Azoospermia - what are my next steps?!

[Ginny27]

Hi everyone,

I'm looking for some advice from anyone who has been in my position

My husband has azoospermia (non-obstructive but with no identified cause) and we finally had our first meeting with the assisted conception unit at Guys yesterday.

We always knew that surgical sperm retrieval (ssr) was going to be our next step, but yesterday the consultant said that he would have to have a varicocele emoblized before we have the ssr. Does anyone have any experience of this and was it successful?

I'd also be interested to know if anyone had either of these procedures on the NHS? It does seem possible, but I'm wondering if I can be patient enough to wait!

Any help you can give me would be great X

[Italy300618]

Hi Ginny, my husband also has azoospermia, but obstructive due to being a cf gene carrier. He had SSR back in may of last year, it was a very positive outcome with 5 vials collected and frozen.

He says the procedure isn't so bad, you are sedated and you dont feel anything it's just afterwards he would definitely recommend tight pants as things can be sore for a few days 😂

We have yet to have a successful icsi. But we will be going onto round 3 soon.

One thing to mention might be whether it's worth doing a fresh transfer may be more beneficial, so same day as your egg collection.

We were originally told that fresh would be better then they changed their minds as there could have been a chance they wouldn't find sperm there.

When we have round 3 even though we have 3 vials left of frozen left we will be doing a fresh ssr.

Hope this helps, best of luck to you, let me know if I can help any further xx

[Ginny27 in reply to Italy300618]

That's really helpful thank you

That's interesting re fresh round, I had assumed, if the extraction was successful, that our only option would be frozen. Do you mind me asking, did you have that done with the NHS? And if so, did it take long? I'm just so impatient at this point!

I have my fingers crossed for you on round 3 xx

[Italy300618 in reply to Ginny27]

It's worth just asking the question, they may not do a fresh retrieval they may only do frozen but see what they say. We had our consultation in the February and my husband has his ssr in the may. Then I really had to chase them, it was then August until we started ivf. I was so impatient, it will all depend on the area. Some areas are so quick, some you really have to be on their backs.

Thank you, wishing you all the best xx

[Hidden]

Hi Ginny, my partner has obstructive azoospermia. Meaning in our case there is a blockage, we had to go private with this and we had a procedure called TURED (trans urethral obstruction of the ejaculatory duct) as the NHS had no funding For it and it was something our GP would have to drive forward which he didn’t. It would have taken aaaages. They found the cause of the blockage and we’re able to unblock one tube, however there was still no sperm present in the ejaculate 😢 I’m glad we explored this option as it has provided closure knowing we will never be able to conceive naturally. It took a lot of research and consultations with a couple of andrologists. There are people out there that have success with this, just unfortunately not us. However, surgical sperm retrieval using ICSI was a success and we now have a 7month old son. I wish you all the best on your journey and if u have any questions PM me. Xxx

[Ginny27 in reply to Hidden]

Thanks Maggie

You were definitely right to try to see if you could conceive naturally, wouldn't that just be great! Our main issue is there there is no apparent cause for my husband's azoospermia - and I'm in the very same position as you, my GP seems to know very little about it and hasn't helped us push for things to happen! Anyway, it's great to hear a SSR success story, massive congratulations XX

[Hidden in reply to Ginny27]

Unfortunately male infertility is something that is not really explored on the NHS and you really have to do your research. Some NHS IVF clinics do have an andrologist specialist and it may be worth exploring. I have heard many success stories with both obstructive and non-obstructive so u have plenty of options. SSR is done under general anaesthetic so partner was unaware of any goings on down there. Lol. Wishing u all the success! Xxx

[Cheles in reply to Hidden]

This gives me hope.My DH has unexplained azoospermia.They retrieved the vials surgically and I am currently on my 1st cycle hoping for egg retrival and icsi next week.Glad that yours went on well,hoping ours will be successful as well.

[Hidden]

We had a varicocele removed and it improved the quality of the sperm within a few months - reduced DNA fragmentation by 10% which helps massively. It’s an easy procedure and recommended you remove it three months before IVF as it will make sure you get better sperm x

[Ginny27 in reply to Hidden]

Thanks for letting me know Anna, it can be so confusing - I had realised it was an option for us! We dont have any sperm at the moment, so can't have a fragmentation test

I hate the idea of three months more waiting, but then I hate the idea of even one month of waiting!

Thanks for the info XX

[Stephybivf]

Hi Ginny, my husband had non obstructive azospermia and unsure why, all genetic/hormone tests where normal. However I will say there is very little information regarding this issue. His GP just basically told him he will never have his own biological children. Once we where referred to the specialist andrologist things got moving pretty fast and he had successful SSR on the NHS.

Unfortunately our first round was unsuccessful due to my eggs being too immature, so nothing fertilised. However, second round was much better with a tweak with meds and supplements and now I’m 35 weeks pregnant with our little girl so it can happen xx the operation itself was done under general and he had very little pain post op. Wishing you all the best x

[Ginny27 in reply to Stephybivf]

Thanks for all of that info Stephy, and massive congratulations, how nice to hear a success story. I am particularly interested since your husband had no known cause either, it's baffling isnt it!

Good to hear that things moved fast for you, and my husband will be glad to hear that the op was not too painful. Best of luck with the rest of the rest of your pregnancy XX

[Cici85]

Hi Ginny , my partner had non obstructive azoospermia, all test came back normals, no reason for d diagnosis. He had SSR done in November n got 9 vials frozen.

I am on my first ICSI cycle and ET is in two days. Got 15eggs , 11 mature and 6 fertilised.

I don’t think the waiting is that long once you get a date, my partner was ok after 2days and went back to work .

Wishing you all the best.xx

[Ginny27 in reply to Cici85]

Hi Cici, thanks for letting me know, it's amazing to get 9 vials - especially since you had no reason, we are in the same boat, I would just love to know the cause!

Very best of luck with your ET and thanks again for your info. XX

[MrsBlu]

Hi. My husband had varicocele embolization due to low sperm (count was around 7 mil although at lowest was 0.8 mil). Aside from fertility issues, it was causing him some discomfort so was treated on nhs. 3 months after embolization, count was 24 mil so can improve things significantly for quite a quick and simple procedure. Our fertility Dr was quite shocked with improvement in such a short time. Husband had to pop into hospital for a couple of hours and literally came out with a plaster on his neck... No pain at all. We did still end up doing IVF/ICSI however as antibodies detected in sperm ( believed to be result of multiple hernia ops) and just started FET after negative first fresh cycle last year. Good luck what ever way it goes for you and your partner x

[Hidden in reply to MrsBlu]

Hi MrsBlu, just wanted to ask if your husband is taking any vitamin supplements? And if so, what is he taking? My husband also had embolization but his count hardly improved! But after the surgery he had complications with swelling which took couple of weeks to settle. Good luck with your FET.

[MrsBlu in reply to Hidden]

Thanks He took a general TTC multi vitamin and took co Enzyme Q10 for a short while but that's about it. I also had him eating fresh fish and Brazil nuts. Think it's easy to get sucked in to taking so much and you can spend a fortune and not know if it's going to work. I read quite a lot about sperm after embolization and how it can take up to a year to see improvement but of course not the same for everyone and sorry to hear that it didn't really improve for your husband. Hopefully there might be some improvement yet to come. Either way, the improvement for us didn't really help with our overall goal as the treatment plan didn't change and still did IVF/ICSI but at least my husband is a bit more comfortable now. Wishing you the best of luck on your TTC journey x

[Hidden in reply to MrsBlu]

Yeah true, he has put on lots of weight since which doesn’t help. He did go for sperm freezing too cz they are concerned about his count getting less. Thank you 😊

[Ginny27 in reply to MrsBlu]

Thanks Mrs Blu, that's quite reassuring. Best of luck with your FET xx.

It's interesting too about the supplements, my husband was advised to take proxeed, which he is doing. It's really pricey though, about 80 pounds a month. I can't help but wonder if it will make any difference, but I suppose I'll do anything!

Thanks again x