Male factor / Azoospermia - which route to take?

[NCS88]

Hi all, after the shock of my husband’s first zero count semen analysis a month ago I think I’m finally beginning to turn a corner and look to the future to (hopefully) diagnosing the issue and investigating our options to fingers crossed have a child one day - one way or another. He has his second analysis test next week, the results of which we will get probably in another weeks time. Since the first result we have been on a rollercoaster of emotions and feel the lack of factual information / moving forward with any speed with tests is making it hard to deal with. I struggle with anxiety so have tried to take some positive steps so I feel like I’m doing something.

We have put some of your recommendations into place in terms of lifestyle (reduce alcohol, caffeine, supplements, loose boxers) but with zero sperm seen we are not sure how much of an affect this will have but we are willing to try anything at this stage!

In terms of evaluation / treatment options so far we have:

1. Been to the GP who has referred us to local hospital for fertility assessment (via gynaecology). I have to do some routine testing/screening before they will give us an appointment.

2. Husband has had male hormone panel done which came back all within normal range (albeit we haven’t seen a professional to look at this in depth) - this didn’t really give us any answers

3. Self referred for a CBT/ talking therapy for myself as I struggle with anxiety and feel this will help me cope.

4. Booked an initial ‘chat’ with a local fertility clinic at their open evening next week.

My question to others that have faced this challenge is how did you go about investigating or moving forward from this? Did you wait for the NHS to do their thing / go through the local hospital infertility service or go to a local private clinic? Or is there any benefit with seeking out a private urologist or andrologist (at our cost) for a faster investigation?

The waiting for answers is the hardest part as we feel a bit lost.

Thank you to those who took time to reply before, it means a lot.

X

Ps sorry it’s a long post!

[Hopeful2019]

Hi, my partner has azoospermia (zero sperm count) both samples showed zero sperm. It could be either obstructive or non obstructive. All his genetic tests etc came back fine. We waited 6 mths on NHS for Microtese op and he took Proxceed for those 6 months. Luckily they found sperm. We had 2 rounds of ICSI but sadly both rounds failed for us. We too have been on a rollercoaster journey. Gutted he had zero sperm, excited they found some, gutted first round failed, hopeful for 2nd round and then gutted again when that failed too. This journey is just plain crap. We were trying for 12 months and i burst into tears when he was told he had zero sperm. Im now considering embryo donation as I'm now 41 so my eggs are poor quality. X

[NCS88 in reply to Hopeful2019]

Sorry to hear this and thank you for your reply. Thinking of you too. X

[Jenifer99 in reply to Hopeful2019]

You not alone, messages here keeps me going as we are both in a similar position and am also considering donation on both. Best wishes to us all and may our dream come true xx

[Nobabyyet]

Hi. Oh so sorry to hear this. It must be devastating for you both. I only found out in nov that my husband and i both have issues and its been a lot to take in. My husband had semen analysis on nhs but We wouldnt have found out about my issues for ages if we handnt paid for private fertility test. I'm glad we did that part so we know. It was about 500 pounds but the price of icsi they quoted is a lot lot more so been doing lots of research. Acupunture and maya massage may help if you want to look into it (if u havent already). Zinc selenium etc supplements but im ordering strong versions online. He has some mobile sperm so icsi is an option. Its my low amh levels that make our issue a little more tricky. I was sceptical about acupuncture but a few sessions have def gave me heavier periods so it does do something and they say its beneficial for males too. If ur going to try go to a practicioner that provides herbs as well. As for maya massage we havent tried yet so cant comment but has good reviews online. I really hope you have some success. It helps me to know we are doing all we can and focus on that and research but its not easy to block out the cycles of anger and sadness about the "why me/us" and your poor husband must have so many feelings of guilt and letting you down i cant imagine. It was the only good thing about us both having issues that we didnt have to deal with that one sided responsibility. Look after your relationship as its the best thing you can do for that little one that will hopefully be in your future. Sending you happy thoughts.x

[NCS88 in reply to Nobabyyet]

Thank you for your reply I will have a research into these tomorrow xx

[Gillyc1]

My daughters husband had azoodpermia due to blocked tubes because he is a cf carrier. After 2 tests at the go he was then referred to a urologist. He was then referred to the fertility clinic. There, he had his sperm surgically removed .To cut a long story short, they have a little boy who is 3 next month and she had her second little boy a week ago. Don’t loose hope. Do your research and be armed with info. Dreams do happen xxxx

[NCS88 in reply to Gillyc1]

Thank you for the advice and hope. We will do xx

[Lynnr54 in reply to Gillyc1]

Can bring a CF carrier give men blocked tubes? I had no idea. I’ve recently found out that I’m a carrier and have passed the gene onto my son. I know it’s many years away yet, but if he could have sperm issues then I need to make him aware down the line. The specialist who came to see us to talk to us about it said that being a carrier shouldn’t impact him, but when he was ready to have children his partner would need to be checked to make sure she wasn’t also a carrier.

[Gillyc1 in reply to Lynnr54]

Well that was the reason for my son in laws infertility but obviously it doesn’t happen all the time or no one would have cf. He was just unlucky xx

[Lynnr54 in reply to Gillyc1]

Definitely worth being aware of. I wish we’d been told that when they came to tell us my son was a carrier. Thanks.

[God_daught in reply to Gillyc1]

Having sperm surgically removed from the groin area was one solution put forward by Barts, when my husband results kept coming up with 0 sperm.

[LKT1]

Hi I know how you feel. My husband also had zero count. We went via nhs and they were brilliant. He had first test at GP and I had the day 3 and day 21 blood tests to check for ovulation. When his results were zero they referred us to the clinic straight away.

We both had more blood tests at the clinic. I know you want answers from his genetic blood test but for us his came back normal so there are not always answers to be found from that test.My husband then had the microtees surgery to see if there was a blockage. Sadly he never developed the tubes where sperm are produced which is really rare. This was difficult as he had never had any health issues before so was so unexpected.

We decided to use a sperm donor and had a councillinh session and chose our donor. We are doing our first round of ivf and have our fingers and toes crossed. I personally am really happy with the service we received, which fortunately was covered by nhs. I assume it maybe a bit quicker privately but It would have cost £7000 a try. We may still need to put our money in for subsequent rounds but I can’t imagine us being able to afford multiple rounds.

In terms of staying calm I have just tried to get on with my life. Sometimes this is easier said than done but I force myself out to see people at weekends. I have also focussed on Gentle excercise, eating healthy and cutting out caffeine so I feel confident that when it came to ivf that I know I have done my best.

Wishing you all the best whatever you decide to do xx

[Refocus]

Hello, I don't have any experience with azoospermia but we were recently referred to a urologist by our fertility clinic due to my husbands abnormal sperm DNA fragmentation results. We had the appointment a few days ago and it's the first time we've had real confidence in a doctor, he spoke real stats and figures with us and really knows his stuff. Not only were we booked in a week after being referred but he sent my husband unexpectedly straight away to get some tests done and we go back for the results in two weeks. All of this is done privately. So my point is, although it was very expensive, it reduces anxiety of waiting and hopefully he's actually going to give us answers or at the very least a lot more facts to go on, which will save us money from more failed icsi/donor gamete attempts down the line. Best of luck, it's such an awful position to be in. Xxx

[aamiller405]

Hi.. we also found out my husband had azoospermia.. that was around the middle of 2016 I think.

We stayed with the NHS right up to November 2018 but at this point we were no further forward... basically just spent all that time on different waiting lists.

We went private in November 2018, my husband had a successful surgical sperm retrieval in December and we are due to start our 1st ICSI cycle at the end of this month.

The waiting on the NHS really got to me, I was miserable, breaking down in tears all the time. Since going private and getting things moving im so much happier.

But it will depend where you live how quickly the NHS will move along so I hope youre in an area that is a lot faster than ours xo

[Suzannah1985]

Hi,

My husband also has azoospermia and we followed the NHS route. He had his second semen analysis in March 2015 and ended up having open sperm retrieval in November 2015.

We didn’t have our first round of ICSI until December 2016, but our referral was done incorrectly by our GP, there were 2 issues, once my husband had the retrieval we were referred to the wrong clinic which wouldn’t be funded by our CCG, so we lost six months due to that, secondly and most importantly, we should have been referred for IVF as soon as the azoospermia diagnosis was confirmed.

I only mention the above to hopefully prevent others from facing the same issues, best thing I did was have a conversation with someone at the CCG who helped to point me in the right direction.

Whether to stick with the NHS or privately fund is a personal decision, for me it would depend on how many funded rounds you would be entitled to through the NHS, and most importantly the financial side. Our NHS treatment was actually carried out at a private clinic as our local hospital can’t provide those services, so although the initial wait was frustrating, once we were with the clinic, things moved very quickly. It might be worth trying to find out waiting times and where the procedures would take place before making a decision.

The other thing to check is how many private rounds you can have before you lose you entitlement to NHS treatment. In some instances you can privately fund some, might be something to consider.

Sorry for the long ramble!!

Suzannah x

[NCS88 in reply to Suzannah1985]

Thanks Suzannah I was going to reach out to you following your reply to my last post. Thanks for the advice, it is very helpful. X

[Suzannah1985 in reply to NCS88]

Anytime 😊

More than happy for you to pm me if you have any questions xx

[NCS88]

Hi ladies thank you again for your support and replies on this. After a 2nd zero count from the GP and no useful advice other than wait for the clinic, and even a hesitation to refer to urologist (!!) we decided to take matters into our own hands and had an appointment with Jonathan Ramsay in London who after examination and medical history, is confident my husband had CBAVD. Genetic bloods and AMH have been taken as well as a scan to confirm this diagnosis. Now I will share this info with the nhs team and see if they will refer us if we qualify. Thank you all

Again ❤️❤️

[Cinderella5 in reply to NCS88]

Glad to hear that you are getting somewhere now! Wishing you all the best.xx