Male factor infertility

[GeorgesMum2008]

What my partner has is so rare I am yet to find anyone else going through something similar. He has ZERO sperm!! Literally, after 3 semen analyses not 1 single little sperm detected. We are 22, I have a son from a previous relationship and can't help but laugh over the irony- pregnant at 18 by a complete idiot, only to find the guy I love who is azoospermic. Is there anyone who even knows someone going through this?! We don't want children for another few years, but hopefully should be candidates for IVF as all the signs point to partner producing sperm, but problems with the transportation of it to him semen. Doesn't get much worse than zero perm count really does it? :(

As I work in an IVF clinic I know of lots of people in your position, you are not alone, please don't feel like that.
How did it come to your partner having semen analyses if you are not wanting to have babies yet? Is there something in your partner's medical or family history that made it likely he was azoospermic?
If he has obstructive azoospermia (ie sperm is being made but cannot get out due to a blockage in his tubes or absence of these tubes) then he can have surgery to retrieve and store this sperm - be aware not all PCTs fund this procedure.

If he has non-obstructive azoospermia and his hormone levels are normal or only a bit raised then surgical sperm retrieval can also sometimes be successful.
It can be a long and frustrating process to get everything done, so I would get things moving a while before you think you want a baby. Once you have the sperm stored you can then think about when you want IVF - oh and surgically retrieved sperm can only be used for ICSI as it is nowhere near strong enough for IVF or IUI.
Good luck

Thankyou so much for your reply. The way we found out he was azoospermic... He produces VERY little semen (o.2ml if I record correctly). We were fobbed off by GPs for a long time with the line "you only need 1 drop there will be millions of sperm", but after a bit of pushing got referred to a urologist.

He also assured us it was likely to be retrograde ejaculation, the volume and number of sperm don't usually correlate, even when the first semen anal came back urologist assumed there was a mistake and said to re-take.

A nurse, on my partner handing her his analysis, began to record he'd has "spillage", when he told her that was everything she responded, "oh thats it??". Leading a very very upset partner and very upset me, thinking she collects these everyday and was shocked :S

Everything is pointing to obstructive so far, testosterone normal... After a few scans and MRI they said he has a missing kidney, atrophic semicle vesicle and things wired wrong way round etc... The doc said "dodgy plumbing". However because we are not wanting children for another few years, question is what to do now... He could have dye tests to try to find blockage that may or may not be there, retrieve sperm and freeze, or retrieve when ready for a baby.

What exactly is ICSI? I keep reading about it but how does it differ from standard ivf? I really have no idea of the prognosis, I was hoping because I am so far fully fertile once they have the sperm it will be as though doing ivf with a "normal" couple... Do they always find sperm with obstructive?

Ahh sorry for such a long message, was just so happy to find someone who knows what I am talking about.

With ICSI an individual sperm is 'injected' directly into the egg. It's an extra step to IVF.

My ex had HFI, he had Kleinfelter's though so a different kettle of fish. Good luck and it's great you're getting into this now and not a few years down the line.

Hi, my dh doesn't produce sperm due to a genetic thing. We have three dc conceived children and I'd be happy to chat either here or via pm. It was a bit of a shock to us (understatement) especially as the gp had never heard of it and said it was a mistake with the semen analysis. But we're seven and a half years on and although we obviously think about it a bit, especially when it comes up with the children, it's just part of us now. I did talk to a brilliant counsellor both Pre treatment, during pregnancy and when we were trying for dc2 which helped me sort it all out in my head.

Oh, and we didn't try to retrieve any sperm. Dh was not keen and I trusted him on it. They don't always find sperm and because of the genetic problem, if they had it would have been complicated ivf with icsi. So that's not to put you off trying surgical sperm retrieval more a reason why it wasn't for us.

Oh wow finally someone who's been through it! Could I ask what dc conceived means? Donor? The IVF will be tricky, as I have a child from a previous relationship, we will not be funded for IVF. Seems so unfair as he doesn't have a child...

I can totally empathise with the whole shock thing, I cried for days, cried in work, I didn't even know it was possible to have NONE, had heard of low counts but not zero.

How does your partner take it? My partner is very keen for no one to know, which is tough as I usually deal with things speaking with friends.

Hi George's mum, if it's any help I cried a lot too! Dc does mean donor conceived-I was worried earlier that it might be too soon to introduce that idea as it is a but further away from ivf or icsi. Dh is and was brilliant about it, he has had to grieve in a way, which contradicts in some ways the fact that it is irrelevant to our parenting that the genetic bit isn't his. We were pretty open at the beginning before it was clear that we would use a donor and me probably more than him. Now, we have shared the way they were conceived with our very closest family and friends, and our children at their level. Oh and school and preschool. I feel relaxed about that and it will be out in the open at some point but at the moment it's not a coffee morning conversation-private but not secret iyswim. I'll post this and then look at your last post-think I've gone off the point a bit !

The very unfair thing about funding for our treatment was that there wasn't any because it was donor conception. We were lucky in that I didn't need ivf because I fell pregnant quickly (first go for dd1 and dd2, had two mc and one failed iui before ds) with iui, much less invasive and time consuming and also cheaper. You know, whatever happens for you, and it does seem you might have options not requiring donor sperm, your fertility and age are on your side. I know that if we'd had failed attempts and especially after ivf, the whole thing would have been loads worse because I coped worse with the miscarriages than getting my head round the donor thing.

I'm so happy it worked so well for you, were you given advice on how to explain it to your children? I wouldn't know where to begin. It's so bittersweet because my partner is so brilliant with my son, so in a way that makes me feel better about the possibility of donors, he already "fathers" my son and loves him like his own. For my own, possibly selfish, reasons the donor option upsets me just because after going through the worst thing I have ever gone through (falling pregnant so young and dad leaving me), I so wanted a "perfect" family unit, just kind of feels as though I will never have the option for a "normal" and happy pregnancy. All I went through with the whole teenage pregnancy stuff affected me indefinitely, even more so than the azoospermia. I think the main thing is how the man in these situations deal with it- we are lucky to have men willing and happy for DC children, as I'm sure many would not. Also how did you get the counselling? No support has been offered to me or my partner :S

Hi there, I relate to the "normality" thing too and I struggled too. Different reasons, but my family growing up was anything but "normal" and a lot of what I dealt with in counselling was my fear of not having a "normal" family. I didn't have the fact that they were FC on my notes in pregnancy because I was very clear I wanted to be treated normally. I think I went a bit ott with it and didn't tell lots of people about our miscarriages because I hated being treated differently (people cushioning news of pg that sort of thing). I can tell you that my family now is normal in every way (feisty six year old, gorgeous floppy haired three year old and bouncy smily baby ) and extraordinary too. The donor thing just isn't relevant at the moment and although it still isn't coffee morning chat (not many peoples conceptions are ) I would feel at ease and ready for the odd person not to get it if and when people outside our family know. I told school last year when pg as I was sure dd would announce it to all but although she knows and understands and was madly excited about dd2 before and after she was born, at the moment it just isn't of interest. And dh is a much better parent than I am! I'm sure it will come up as more of a thing for them to get to grips with at some point but for me it has made me realise that biology isn't what makes a dad. We had free counselling through our clinic, which they have to offer as a requirement (did when we had treatment, although last treatment was a year and a half ago). Right-sounds from downstairs suggest my "normal" family are getting restless!

Oh-re advice on telling children, the donor conception network are brilliant and we have a picture book that both older dc love called "my story" that explains it in child friendly language. I started telling mine when they were babies so that I'd got the language sorted before they could understand it and so it felt natural. That was after advice from dc network and my counsellor and it did help. Just remember, you may or may not need the Dc route-your situation sounds less cut and dried than ours.

Yes maybe, I know this may be too intimate (PM me if you like!) but how do they actually go about conception without IVF using donor sperm? I thought that requires iVF too :S

I guess everyone in this situation has to get over the initial concept of "normality" and realise that they is a different kind of normal is that makes sense lol!

I think the hardest thing now is knowing what to do and when, we're only 22 and I'm on a master, partner finishing uni next month so another few years yet... But I don't know how long it all takes, whether to try and find sperm now or when we're ready, not sure about freezing it and benefits/bad points of that. It's easier in a way knowing what we will have to deal with, without having to go through the heartbreak of trying to conceive, not being able to, wondering what's wrong, stressing etc... But now we are in limbo, and I almost wish we'd found out when we were ready!

We had Iui. This means intra uterine insemination. What they do is they take the sperm sample, wash it, put the sperm into a carrying liquid. Then they put it into the womb via a thin catheter. It's uncomfortable, but really no more involved (from my perspective-obviously a bit more technical for the people sorting it out!) in the same ball park as a smear test. If you're normal fertility wise there are no hormones involved and you just do ovulation test kits to make sure they do it at just the right time. The first time, and afterwards if you request, they scan you the day before and just before treatment to check that the test kit is telling the truth and you are about to ovulate or have just. I really don't know anything about the sperm retrieval and storage side of things. My best guess is that to answer all your questions you'd want to be referred to a clinic, Nhs or private, so that you know exactly how things are for you. Then you could wait until it was the right time to start trying for a baby before you did anything else. They'll store sperm from a donor for ten years but the ones retrieved surgically might be different.

Fwiw, I think it would have been good for us to have been able to take our time to process all the options and emotions before starting treatment. But at the same time we had six months (long ones at the time) between finding out the problem and being pregnant. Who knows which is best!

Wow, it has been six months since my partner had his last test and still waiting for next test! He did it through insurance so went private but that has actually caused a lot of delay. So is IUI more successful than IVF? I have heard of IUI but don't really know it's benefits over IVF, assuming it's not as full on :S

If your DH has low sperm motility the IUI is not an option, with IUI still the sperm should have the ability to move. the only option is ICSI , they inject the sperm into the egg so they by pass the movement element.

Betti's right-they wouldn't get enough sperm to do iui from retrieval so icsi is the option then. But with donor sperm they can try either ivf or iui. Icsi isn't usually needed.

Check out fertilityfriends.co.uk male factor infertility message boards. They are very busy with people going through treatment for male factor.