hi Mrs CC and DCaine!

I saw this thread pop up and just thought I would send you a big  ^hugme^ and some positivity too!  Like yourself, my DH was also diagnosed with azoospermia.  Although he was referred to a urologist and had an ultrasound scan done, the urologist actually did not do too much as we were under the care of a fertility nurse by the time we saw him and were eventually referred for ICSI treatment with sperm retrieval.  When we first met the consultant at the clinic he gave us the 'obstructive' diagnosis (I have also known others with non-obstructive having had positive icsi cycles!). MY DH underwent sperm retrieval first a month before we commenced our cycle so his frozen sperm was used rather than fresh and we were incredibly lucky that we got a BFP on our first cycle.  Again, like yourself, my DH brother also had exactly the same problem and had the same treatment with a positive outcome (they have just had a second DD from fresh ICSI cycles!)

I totally understand what you are currently feeling and going through but please remain positive and be open with each other about how you feel.  We enjoyed a nice holiday together to get away and "take it all in". I also found it helped talking to my close work friends who were very supportive as we went through our journey (we did not tell friends or family, not even his brother, as we wanted to concentrate on us and focus on treatment).
Like DarceyJay we cut out alcohol (we don't smoke), caffeine, ate a healthier diet, excercised a bit more (well he rode his bike once a week and I did zumba class so not too much exercise!) and took the pregnacare vitamins and followed all advice from clinic as they know best!

Sending you both positive vibes and good wishes!!xx
 
#26 ·
Hope things are going well for you Jessica7?

We've now had our first appointment at LWH after 3 SA and blood tests for us both. We're feeling quite positive, OH had blood tests on the day and has been given a date for a follow up appointment, in between this he has to return two samples and attend an ultrasound. He's also been told to take individual vitamin C, vitamin E and zinc, the andrologist said that Wellman Conception is okay but the levels are not hough enough!
 
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