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Discussion Starter · #1 ·
Hi,

Just wondered if I can ask a question to those ladies who are having tx because of male factor infertility. What initial tests were you and your DH/DP asked to do before starting tx? Especially, once the male factor was identified, were YOU told to have other internal tests apart from a scan? I`ve had scans and blood tests and nothing else, so was wondering how it has been for others...

Any feedback is very welcome,

Roses
 

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Hi
When MF was diagnosed with us, I had already had the standard blood type tests  - can't remember them all but HIV/Hep B etc. etc. (well we both had) - the clinic we went to first insisted on a HSG - hysterosalpingogram or hycosy before they would treat to check my tubes were clear  - probably because we were having DIUI. Apart from that I think it was hormone levels and that type of thing - nothing else invasive. I have had a follow up this morning and he hasn't requested any more tests though I did ask him about other tests but he didn't feel any were needed.
Hope this helps a little. Each clinic is very different in what they seem to want.

Good luck
Tiny xxx
 

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Discussion Starter · #3 ·
Tiny,

Thanks for your reply. I would imagine HSG test is necessary for IUI, but as we need ICSI, it seems to me that they didn`t see it as necessary as I haven`t had any internal tests apart from a pelvic scan. But, I am concerned that I would like to know if my tubes are ok and they aren`t blocked or have fluid in them as I have found out on FF that this can cause BFN`s and m/c`s. So, I`m not sure whether I should insist on a test before our next go in June.

Do you know if it`s possible to have a HSG in the month just before starting a new cycle? Do they do GA or sedation with it and are there any side effects and risks?

Thank you,
Roses
 

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Hi Roses
I would think that your clinic would suggest a HSG if they thought it was needed - have you asked them? I found it quite unpleasant (that might be an understatement!) - no sedation or anaesthetic is given. I am sure if they thought it neccessary they would be suggesting you have it?  As you are having ICSI I wouldn't think you need anything else really - it would just be more stress. I would ask though to put your mind at rest.

I would think, in terms of timing, if you did have one, they would probably want 1 period between it and starting tx just to get rid of any dye? But I honestly don't know.

Tiny
 

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I had a HSG prior to even talking about any possible tx, despite DH having a poor SA. I was then told I had a possible blocked tube and was then booked in for a lap n dye. But, I then got preggy naturally after the HSG, the next cycle in fact!

I found the HSG quite painful but worth it as it must have unblocked something for me to get preggy!! THe HSG is done while you are awake and the only pain relief you get is a couple of paracetamol that you are advised to take beforehand.

I believe an internal scan would show any possible hydro's which are what would contribute to mc's etc. But don't quote me on that!!

Good luck!!
 

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Discussion Starter · #6 ·
Thank you ladies for your replies.

Tiny, after the m/c I had last year even before we asked, the doctor had said that they do further testing after recurrent BFN`s or m/c`s. But, I haven`t asked specifically about having a HSG. I am planning on asking during my next appointment. Because there is no evidence that shows my tubes are ok, I keep on thinking what if they aren`t? I guess I am just hoping for that natural BFP as these tx seem never-ending :( . I`m thinking that I might not have enough time to have HSG anyway before next tx starts hopefully in June. DH had another SA done and will also find out what the situation is now as he has been on some vitamins for 2 years. We will find out the result this week.

Kitten1, you are so lucky to have got a natural BFP!! I`m assuming having read your signature that your DH`s SA wasn`t too severe as you were about to start having IUI or IVF. We have only been offered ICSI because DH has very low count and motility. As I don`t know if everything is ok with my tubes I sometimes feel like I`m infertile as well :( . I had my appendix removed in the past and had ERPC for my m/c last year and I just can`t stop wondering whether these procedures could have caused blockages in my tubes. Maybe I`m just going ^idiot^ . I don`t know what to think anymore.

Thanks again ladies,
xxx
 

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We've got incredibly severe male factor, no sperm at all and he's had to have a biopsy and they only managed to freeze one vial of sperm.

So we're having ICSI. I've had basic blood tests done to check hormone levels and other blood tests to see if I'm a CF carrier for example as I want to egg share.

And had a single pre-treatment scan.

And that's it.

I too worry LOADS that I have problems too. But I guess we can only find out by trying really. Otherwise they could test you for every single problem in the world and it would cost millions and you may get pregnant anyway, or you may not! It's really not an exact science I'm starting to decide.

I have never been pregnant in my life, and I'm terrified that for some weird reason it's because I can't get pregnant, even though we've only been trying for a year and a half.

But having 0 sperm is a pretty good reason for me not to be pregnant!

I am worried that I have hormone problems which will stop an embryo from implanting, because I get as much as 4-5 days of spotting before my period most of the time. But my hormone levels came back normal, I have a normal smear. I had some dodgy female type pains, during sex, bad periods, etc and they suspected endo, but I had a laparoscopy and they found NOTHING, NADA, ZILCH. So I think I'm needlessly paranoid and need to stop overanalysing.

I would say ask the questions you need to, but also maybe keep some faith in your clinic. I'm happy enough to give this a couple of tries maybe, before I start demanding more tests.

I have NO idea why blocked tubes would cause you any problems. Surely the egg is going to go nowhere near the tubes, so why would it matter if they were blocked for ICSI? They suggest these types of procedures for women who HAVE blocked tubes, so I'm not following your logic here (but then I am having a thick day...).


 

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DH's initial SA showed very few spermies and those he did have were not very good looking.  ;) We were told we'd need ICSI at first but DH made some lifestyle changes etc and managed to get the wee swimmers back to good health. Think we were very lucky.....  ;)
 

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Discussion Starter · #9 ·
Maybe-if, thanks for your reply hun. It does put me at ease slightly to know that I am not the only worrier. Glad to hear they didn`t find anything with your lap. I heard sometimes what is not seen on HSG is seen on lap, so it sounds like a more gauranteed test. You are right with the fact that with so much worrying going on we tend to lose faith in our clinics and I feel like questioning everything they do or don`t do most of the time! But, on the other hand, how can we help it when we want a family of our own so much :-\ .

I`m with a fertility unit in an NHS hospital at the moment and any tests done would be through the NHS we would not have to pay for, so the first thing that comes to mind is "because it is NHS are they trying to save money by not doing the required tests?".

Here`s what I found on FF and it explains a condition called hydro... which also explains the reason for my worry on the matter of not having had my tubes checked. It`s a condition where the tubes have fluid in them and is toxic for the embies. You don`t have to worry about this because you had lap done that`s why I`m posting it, otherwise I wouldn`t have posted it.

http://www.fertilityfriends.co.uk/forum/index.php?topic=134346.0

Kitten1, good on your DH for doing his bit ;) . We didn`t have much life changes that needed to be changed apart from being on vitamins, maybe all we need is a miracle OR more ICSI :-\ . Give your little one a big ^hugme^ for me.

Rosesxxxx
 

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Hi Roses,

When we first got the hint that we weren't conceiving we went to our GP and I had a very crude internal exam, and dh was sent for a sperm test. This came back showing low count and it was then that dh asked for a physical exam as he was sure something was 'different' down there ... that's when he was diagnosed with having damage probably from mumps as a child. We were referred to the nhs fertility clinic but the appointment was a long time into the future.

Being impatient, I booked us into a private fertility clinic who, as in your case, told us that icsi was our only option, no need to test me any further. This made sense as like you said you dont need your tubes for icsi, the normal pelvic exams of tx should show fibroids etc and this seemded clear.

Three failed tx's down the line and i've just aked for a hycosy - similar to an hsg but using ulrasound (maybe also cheaper? gives the same results anyway, have a check) as every month i hope that one of dh's sperm will get through and do the trick and I thought well there's no point in hoping for that if I'm not working properly either. Thing was I'm now done as far as the nhs are concerned, I've had my nhs icsi and so they wouldnt give me anymore tests (apart from blood tests done at the request of my private clinic). so my advice would be to get them to do this for you now. As far as I know you have it done before ovulation, so it is possible to conceive that same month, and I cant see a reason why you couldnt have tx the month after, there are no lasting side effects or damage that you nee dtime to recover from. For a hycosy they use a sugar solution which is absorbed by your body.

I'm very frustrated being where we are now that we'd rushed into three invasive icsis and werent all checked out beforehand. It might not have made any difference to the outcome but I'm certain I would have felt better having covered all bases.

Anyway, better be off low battery is flashing! best of luck, Kerry x
 

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Roses

Welcome - just thought i would copy and paste the 1st post i put on here as it provides details of some the tests we have had ... BRCM have been extremely thorough - if you have any questions eg want to know about Karotype etc please post or PM me x

Malak said:
Hi All

I am a fairly new BRCM girlie - have just been settling in with the Repromed Forum girls but as my DH has recently been diagnosed with olizoospermia they have mentioned that i may find some good advice on this forum as it has more members so here i am. Just to bring everyone up to speed - things looking not too bad in my department - ovaries have slight polycystic appearance but i have normal BMI and no other issues so don't think this is too much of an issue however DH has had a karotype and we have discovered that he has olizoospermia - basically a dire sperm count. We just did the overnight survival test and only 29 individuals made the journey so we have been advised to not proceed with ICSI but to try and freeze some samples and see whether these samples are representative of the one given the other day. If they are I think we have a bit of a situation on our hands - no idea what we are going to do then but i know crying all the time is counter-productive so at the moment i am just trying to get some support and PMA from others in our situation. It would be really great to share info and BFP news with others - I know it only takes 1 for each egg but 29 in total instead of 20 million is a little dire ! Sorry for opening a new topic but this site is huge and its gonna take me a while to get my head around it !!!
 

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Discussion Starter · #12 ·
Kerry, I`ve just done a search on HSG and Hycosy and found most sites saying this:

"For both of these procedures it is likely that antibiotics and a long acting analgesic should be prescribed by your clinic/doctor."

Is this what they said to you about how they are done? I`m going in for a scan this Tuesday and will ask about whether we can have one done next month. I`ll let you know what they say. Once I get my next AF they will be putting me on the pill, and I`m not too sure if I can be on the pill and also have one of these tests ??? . If I had known about these tests right in the beginning I would have insisted to have it done.

Before our GP had referred us to our fertility clinic we had all my bloods done (thyroids, FSH/LH/oestradiol, liver function, white blood cells etc), ovulation bloods done, pelvic scan all on the NHS and all were normal. My DH had 2 SA`s done before we were referred to the fertility clinic. Once we were referred the doc at our first consultation suggested that my DH can have a genetic analysis and Y-deletion tests privately if he liked, and he had it done for £250, which came back normal.

There are so many tests that can be done but we just don`t know when we are supposed to have them done :-\

Malak, my DH has had the genetic and y-deletion tests done as I mentioned earlier and he has had a physical checkup as well as a few Sa's. I can't think of any more tests that can be done for him. It`s just me I`m worrying about most of the time, whether I should have had more tests done internally.

Well, it`s been really nice sharing my concerns with others. Thanks for being there, we`ll see what they say on Tuesday. Best of luck to you all.

Roses
 

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Hi Roses,

It is a minefield isnt it, I think like you say you could test every little thing until the cows come home, it really is up to you how far you want to go. As for dh I have been looking into it and there are so many tests that can be done, looks like you've had the major ones esp looking at his genetics (y deletion), that's the next thing we'll be considering as we were told 'it only takes one good sperm' but how do they know which sperm are the good ones? They go on general appearance and I'm worrying that this isnt good enough if there's something wrong with the genetic material within each sperm ... good that you've had this checked already though.

For my hycosy, and for many other women I've read about, all that is receommended is that you take painkillers (paracetamol and ibuprofen) a couple of hours before the procedure as it does cause some cramping. Antibiotics weren't mentioned or offered. I'm sure you've read all about it but I'll tell you just in case, you have to be between days 1 and 7 in your cycle (to ensure you're not already pregnant), they insert a catheter through your cervix and inflate a small balloon on the catheter to hold it in place - this is the bit that can be uncomfrotable as it feels like very bad period cramps. I felt quite winded by this, you know how bad af cramps make you feel a bit sick and dizzy, but it passes in a minute or so as your owmb settles down. They then insert the dildo cam and flush the sugar solution into the catheter and through your womb and watch via the ultrasound machine for it travelling through the womb, up through the tubes and out the other end. This bit I didnt find painful at all. My consultant said that he'd used 10ml of fluid (2 teaspoons) so its not like you feel bloated or anything. You do feel a bit pulled about afterwards and they let you rest for a while then its all back to normal. I shouldnt think that being on the pill should affect you at all, they're not checking any hormonal balance or anything its just to see if the tubes are open. As far as I am aware - but bear in mind I've never had one - an hsg is the same apart from they use a dye and track its movement through your womb and tubes by taking several xrays which they then study afterwards.

If you want a hycosy or hsg and they try and put you off by saying isci is the only way for you, I would argue that your dh has some sperm and so natural conception isn't entirely out of the question (I hope this is the case and his count is just low, not zero) but you don;t stand a chance if your tubes are blocked. Plus like you mentioned before problems with your tubes could affect implantation in icsi and its best to know now. The waiting list might be quite long. If you do go private like we did our hycosy cost £300.

Good luck on Tuesday I look forward to hearing how you get on.

Kerry

 

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Discussion Starter · #14 ·
Kerry,

Thanks very much for your detailed description of hycosy, it has been really helpful and has put my mind at ease. You are right about the difference between hycosy and HSG, that`s what I read about them as well. The only difference seems to be one is checked on u/s and the other with x-rays.

How long is the waiting list for hycosy or HSG on the NHS? For my very first scan while still with our GP I had waited 3 whole months for just a pelvic scan! Although we were at the same time waiting to be referred to the fertility clinic and waiting for our first consultation, so there was no need to have that done privately.

I forgot to mention earlier that after our immense internet readings and with our own initiative, DH went back to the GP to have a physical for any varicoles (I may have miss spelt that!, however I`ve later found that this is best checked by an ultrasound), and also had bloods done for testosterone, elect/GLU/LFT`s, serum urea level, AUTO-GLOM-FIL-RATE, thyroid function test, FBC (full blood count), differential white cell count, serum ferritin. All were normal except for LFT, the enzymes in his liver were slightly higher than normal and this needs to be repeated every 6 months. But, the GP said that this does not effect his fertility.

Have a nice day,

Rosesxxx
 

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Oh my word roses that's a lot of tests, thanks for sharing that it'll definitely be something I'll be asking around to get for dh he's had hardly anything done. We're seeing a urologist in march to look at dh in more depth so I'll go armed with your list!

You too have a good day. time to take the dogs for a walk and its started raining  ::)

Kerry x
 

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Discussion Starter · #16 ·
Katie, you had a very good initial investigation for the both of you. Once you start your tx at least you won`t hear of tests that weren`t offered to you and that will be one less thing to worry about. Unfortunately, not all doctors do thorough initial tests and we feel like we have to chase them up to have them done :mad: . Were all your tests all done with your GP or did you have them done privately?
My DH was never sent to a urologist and only physically checked by the GP because we had asked for it. What does a urologist do?

Thanks,
Roses
 

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Discussion Starter · #17 ·
Hi ladies,

Well, we went to the clinic yesterday for a scan to see if things have settled after my over stimming and heard good as well as not so good things from the Dr. The scan went well and everything has gone back to normal and as of yesterday have started taking the pill. BUT, he said the fact that the same thing that happened twice can still happen. We won`t know anything for sure once I start stimming. I will be on SP for the first time and a lower dose of FSH (stimming drug) Puregon 100! Even with that dose I`m at risk :mad: .

Anyway, once I get AF next month I have to go in for a Day 2 scan and if everything is ok I will start stimming right away. If I over stimmulate again, they`ll have to use buserelin to calm things a bit and try and take me to EC with the suprefact instead of the Ovitrelle, as it is the Ovitrelle that can cause OHSS. If they end up having to take me to EC by using the suprefact then we won`t have a very good outcome with regards to egg quality and quantity. He said "don`t worry we`ll try and work something out". I sure don`t like the sound of less eggs with lower quality .

My DH had another SA last week there and we got a written result yesterday and unfortunately the vitamins he has been on the last 2 years have made no difference and he still has severely low count, motility and morphology. With regards to HSG the doctor said if I had fluid trapped in my tubes this would be detected on the scans, and he thinks it`s unnecessary. Once I heard that they can see fluid in tubes and DH`s SA, I changed my mind having to go through a HSG. I asked about natural IVF and he said we would even have a lower chance of success with that because of the MF. ICSI is our only hope, if that can even be achieved...

I`m not feeling too hopeful at the moment :(

Hope you are all doing fine on this ^rain^ day,

Roses


Take care,
Rosesxxx
 

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Hi Roses,

I see what you mean, it must be good having a bit more info but that in itself has opened up new questions and worries for you. Fingers crossed you wont overstimm next time and you wont have to muck about changing drugs, but if you do try and se it as making the most of the situation, it doesnt necessarily mean that your eggs will be pants. It sannoying when they give such fliipant remarks as 'we'll try and work something out', durh yeah you'd better, but I'm sure they deal with loads of different women with diferent problems and so when he says that he's really referring to a whole host of tricks they can try as and when the situation arises. Hope so, anyway. You might not be feeling too optimistic right now but do try and keep an open mind  ^hugme^ I know how hard that can be.

So, wishing you well for the next few months ahead lovie.  ^reiki^ ^reiki^ ^reiki^ ^reiki^ ^reiki^

Kerry x



 

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Discussion Starter · #19 ·
Thanks Kerry ^hugme^ . You are right though that the doctor talking like that has brought up new worries, it`s like everything depends on chance. He sure is doing his best to prepare us for the worst :-\

Whatever happens next go (which is still part of the last go and our only free go on NHS) that`ll be it as we have decided to go private after that.

Good luck to you as well xxx
 

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Cheers Roses.

Fingers crossed you wont need another go after this, but it might open new ways of doing it if you do. For example we did it back to front - 2x private first before making our way up the list to get our free nhs go. Our private tx's were short protocol, the nhs one was long protocol take it or leave it. I actually preferred the short protocol and really did try and push them to do it but they wouldn't budge, it deffo seemed a bit like a conveyor belt.

Also I found the private consulatants more willing to dicuss the what ifs ... probably cos you're paying for the time of the consultation! rather than just like your doc has said that he'll sort it as and when, which doesnt help your peace of mind does it?

Just looking at your signature and cant work out if all the tx's you've had so far have been nhs? Have you had any private tx before?

Kerry x
 
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