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Discussion Starter · #1 ·
Hi my DH has been diagnosed with azoospermia. Has anyone from this board had any successful treatment where they have found sperm. I know they can operate to find sperm but what is the odds of finding any sperm. My DH is scared to have this operation and i think it would hurt him all over again if they operated on him and found no sperm. He has said to me he don't mind using donor sperm as he loves me and he will love our children. I have been to see a gynaecologist last week he wants my husband blood checked he hasn't said anything about an operation. Please if anybody on here could give me some advice it really would be appreciated.

Debbie
 

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Hello,

Finally I have met some1 on these pages in exactly yhte same boat. My dh has azoospermia, and is scared to have the op and sure that he still wont have anything even if the op goes ahead, was due in to have it done in OCt 04 but pulled out, we have gone down the donor route and had 2 x iui's both ended with a
-ive. But we are thinking about re addressing the op, dh is still scared but doc has asked him to do another semen count and then if still no sperm it's 99% sure there wont be any after an op, so we are just doing this again and then we'll know but to be honest if there were sperm i would be pg by now, so sure it's still azoospermia.

My dh's blood was fine, and everything else was fine if it's still azoospermia then it probably means dh was born with abnormal testis. Quite common apparently but you the first ppl i have met in this situation, other dh's have a reason due to mumps or cancer or something such like.

Hope to hear from you, let me know whats happening x x
 

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Hi Ipswichbabe and Debbie

My DH also has azoospermia, we don't know why as we chose to go with donor sperm rather than surgical investigations.

If you haven't already looked can I point you towards the Donor Sperm/Eggs section as there is a thread on there (on second page) called 'Should we have the SSR or go straight to DIUI' - several people have replied here giving various views and it is a worthwhile read.

All the best with whichever treatment route you chose!

Dawn
 

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Hi Debbie,

My DH is also Azoo. He has had 2 SSR's (TESE) to find sperm. We were lucky and found sperm each time.  However, all of our ICSI attempts using this sperm failed.

We don't know why my DH's cancer free testicle doesn't produce sperm in the ejaculate. It was an undescended testicle when he was a child and that may explain it.

My advice would be to find the best possible surgeon to carry this out if you decide to go ahead to SSR. Ask advice from other people and pay to go private if you can afford it.

We got much more usable sperm on our second attempt. It's bad enough doing a SSR once but twice...

If there is no hormonal reason for the lack of sperm (and the blood tests should have covered that) your DH may have a blockage or something similar that is easy to fix. Then you can try to have children with DIUI or ICSI.

It's such a personal choice but hearing how other people cope and come to their decisions has helped me.

If we had done DIUI at the start of this our child/children would be off to school now.

Hope that this helps.

With warmest regards,

 

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Hi

(DH speaking) I was diagnosed with the same condition originally and had the same operation as your husband is considering. They found the sperm after a biopsy. I was told they were expecting to find it with me as my chromosome test indicated that I only had a production problem (a microdeletion on the y chromosome).

I read an article about how vv low sperm counts could find enough for ICSI using a fresh sample and they agreed to test me for this.The operation turned out NOT to be needed after all as they found some (though vv few) in fresh samples later after looking for over an hour-  In the end it was reassuring for me to find out I did have some sperm even though it was poor quality. We have always worked on the basis that knowledge is power in this business- it also has helped us to come to terms with a LOT.

My advice would be to go ahead and get as much info as you can (try without operation first as this is invasive surgery and most azoospermic results are done in a rushed way- especially in NHS where you are just a number to the lab technicians.They are often wrong. They do not look hard enough!  I was diagnosed azoospermic on 3 separate tests.

After a long road of IVF treatment our chances were increased by using my brother's kindly donated sperm and we have now got a pregnancy using both donor eggs and sperm.

I also know a friend who had the operation and they did not find any but he had been diagnosed with a syndrome- Klinefelter's meaning they were not expecting to find any. (They now have a beautiful daughter using anonymous donated sperm) and are the proudest parents we know.



Dr Simon Fishel at Nottingham CARE has pioneered a method whereby they take three ejeculate samples or more given within a short space of time and spin the sample to concentrate the sperm to a drop- within that drop MOST samples have some sperm. I did not need this method to find any.

Good luck with all- I'd certainly be willing to discuss further
 

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Discussion Starter · #7 ·
Thankyou all for replying i really appreciate it been really depressed since we found out my DH has azoospermia. We found out in 2001 i was totally shocked in my head i thought how can there be no sperm. Then we went back to our GP in 2003 and tested again same result he wanted us to go to see a specialist then but we was too heart broken. It took me and my DH til June this year to go back to our GP and asked to be referred to a specialist. We saw a gynaecologist last week he checked my DH private parts said they are OK. Sent him to have a blood test. I have to have a HSG test did you all have to have this test? but i have to wait until April its a long wait. Well if we could wait 8 years i am sure we can wait until next year before trying.
Debbie
 

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Hi Debbie

I can sympsthise with what you are going thru as my DH and I have been thru it.  He was diagnosed as azoospermic nearly 3 years ago and in some way it made the disappointment of not being pregnant each month by trying naturally, a little easier to cope with and we learned to relax about it and went on the NHS waitinglist for ICSI.  My DH did have the operation to check his testes for sperm and although he does admit it wasn't very comfortable after the op, he is glad he did the op as we did get sperm and this means he does have the chance to be the biological father to his own child, something we are really glad about :)

I know that it is hard coming to terms with every thing but we are now in the middle of our 1st ICSI treatment and due to go into hospital in just over a week to have EC/ET and then who knows ???

What we do know is that if he had never had the op we would always have wondered if there were sperm...

Good luck to you whatever you decide ^reiki^ ^reiki^

Lynne ^Bubble Gum^
 

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Hi there

I could go on at length about the different types of azoospermia but the best place to read up on it is an australian site, it's very well presented and reasonably easy to understand.

http://www.andrologyaustralia.org/infertility/causes.htm

My DH had SSR and minimal discomfort, but it does vary from man to man and from diagnosis to diagnosis.

The most important thing is to have blood tests done as soon as possible as this will tell you the nature of his azoospermia, is it obstructive or non-obstructive? If it is obstructive (i.e. sperm being produced but can't get out), then you usually have a pretty good chance of retrieving sperm. Even with non-obstructive (which is what we are), there is still a good chance of finding sperm but it's very important to have a good surgeon doing this!

As PippaA's husband said, SA's can also vary, it has done for us from zero to a few thousand, so "azoospermia" as defined by an NHS lab is not the be all and end all. By "washing and spinning" the sample, fertility labs can usually in fact find enough sperm for ICSI.

I'm not sure why they sent you for an HSG to be honest. They don't normally do it unless you are looking at donor sperm (and therefore IUI). Your tubes aren't relevant when it comes to ICSI!

There are various girls on the Male Factor thread on the ICSI board who have azoospermia (or severe oligospermia). You aren't alone and there is still hope! The most important thing is to inform yourself as much as possible and you've made a great start by joining FF!

All best
 

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Hello

My DH and i found out we had male factor infertility about a year and a half ago when he was found to have a very low sperm count due to an undescended testicle. We were put on the NHS waiting list for fertility treatment and had our first appointment last July where DH was asked to provide another sample. When we went back for the follow up appointment a couple of weeks ago we were told that no sperm had been found in this sample so it looks very lightly that my DH also has azoospermia also.

We are both very disappointed about this and feeling very negative at the moment. We have been told that a biopsy may be an option as DH has a FSH level of 13 so there may be a blockage but DH is very scared about having this done and i hate the thought of him having to go through this especially as any sperm found would be frozen and as this appears to decrease the chances of success i cant help wondering if it would be worth while.

We are now having to wait two months for next appointment where we will be given results of another sample and blood tests one of which was the chromosome check. I am finding the wait between appointments very hard to deal with but looking at this site i have been amazed to see so many people in exactly the same position as us. It makes such a difference to know that there are other people you can talk to and learn from.

I have also been trying to find information about azoospermia on the web and came across a site which talks about a test being done on over 100 azoospermic men undergoing PESA or TESE. They have found that measuring the level of inhibin B in these men accurately predicts whether viable sperm will be found before having the operation. I was wondering if anyone else has heard of this. It would make such a difference if you could know before hand if sperm were lightly to be found. The address of this site is www.ivillage.co.uk if anyone is interested.

diesel

 

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Hi all,

I won't go into the details on Azoospermia as Claudine has covered it most informatively, well done Claudine as usual.  I am going to email you later.

All I wanted to say to Debbie and everyone else is if you are not totally sure on donor then please do not give in until you really have tried everything.

Debbie you need to get an appointment for your DH to see a good Urologist.  Go and see your GP and get him to sort it out for you.  At the moment you may be panicking more than need be.  The Urologist will be able to talk you through everything and establish where you go from here.  You really should try and see one as soon as possible or you will go crazy trying to sort things out yourself (I know I did).

I also wanted to let you all know that not everything along this IVF road is plain sailing or indeed Black & White.  My DH was diagnosed with Azoospermia a year ago now even though we were pregnant in 97 (sadly miscarried).  Our Urologist in Cardiff told us simply to give up so we went to London where the Urologist there carried out a 15min Tese procedure but sadly found no sperm.  We were ready to give up but then started to come across lots of info on Cornell's in New York and their Dr Schlegel who had found sperm in men where no other Doctor could (Diesel ivillage was one of the sites).  We went out there to see this guy in June and the treatment in New York is amazing compared to here in the UK and they found that my DH has Varicoles where it was not found here in the UK.  Also they found my DH had extremely low Testosterone levels and after he has been on Clomid with them for 2 months his level has risen right up.

We are now going back out there in Nov/Dec for Microdisection Tese with them which takes about 2 hours and hopefully the Doctor will find some sperm but if not then I truly feel like I have gone to the best and will be at ease with Donor because I would have eliminated all my 'what ifs'.

Sorry to go on and I am not advising people to travel half way across the world but all I am saying is make sure you have done all you can as I know the 'what ifs' can sometimes be just as hard as dealing with this IVF nightmare.

Hope I have helped.

Lol and luck to everyone.

Fin xxx
 

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Hi Diesel

With your man's FSH level being slightly elevated, it may be that he is non-obstructive.  If there was sperm before, it may be that it will come back again.  I know waiting for the appointments can drive you crazy.  All I can say is that we tried to use the time in between to best advantage.  Lots of sleep, vits, healthy food, cutting back on alcohol and regular ^hump^ seemed to improve things.  Interestingly (and distressingly) the zero samples we had seemed to coincide with periods of high stress for my DH.

Equally, believe me when I say that I know how desperate and distressed you are feeling.  We are only now just getting to grips with this diagnosis and what our real options are (and that's after 3 cycles!).  You just have to keep chipping away at this mountain, day by day, but it has certainly helped me to talk to others who are also facing the mountain or who've climbed it and can shout down tips and shortcuts!

Like Fin, we are going to Cornell.  The site, www.maleinfertility.org, is extremely useful.  It contains a good amount of information, particularly on azoospermia.

I've heard about the Inhibin B study but have put myself in hands of urologist at Cornell who hasn't mentioned testing for it.  Studies I've read seem to always find someone who doesn't fit the pattern, there doesn't seem to be an absolute indicator for success.

Will have another read of your study though and see if I can come up with a more helpful comment than the one I've just given!
 

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This is all very interesting, it's amazing how many ppl (men) suffer with azoospermia. i am pleased we aren't alone, although it feels that way. Sadly.

anyway, diesel not heard of that b4, that would b ideal for dh as he's not wanting the op at all, We have pretty much decided that donor is our only way.....
 

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I have had a look at the ivillage article and also at Midlands Fertility Services who are supposed to be offering this test. It doesn't say how old this article is. I didn't see anything on MFS's site that indicates they still offer this test so I'm a bit concerned that this might be out of date.

What WAS impressive about MFS was their publication of stats for ICSI with MESA/PESA, i.e. they isolated their success rates for infertile as opposed to subfertile men and their partners.

I have found a recent study (2002) that states Inhibin B can't be used predictively in non-obstructive azoospermia. http://humrep.oxfordjournals.org/cgi/content/abstract/17/4/971
I've read up a lot myself on azoospermia, and in particular the chances of successfully retrieving sperm, when we were told that the chances of finding sperm (this is after one successful retrieval!!!) was 20%. I didn't believe them needless to say and they have since changed the diagnosis.

I haven't come across anything that DOES accurately predict whether or not they'll find sperm, but I do know that they can guess at your chances depending on the diagnosis. It is unusual not to find sperm if it is obstructive. And even with non-obstructive, you can still be lucky with retrieval, we were and we know of at least 2 babies on this site born to men with this diagnosis.

Saying that, Diesel, our first cycle used frozen sperm and it was a disaster. If I'd read the article you have clearly read before we started I'd have insisted on having a side-by-side. Too late now!

Ipswichbabe - Only you and your partner can decide whether it's worth the op to find out... If you are happy to go donor then you are taking one very quick route to getting your family and that's great! It will certainly save the time you spend in limbo that DH and I are still inhabiting!

As for how many of us there are, I understand that at least 1-2% of the male population is azoospermic. That's a lot of infertility. Not surprisingly we don't hear much about it - a lot of people don't want to discuss it! And a lot of people don't want others to know they have gone the donor route.

I was on a US message board today and heard that Tom Arnold has "gone public" in an interview in People Magazine - he and his second wife have been through 4-5 rounds of ICSI due to low sperm count, all have failed. He's said they are considering donor. Good on him!
 

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Hi Claudine

Thank's for your advice and for taking the time to look at the article about Inhibin B you really do seem to have wealth of knowledge on the whole azoospermia subject. I did have the feeling that this Inhibin B test might be to good to be true otherwise all men with this condition would be having it done but at least it is something else to think about. I have also had a quick look at the male infertility site you mentioned which seems very informative. I will be looking at this in more detail when i have more time.

I seem to be spending every spare minute I have at the moment either reading posts on this site or looking for more information which is beginning to drive my DH mad as he seems to prefer to do things that take his mind off our problems.

Diesel
 

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Hey Diesel

I know what you mean about spending hours glued to the PC.  I was going to say that it's a male/female thing, but actually I can think of a few guys who have been on this site, one in particular, who did in fact do a huge amount of research into his diagnosis and IVF/ICSI.  So maybe it's just that in a couple, there is one more likely to want to find out as much as possible when the other prefers to leave it to the experts and distract him/herself in the meantime.  No guessing which half of the couple I am!

Saying that, DH keeps me grounded and it's a good job he doesn't get himself quite as worked up as I do or we'd be in a right mess!

It occurred to me last night that I didn't tell you that we managed to get funding for our first ICSI cycle (which included DH's SSR) and it was organised within a couple of months.  We were lucky I think that our PCT had some money, but I do also think that because there was a specific cause for our infertility, we were prime candidates.  Basically GP sent off a form stating that we were married, under 40, no other children etc to N Warwicks PCT.  I called up about a month later and was told that we'd got the money.  Normally they worked with clinics in their region, but because we'd already got so far down the line with B'ham Womens, they would arrange for our funding to go there.

So nag your GP, and research your options and what can give you the best chances of success.
 

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hi everyone

Diesel - Claudine is becoming our resident expert on azoospermia!  ;D

haven't read everyone's posts in detail, but would like to put in my two pennies worth in case  they are helpful to anyone, especially Debbie.

My DH also has non-obstructive azoospermia, they are not able to tell us why. His natural sample for semen analysis showed absolutely no sperm, but on TESE they were able to retrerive about 10 sperm...only a very small amount, but it was sufficient to get us through an ICSI cycle and as far as embryo transfer. Therefore, my instinct is to say say if your DH can possibley face it, its worth a try. But I do very much sympathise with that terrible fear and dread of finding nothing.

Also, another chap who used FF was in the same boat as my DH...i.e no sperm in sample, and single figures on TESE, and his DW got a BFP their first ICSI! So there is hope!

I know that there are different kinds of azoospermia, and that everyone's situation is slightly different, but don't give up the fight without asking more questions. It's all so horribly technical thoough isn;t it! I often feel a bit lost when I start reading about all the hundreds of research papers and the wealth of information out there.

Good luck to everyone however you proceed. If you feel alone, come and join ous on the ICSI Board in the Male Factor ICSI thread.

Sending solidarity hugs all round.
^reiki^ ^reiki^ ^reiki^
 

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Claudine - I didn't realise you managed to get funding for your first ICSI. When you say you think it was because you have a specific reason for the IF, do you mean DH's azoospermia?  We told we weren' eligible BECAUSE of DH's azoospermia. Also, did you end up on an interminable NHS waiting list?

Bit concerned that we may have been misled, and that if our finances run out we may not be eligible for funding in future because we have funded our first 3 cycles ourselves.
 

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By the way, regarding TESE,  I forgot to say that in our case it definately seemed to make a difference if the surgeon/andrologist was prepared to incubate the samples he took.

DH's first TESE appeared to retreive nothing, but the samples extracted surgically were incubated overnight, and they found enough sperm for ICSI, whereas his 2nd TESE was not incubated, and they found nothing. 

 

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Dear Diesel
(DH, Mark here)
My experience is: I had 3 'zero samples' from an NHS lab, one 'only dead sperm' found in a private test (good news because if they are dead they must have been alive) and then had an unnecessary operation to retrieve sperm surgically. I asked our embryologist to try a fresh sample on one of our IVF attempts and after really looking hard for it she found enough for ICSI- in a lab test you are just a number- I don;t know if they realise the devastating effect a zero result can have. It jsut means that THEY didn;t look hard enough to find it. I have noticed that this is not an isolated experience (from this board and elsewhere) In the past (pre-ICSI) they were right very few sperm meant a zero chance of conception , even with IVF. Now of course only a few are needed. If your DH has only slightly elevated FSH the chances are that there are sperm there- if you can get anyone to look long enough to find it- contact Fishel at Nottingham CARE- he is the leader in this area. Don't just believe the doctors who tell you you need an operation- I wish I hadn't. 
All the very best
Mark
 
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