Ejaculated sperm vs tese sperm. Any experiences?

[Jessy1280]

Does anyone have experience of doing icsi cycles with ejaculated sperm without success only to then move forward and try tese sperm? Did you have a better outcome eg fertilisation rate or embryo quality?

Dr jonathan ramsey says the likely problem is a partial blockage following VR causing fluctuatating count and motility. His suggestion is tese. He says that if there is a partial blockage then sperm is getting stuck and deteriorating in transit by the time it's finally ejaculated. My new ivf clinic agree.

Now I've read lots of studies suggesting no difference in fertilisation rate but significant improvement in LBR compared to ejaculated sperm.

Just wondering if anyone has any personal experience?

[Peony85]

Hi Jessy, we did TESE with Ramsay after 3 failed cycles (1 nothing to transfer; 2x BFN; 1 MMC). Our reason was DNA fragmentation. The cycle ended up being a disaster (nothing to transfer) which was attributed to poor egg quality (in review, it was clearly worse egg quality than other cycles for some unknown reason, which you could tell from the day 3 grades / cells). We then did a 5th cycle where we went from short to long, added HGH, and used the frozen testicular sperm from the TESE. We still have one epidydimal sample frozen but the testicular seemed to be a lot better which is why we started with it. This last cycle gave us 2 to transfer and 1 to freeze. Of the 2 transferred, one took and was measuring right on target at 7w 1d with a strong HB. Far better result than the MMC where we did see a HB but it was measuring 11 days behind so didn’t have much hope. So it’s still early days but I think the testicular sperm did help once we sorted out my egg quality on the last one, as we had the best % continue from day 3 to 5.

After the disastrous 4th cycle we saw another clinic and the medical director kind of rolled his eyes about Ramsay, saying he thinks he cuts men open too early / without good enough reason and it can be solved by IMSI. Everyone seems to have a different opinion for this, but I think it has helped us.

There were some things I didn’t know about testicular sperm which I wish I had... it is fragile and doesn’t always thaw well (ours had to get a special additive put in to wake it up since the thawed sample didn’t have any motility at first). The fresh testicular is so much better and so if you have any questions about egg quality best to try to improve so you have the best chance with the fresh stuff. That’s why we used HGH on round 5. I had a feeling the stimming phase on cycle 4 wasn’t going that well and kept going and I wish I had abandoned and tried again on a new cycle. Also we had the lowest fertilization we’ve ever had with it which is apparently normal for testicular sperm and they are happy with >50% but I was shocked as before this we were at 90%+. Also the recovery is more painful and takes more time than what Ramsay alluded to.

Happy to answer any questions you have about it. Best of luck xx

[Jessy1280 in reply to Peony85]

Thank you for your detailed response. Weve done imsi twice and it sadly hasn't helped. I feel so overwhelmed by it all and clutching at straws with tese sperm. As this is my last cycle I'm scared of these new things were trying x