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Original poster

Varicocele treatment or straight to IVF/ICSI?

98 replies

HayMay · 19/08/2022 19:19

Hello,

Just wondered If any of you had partners who have seen a dramatic increase in SA results following treatment of a varicocele? My partner has had an ultrasound today and they measured one to be 3mm ish and I think he had a small one in the right side too. Mr Ramsay suggested IVF/ICSI and maybe a varicocele treatment but did imply it’s unlikely to get the numbers up to where they need to be for natural pregnancy but that it would help with ICSI nonetheless.

It came as a bit of a surprise: so trying to process it mentally and not sure where to go next.. I’ve not researched ICSI properly yet as we always hoped the anastrazole would help and whilst there has been a small increase, it’s nothing massive. He has been prescribed 3 months more and to take one every day from now. His total motile sperm count is c2m. Morphology and count really low, motility ok.

Just can’t decide whether a varicocele treatment could help us get pregnant naturally or if I’m just holding on to hope and it would be a waste of money so might as well head straight for ICSI?? Feel so flat. Any advice welcomed! Thank you xx

OP posts:
MoreTeaLessCoffee · 19/08/2022 19:28

We went down the ICSI route, we felt we'd been trying long enough at that point to faff around with a treatment with a fairly low likelihood of success. Ivf has a good success rate for this type of problem, unless there is something else going on you don't know about, there's a good chance of it working. Having said that our first cycle was a failure because my meds weren't quite at the right level, the consultant corrected it second time around and we got our baby. Crossing fingers for you.

TimetoChangeClinics · 19/08/2022 19:28

Hi OP,

Has your partner had a DNA fragmentation test? Just on the basis of our experience, I would really recommend getting the varicocele treated to make sure you have the best possible chance of success with ICSI. We didn't realise that my husband had any sperm quality issues until our first IVF cycle, where all our embryos arrested before blastocyst stage. We then did a DNA fragmentation test which revealed very high levels of DNA fragmentation that were in part caused by a varicocele, explaining why the embryos couldn't develop. Ultimately, ICSI overcomes fertilisation issues but can't compensate for sperm quality.

Summerdays90 · 19/08/2022 19:31

TimetoChangeClinics · 19/08/2022 19:28

Hi OP,

Has your partner had a DNA fragmentation test? Just on the basis of our experience, I would really recommend getting the varicocele treated to make sure you have the best possible chance of success with ICSI. We didn't realise that my husband had any sperm quality issues until our first IVF cycle, where all our embryos arrested before blastocyst stage. We then did a DNA fragmentation test which revealed very high levels of DNA fragmentation that were in part caused by a varicocele, explaining why the embryos couldn't develop. Ultimately, ICSI overcomes fertilisation issues but can't compensate for sperm quality.

Thanks for this.

Mr Ramsay suggested maybe doing a cycle of ICSI and then doing the varicocele if that didn't work along with a dna frag test. My head is scrambled today, I just wasn't expecting it.

I probably need some time to process it. How do you overcome these feelings!

Xx

Summerdays90 · 19/08/2022 19:34

MoreTeaLessCoffee · 19/08/2022 19:28

We went down the ICSI route, we felt we'd been trying long enough at that point to faff around with a treatment with a fairly low likelihood of success. Ivf has a good success rate for this type of problem, unless there is something else going on you don't know about, there's a good chance of it working. Having said that our first cycle was a failure because my meds weren't quite at the right level, the consultant corrected it second time around and we got our baby. Crossing fingers for you.

Thank you. Yes I know what you mean. I'm sort of at this point having already spent a lot on consultations and tests with Mr Ramsay after getting nowhere sadly with the NHS. It's all £££ isn't it. Really don't know what to do! I think I'm holding out hope for a miracle and that sorting the varicocele will help us conceive but I know that is very unlikely so probably just feeling a little raw and need to process the news.

Mr Ramsay said it will feel like a loss being told this.. and it does. I feel all sorts of ways! xx

daisyrosebuttercup · 02/09/2022 07:53

My husband had a very very low count and had a varicocele in both sides but bigger on the one side. He eventually had the embolisation and his count increased dramatically 0.3 to 10 mill (still much lower than normal levels but vast improvement on what it was). We're now waiting for genetics tests to come back as they won't let us start ICSI without them.

Hithere22 · 03/09/2022 19:13

daisyrosebuttercup · 02/09/2022 07:53

My husband had a very very low count and had a varicocele in both sides but bigger on the one side. He eventually had the embolisation and his count increased dramatically 0.3 to 10 mill (still much lower than normal levels but vast improvement on what it was). We're now waiting for genetics tests to come back as they won't let us start ICSI without them.

Thanks for responding, that's really helpful. Would you be IUI candidates with your numbers currently? Best wishes for your journey x

Do you know what size your husbands varicoceles were? My partner is 3.3mm on the left (moderate to severe) and 2mm on the right (mild)

Thanks again!
X

JeanieJ · 07/09/2022 08:11

Hi OP👋🏻

Are you with Dr Ramsay?

We just had our follow up appt with Dr Ramsay & my OH has a very large varicocele (5mm), that he's recommended we get embolised before trying ICSI.

Bit of background - ttc for 2+ years - 'unexplained infertility', was just about to do a round of IVF (NHS funded) when we fell pregnant, but had an MC at 11 weeks.

Decided to do that DNA frag test before trying an IVF cycle & OH had awful results ... the embryologist said she didn't even think ICSI would work, and we were a high risk for more miscarriages.

So, we knew OH had a varicocele but we didn't know if it was big or not and our doctors didn't think it was a big deal 🤷🏻

Went to Dr Ramsay & OH got all the tests done & he's clear everywhere else, except varicocele is v large, so next step is to get the embolisation, as he believes it's the cause of his high dna frag.

Dr Ramsay is confident we could conceive naturally within 6 month, but said we'd be in a good place to try ICSI in 3/4 months.

It's totally up to you what you do. Is your cycle funded? The embolisation is ££ and it's hard to get it on the NHS.

My fertility clinic think I should just try the funded ICSI cycle before spending money on my husband, but we're terrified of another miscarriage, so we're using our savings to get it sorted.

xx

Hithere22 · 07/09/2022 10:04

JeanieJ · 07/09/2022 08:11

Hi OP👋🏻

Are you with Dr Ramsay?

We just had our follow up appt with Dr Ramsay & my OH has a very large varicocele (5mm), that he's recommended we get embolised before trying ICSI.

Bit of background - ttc for 2+ years - 'unexplained infertility', was just about to do a round of IVF (NHS funded) when we fell pregnant, but had an MC at 11 weeks.

Decided to do that DNA frag test before trying an IVF cycle & OH had awful results ... the embryologist said she didn't even think ICSI would work, and we were a high risk for more miscarriages.

So, we knew OH had a varicocele but we didn't know if it was big or not and our doctors didn't think it was a big deal 🤷🏻

Went to Dr Ramsay & OH got all the tests done & he's clear everywhere else, except varicocele is v large, so next step is to get the embolisation, as he believes it's the cause of his high dna frag.

Dr Ramsay is confident we could conceive naturally within 6 month, but said we'd be in a good place to try ICSI in 3/4 months.

It's totally up to you what you do. Is your cycle funded? The embolisation is ££ and it's hard to get it on the NHS.

My fertility clinic think I should just try the funded ICSI cycle before spending money on my husband, but we're terrified of another miscarriage, so we're using our savings to get it sorted.

xx

Hi.

Yes we have been to see Mr R too! What a lovely guy.

My partner has terrible results in terms of count and morphology - motility not too bad. But only had about 1.1m motile sperm in total.

Mr R recommended that if no money was no object that we would do the varicocele and ICSI.. I don't think he believed the varicocele would make too much impact in terms of helping us get pregnant without assistance but he said that we would be good candidates for ICSI and therefore he was recommending that route because of time. Does your husband/partner have good semen numbers otherwise?

We would be eligible for NHS funding if I lost 3 stone... so we've decided to get the varicocele treated whilst I lose weight and then hopefully either way the varicocele embolisation would help with ICSI numbers and we would be eligible for funding...

My partner has been back to the GP (who unfortunately has been useless) to say he's had some pain... he's now been referred for an ultrasound on Sunday and he only went to the doctors last week - so we are going to see if it's something he can get done on the NHS And not mention fertility... (I'll keep you updated). It's frustrating that so little is done for mens fertility isn't it? Sorry you're going through this.

Xx

JeanieJ · 07/09/2022 13:04

Hi @Hithere22

So my husband has normal levels elsewhere - it's just very high DNA frag.

That's why we were 'unexplained' for so long. We didn't even know what a varicocele was until we listened to a fertility podcast one day and OH was like 'oh, I have that' 🤷🏻. That raised some alarm bells & then when we lost the baby, we knew we had to get the DNA frag test because high DNA frag is linked to miscarriage.

Our GP & fertility clinic were so blase about the whole thing, but OH has managed to get a referral to an NHS urologist, but it's months away. We know that because it doesn't hurt him, they won't treat him or we'll be stuck on an NHS waiting list, so we're just going private.

I sound like I've buckets of ££. I don't. It's literally our life's savings, but we'll do anything to avoid what happened to us earlier this year.

We have funding for one round already granted & need to use it within 12 months of the offer, otherwise we go back on the waiting list. I hate the NHS stipulation around BMI for funding, its exclusionary.

Male fertility is so under-researched, its depressing.

Sounds like you're making some progress though? I think you're making the right choice with the embolisation if you can afford it, it will improve your icsi chances!

xx

Hithere22 · 17/09/2022 08:38

JeanieJ · 07/09/2022 13:04

Hi @Hithere22

So my husband has normal levels elsewhere - it's just very high DNA frag.

That's why we were 'unexplained' for so long. We didn't even know what a varicocele was until we listened to a fertility podcast one day and OH was like 'oh, I have that' 🤷🏻. That raised some alarm bells & then when we lost the baby, we knew we had to get the DNA frag test because high DNA frag is linked to miscarriage.

Our GP & fertility clinic were so blase about the whole thing, but OH has managed to get a referral to an NHS urologist, but it's months away. We know that because it doesn't hurt him, they won't treat him or we'll be stuck on an NHS waiting list, so we're just going private.

I sound like I've buckets of ££. I don't. It's literally our life's savings, but we'll do anything to avoid what happened to us earlier this year.

We have funding for one round already granted & need to use it within 12 months of the offer, otherwise we go back on the waiting list. I hate the NHS stipulation around BMI for funding, its exclusionary.

Male fertility is so under-researched, its depressing.

Sounds like you're making some progress though? I think you're making the right choice with the embolisation if you can afford it, it will improve your icsi chances!

xx

Hi,

How are you doing? How's things at your end?

Just to update, we've got a consultation next week re varicocele. It's £2,250 (£200 consultation) but is the cheapest we've found so far!! Hoping after the consultation that we can get in really quickly to actually get it done... I'll keep you updated with progress.

Xx

Hithere22 · 17/09/2022 08:40

JeanieJ · 07/09/2022 13:04

Hi @Hithere22

So my husband has normal levels elsewhere - it's just very high DNA frag.

That's why we were 'unexplained' for so long. We didn't even know what a varicocele was until we listened to a fertility podcast one day and OH was like 'oh, I have that' 🤷🏻. That raised some alarm bells & then when we lost the baby, we knew we had to get the DNA frag test because high DNA frag is linked to miscarriage.

Our GP & fertility clinic were so blase about the whole thing, but OH has managed to get a referral to an NHS urologist, but it's months away. We know that because it doesn't hurt him, they won't treat him or we'll be stuck on an NHS waiting list, so we're just going private.

I sound like I've buckets of ££. I don't. It's literally our life's savings, but we'll do anything to avoid what happened to us earlier this year.

We have funding for one round already granted & need to use it within 12 months of the offer, otherwise we go back on the waiting list. I hate the NHS stipulation around BMI for funding, its exclusionary.

Male fertility is so under-researched, its depressing.

Sounds like you're making some progress though? I think you're making the right choice with the embolisation if you can afford it, it will improve your icsi chances!

xx

PS we also got a referral letter to urology, but it's not until late December and then there'f be the waiting time for the actual treatment - if they actually agreed to treat it, so we've bitten the bullet and just doing it xx

PopcornPaz · 18/09/2022 15:31

Hithere22 · 17/09/2022 08:38

Hi,

How are you doing? How's things at your end?

Just to update, we've got a consultation next week re varicocele. It's £2,250 (£200 consultation) but is the cheapest we've found so far!! Hoping after the consultation that we can get in really quickly to actually get it done... I'll keep you updated with progress.

Xx

Show quote history

Hey! Jumping on this thread…

We have been TTC for 9 months now and husband has been diagnosed with Varicocele on both sides. Just waiting for SA results that we should have next week but I’m already preparing myself for the worst news to be honest.

I’ve been looking at going private for embolisation but the costs vary…where did you find it for that price of £2250? If you don’t mind me asking.

Male infertility is such a minefield and I’m unsure what to do.

Thanks 😊

Hithere22 · 18/09/2022 22:55

Hi @PopcornPaz - don't think the worst just yet! Some men's results can be fine even with varicoceles so sending positive vibes your way!

It's at Derby Private Health. We have the consultation next week so will keep you updated. Just can't bare the long waits - it will be months and months for us to wait otherwise!

Wishing you all the best on your journey xx

Beyondshit · 18/09/2022 23:01

Hi op. My DP had this done. It improved his SA but we never got the DNA fragmentation test done again and probably should. We went straight to ICSI as his results still weren't amazing but much better.

It cost less than you and JeanieJ have been quoted. Around £1200 I think? Dr Khanna at Wexham Park.

Hithere22 · 19/09/2022 00:16

Beyondshit · 18/09/2022 23:01

Hi op. My DP had this done. It improved his SA but we never got the DNA fragmentation test done again and probably should. We went straight to ICSI as his results still weren't amazing but much better.

It cost less than you and JeanieJ have been quoted. Around £1200 I think? Dr Khanna at Wexham Park.

Thanks @Beyondshit - I've contacted them for more info!

Do you mind sharing your partners results before and after the surgery? I'm trying to stay realistic as we have really low starting numbers!!

How are you getting on with ICSI? Wish you all the best on your new journey xx

Beyondshit · 19/09/2022 14:10

So we measured before, just after and then a further two months on.

Volume - unchanged.
Concentration (is this count?) - 20, 20, 24
Motility - 18, 46, 16
Progressive motility - 12, 41, 9
Morphology - 1, 4, 7

I don't know why some got better then worse...

Two rounds of ICSI done this year and sadly nothing to show for it.

Wishing you good luck x

IslaO · 20/09/2022 21:00

Hi all,

just jumping on here. TTC nearly a year. All my bloods and pelvic scan ok. DP got a SA done and zero sperm was detected. Absolutely heartbroken.

we have another SA booked in and an appt with a urologist in December. I’m hoping to get an embolism with the hopes of improving our ICSI chances.

i think I’ll push for a fragmentation test too.. is there anything that can be done to help with poor fragmentation?

I hate that I’m learning so much about all of this.. wish I never had to!

sending you all love x

JeanieJ · 21/09/2022 21:30

Hey all,

My husband just had his varicocele embolisation at the London Clinic today.
He seems fine now & was able to get the train home & walk with me after 🙂.
Fingers crossed his DNA damage reduces in a few months 🤞🏻🤞🏻

IslaO · 22/09/2022 06:13

@JeanieJ great news!!! Keep us posted on how things go xx

Hithere22 · 22/09/2022 07:12

Hi all.

We've booked in London for 10th October - we had an consultation elsewhere this week and left feeling deflated. The private consultation was with a urologist (who didn't specialise in fertility) and he was a bit meh about it working and also felt we shouldn't have to pay which was nice of him but then put us at a bit of a crossroads about what to do next, as we just need a plan and getting nowhere with the NHS sadly and will be waiting foreverrrrr! He said there would be no harm in doing it but didn't feel like it would make too much of a difference and was just generally meh and didn't know if we should just invest the money straight in IVF, which made me feel pretty deflated. He also talked about sperm numbers rather than dna fragmentation and didn't seem to know that this could be impacting the dna frag too and would therefore help with IVF either way. He was interested to know why we went to see Mr Ramsey etc - all quite interesting!

Anyway, fast forward to today, we are booked in at the place @Beyondshit recommended for a double embolisation on 10th Oct so I'll keep you updated. It was a lot more expensive than £1200 but mainly because we need a mri scan and 2nd ultrasound - but it was still a lot cheaper than elsewhere we've found (and pretty consistent with Derby who we looked at originally).

Sending love and best wishes to you all x

Hithere22 · 22/09/2022 07:17

IslaO · 20/09/2022 21:00

Hi all,

just jumping on here. TTC nearly a year. All my bloods and pelvic scan ok. DP got a SA done and zero sperm was detected. Absolutely heartbroken.

we have another SA booked in and an appt with a urologist in December. I’m hoping to get an embolism with the hopes of improving our ICSI chances.

i think I’ll push for a fragmentation test too.. is there anything that can be done to help with poor fragmentation?

I hate that I’m learning so much about all of this.. wish I never had to!

sending you all love x

Hi @IslaO

Sending love your way. The journey is really difficult and no one can quite prepare you for it can they?

I would 100% recommend seeing Mr Ramsey if you are able - he is the leading urologist specialising in male infertility and if you see him, you can have various tests on the same day and he will then discuss results with you.

Has your partner had genetic testing etc already? Please try to stay hopeful, there is still so much you can explore and different things you can try and make sure that you aren't told otherwise by the NHS and can advocate for yourselves and what you want. First step would probably to see if there's any varicoceles/genetic testing etc and then depending on next steps, they could explore TESE etc (I'm no expert and we have slightly different issues, but there are definitely things for you to explore so please hang in there) x

Sending love x

Hithere22 · 22/09/2022 07:18

JeanieJ · 21/09/2022 21:30

Hey all,

My husband just had his varicocele embolisation at the London Clinic today.
He seems fine now & was able to get the train home & walk with me after 🙂.
Fingers crossed his DNA damage reduces in a few months 🤞🏻🤞🏻

Great news!! We are booked in for 10th so would love to hear updates!!! Was yours a double or single?
Best wishes!
X

CocoPocoLoco · 22/09/2022 07:20

TimetoChangeClinics · 19/08/2022 19:28

Hi OP,

Has your partner had a DNA fragmentation test? Just on the basis of our experience, I would really recommend getting the varicocele treated to make sure you have the best possible chance of success with ICSI. We didn't realise that my husband had any sperm quality issues until our first IVF cycle, where all our embryos arrested before blastocyst stage. We then did a DNA fragmentation test which revealed very high levels of DNA fragmentation that were in part caused by a varicocele, explaining why the embryos couldn't develop. Ultimately, ICSI overcomes fertilisation issues but can't compensate for sperm quality.

Had the same experience as this poster except 2 rounds with no embryos until we found out about dna frag and got the varicoele fixed.

Hithere22 · 22/09/2022 07:21

JeanieJ · 21/09/2022 21:30

Hey all,

My husband just had his varicocele embolisation at the London Clinic today.
He seems fine now & was able to get the train home & walk with me after 🙂.
Fingers crossed his DNA damage reduces in a few months 🤞🏻🤞🏻

PS do you mind me asking where you went for it and how much it was (sorry for being cheeky!) - just want to make sure we're in the right ball park (no pun intended!!!!)

I'm hoping so much that this works for you guys! x

Hithere22 · 22/09/2022 07:23

Thanks for responding @CocoPocoLoco - do you know if his other semen results improved too?

I suspect we have high dna frag and we've got such low numbers across the board, not sure if it will improve the numbers much but will hopefully help with dna frag, which we haven't had tested.

We just thought best to get ourselves in the best place and to have done everything we can do before we start IVF - gives me a bit longer to mentally process everything and lose weight too i guess! x

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