Azoospermia

[TwinkleStars15]

We've just found out that DH has no sperm, not one! He had a SA last week and the GP wants him to have a blood test to check his hormone levels. We've got an appointment on Thursday to discuss his results.

Is anyone else is this situation? I'm panicking a lot now that this is the end of the ttc road for us and I'm devastated Any advice would be gratefully received.

DH has it due to raised hormones, mumps in childhood & being kicked 'down there'. The odds were against us from the start.

So hard to come to terms with. We tried acupuncture, various dietary supplements & Bowen therapy with no joy.

Tried IUI many times with donor sperm unsuccessfully.

Then a decade of privately funded IVF with donor sperm.

DD is now asleep in her cot.

It took 20 years but as time went by I developed issues too.

We did end up going overseas because time wasn't on our side & I couldn't afford to wait another 2 years for (as it turned out) an egg AND sperm donation in the UK.

If your partners hormones are low they can be raised apparently.

hi, the only advice i will give is dont rely purely on NHS as this can be a very long/slow process (depending on where you live).

seek second opinion, try and look at private clinics that specialise in this area. i know its easier said but try not to be dishearted... look at private clinics. initial consultation cost around £150.00 approx and get their opinion... it will help you know your options going forward. x

Thanks 18 your story is lovely, congratulations of DD after such a long slog. However, for us donor sperm is not an option, DH has said from the beginning that he would not like that and I need to respect his wishes. It's so devastating to think that we could have no children, ever

aussie has your name got anything to do with where you live? nosy Thank you for your advice and I fully agree, if we get no where with the NHS I'd definitely seek a second opinion privately. We've got the doctors on Thursday to discuss, other than that I have no idea what will happen.

Please don't take his word as a given.
Part of the reason we took 18 years was because for 3 or 4 of those my DH was refusing point blank to consider it.

We very nearly got divorced over it. I realised that all the beating him up about it was exactly what I shouldn't have been.

So I left him to it, never mentioned it. Lo & behold he announced on my 39th birthday he would let me try 2 last attempts with a donor.

Any chance your DH/DP will 'back down' over time?

Would he consider using sperm of someone he knows?

hi twinkle, yes the name gives it away lol ... im from aussie but been living in london for almost 8 years now. :)

its good your dr appointment is on Thursday and best to wait and see what they have to say. i originally started my IVF journey with NHS and getting all my tests down with them etc but honestly in hindsight i wish i just went straight to private. purely because of the time it has taken... i never thought it would be such a slow process. i wish i knew lol. it all depends on your personal circumstances... not to be mention financial circumstances.

where do you live? ive registered with a private clinic in harley st (london) x

18 I honestly don't think it's something he'd change his mind over. I asked him if he would consider it if a donor egg was used as well but he still said no.

aussie I'm tempted to go private now - once the diagnosis is confirmed ( he has to have another sperm analysis, even thought they said the chances of it bring a lab error are very low) can I take that to a private clinic? How much are we talking, roughly?

hi twinkle, my clinic cost me initial consultation with SA approx £200.00. to be honest (i think) regardless what NHS say they will still do their own SA analysis. if there is a problem, and IVF is needed there are other tests (mainly for yourself and few for your partner) which you can do via NHS as it will be free. it all boils down to how desperate (in the nicely possible way) you are?

i decided to do all my tests with NHS last year to save money but now a year later regret it as everything on private is much quicker and in hindsight i could have had about 3 cycles of IVF by now (i hope im making sense) lol

it all depens on yours personal situation. but yes, you can wait for the results before you consider private. theres no right or wrong answer. xxx

Thanks for the advice aussie. We're really desperate, all I've ever wanted is to be a mum, I'm so sad I'm worried sick that we will be told there is nothing that can be done, not even IVF or ISCI. Apparently there are two causes for a zero sperm count, obstructive and non obstructive and if it's the latter then I don't think there's anything that can be done. I guess we'll just have to wait and see what he says tomorrow. If I had all of the tests on the NHS would a private clinic accept them or would I have to have them all done again?

please dont feel sad... ive been there and done that ... but at the end of the day nothing changes. so you might aswell be positive and proactive (well thats what im trying to do ... but still have my low days) :)

thats the good thing about this site... you meet people which are on the same journey as you and have people to help you also and understand you x

you can do the tests via NHS and take them to private but it all depends on the timings as some tests i believe are valid for 6 months and some for 12 months. dont take me wrong... NHS is good but in terms of timings might not be ideal.

im guessing tomorrow the dr will do a few tests and then you ll have to wait for results?

i hope it all works out well for you tomorrow xxx

Thank you aussie I really appreciate having someone to talk to. Yes he's having a blood test to check his hormone levels, I think this indicates if it is due to a blockage or not, or a genetic condition. He had a hernia op when he was about 6 years old and I've been reading that this can damage the tubes, sounds mad but I'm hoping this is the case as this means it is likely he is producing sperm but they're not getting though, which means we can have ICSI - trying to be positive

Where are you at in your ttc journey?

im going to be 33 years old this year and have been trying to conceive for a few years... never really went according to dates as i always thought it will just happen... just like the movies lol

but last year (after 4 years of marriage) decided to get a few tests done and now here we are lol

i had my immune testing done and my NK cells were too high so had to take a course of humeria. just finished taking the course and had blood test. waiting to get the results back... hopefully i will get the green light to start my treatment. if nk cells are still high... i will most likely have to do another cause of humeria. the only problem is that it delays the cycle (somewhat 7 weeks) but saying that it is meant to help with implantation so probably should complain too much lol

hi, i hope it all went well today x

When will you get the results aussie ? Everything with ttc takes so long doesn't it.

As expected he knew nothing about fertility buy confirmed that DH has a zero sperm count and explained that the fertility clinic want him to have a blood test to check his FSH levels. The results will be in tomorrow. I've tried to do some research and it seems that this will explain whether it is a blockage or issue with his testes. Then I went back to work after my holiday to find out that one of the girls I supervise may be pregnant, not planned, and that someone else is hoping I'll go on maternity leave soon so they can have my job! Feeling very fragile

Hi Twinkle, hope you don't mind me joining in, slightly different circumstances with me as DH had a vasectomy years before I met him in his 20's when he was in a serious relationship & they weren't planning any kids, but broke up a few years later.

So for us we knew it would be sperm aspiration (PESA/TESA) as a reversal was unlikely to work and I'm 36 so need to get moving!

DH has had the same hormone blood tests you mention, testosterone, testicular scan (with cold gel!) and last blood test today prolactin. We're in the queue for the op which is done under general, hopefully looking at August-ish timescales it seems. They start the op with PESA (needle aspiration) and check straight away if have sufficient sperm, if not they then go to TESA in the same op (takes some tissue from testes which they then root through afterwards to try find sperm).

We've been a mix of private and NHS, seemingly we can get the aspiration on the NHS but my IVF may need to be private due to the choice of vasectomy.

Wishing you luck on your journey x

Hi yoga thanks for telling your story. I wouldn't mind if we have to go through any procedures, ICSI, IVF, TESE etc I'm just gutted at the thought that we might not be able to have these if he has no sperm production. If he has got sperm in his testes then I would jump at the chance to have these done. Obviously I'm upset at not being able to ttc naturally but my desire to have children means I will go through anything to make it happen, as most people would. I'm terrified they'll say there's no point.

Hoe long has it taken you to get to this point, if you don't mind me asking? And has this all been NHS so far? Will the sperm be frozen to use for your IVF?

Good luck

I know what you mean, whilst DH had a vasectomy there weren't any babies before that so there's no guarantee there will be sperm from the ops.

After the op, if there is sperm then it will be frozen and then I'll kick off my IVF bits at the clinic ready for ICSI. We're doing DH first as he wants to check there's is sperm before I go through the injections and hormones, if there's no sperm then we won't be using a donor so that's it for us so all my hopes are on this or it will be devastating.

It's taken us about 6-8 months for where we are, we started with a private urologist but were able to get blood tests and scans via NHS which did add time but saved money. We spoke with GP and managed to get referral to the same private urologist (as he also works on NHS) and it took about 2 months for that appt to come through (and which we finally had today!). To be honest the GP referral was the trickiest and the GP wasn't convinced the NHS referral people would accept it but we got through somehow, it may depend on the different NHS areas.

If we hadn't got the NHS referral we probably only would have been able to afford PESA as TESA would have been just too much with surgery costs, general anaesthetic costs etc.

yoga we won't be using a donor sperm either so I know how you're feeling, the thought of being childless is so hard to comprehend. I don't know how I'll live a happy life without children.

How come DH had a vasectomy so young and childless? That's a big decision to make.

How much does PESA and TESA cost privately? And your IVF treatment? Sorry for all the questions, I'm preempting that we may go through this, if we're lucky enough.

I'm confused why they only tested for FHS levels and not testosterone or anything else. I also don't know what the next step is which is quite worrying but I guess we'll have to get used to waiting! It's lovely to have people to talk to so thank you yoga and aussie

Yeah it was young, late 20's, he was in a really serious relationship, she had a child already and had suffered major issues during preg and birth so knew didn't want more, plus would have had health issues with GA and sterilisation so DH had the snip, young and in love, thinking that was them together forever. He was open with me about it from the start.

The one thing I've found with costs is they vary as you start with a price but then consultations have been £150-£200 here (London) plus drugs plus tests for xyz which find out need along the way etc so it can ramp up.

The guide we were given (again London prices) for private were-
PESA - £2-3k ish
TESA - £4-6k ish
That's why we just wouldn't have been able to fund TESA privately, the costs are so much more as you have to pay more for surgeon, general anaesthetic and anaesthetist and hospital costs (bed, theatre etc).

For IVF and ICSI a very rough guide has been £6-8k ish including the drugs.

It's frustratingly expensive and with no guarantees! I'm just taking it step by step for now so we'll deal with DH's blood test from today, hopefully no issues and then see when we may be able to have the op. Then next step will be seeing what outcome of that retrieval may or may not be....

Such a scary, and sometimes exciting, journey can only keep fingers, toes and everything else crossed.

Twinkle, if you do need private treatment I would strongly recommend you look at going abroad for treatment. Myself and lots of other women are having treatment in the Czech Republic. They are amazing over there and ICSI only costs £1500. They offer TESE as well for around £450 so you will save so much money. They have better success rates than UK clinics too.

Thanks yoga and lucie The price difference is quite shocking isn't it. I think I need to establish whether it's even possible first, before I start getting carried away and researching all of this, as I'll only be more crushed if they say it's impossible. DH's blood test came back for FSH levels but the receptionist couldn't interpret it so I have no idea. He has another SA booked for 15th June and he will have a variety of blood tests then (FSH, LH, testosterone, prolactin etc) and then we will be told at the fertility clinic appointment on 29th July what the outcome and prognosis is. It feels like forever away, but then I think I'd rather that as I can hold onto hope for longer. I'm terrified it's the end already.

Oh twinkle that does feel like a long time to wait to get any answers! Is that on the nhs? Why are they taking over a month to tell you the final outcome? I had all those blood tests done and it only took about 4 days to get the results. The gp will be able to tell you if they are normal or not.

Don't get ahead of yourself, please don't.

First of all await the result of his blood tests.
The semen analysis will need to be repeated.

You both must speak to a fertility expert before you give up all hope - individual semen cells can sometimes be extracted directly from the testicle by a surgical technique (Google PESA and TESA). There are non-surgical techniques too that if possible individual semen cells will be used for ICSI. One of my best friends with PCOS and her DH (Azoospermia) ended up with 7 semen cells, 3 embryos and 1 DD .

Pace yourself.
Do get all the info in.
Yes, you may need to make your peace with the devastation that is coming to terms with not having children that are biologically your own, but now is not the time for that yet.
Good luck.

bewildered what was the cause of the azoospermia? And did they freeze the 7 sperm cells to use with ICSI/IVF? This story gives me hope thank you for sharing

lucie I think the blood test results will be back sooner but the GP won't understand them fully so we have to meet with the consultant so she can explain what it all means, which is not until 29th July. Yes it's the NHS, so far. If, and this is a big if, we are lucky enough to find some sperm cells and have ICSI I may come back to you for some info about the Czech if that's okay? I followed your story on the ttc thread and hope with all the hope I have that the next round works for you

Aww thank you so much, yes of course please come back to me. I'm happy to help you anyway that I can. Have you thought about getting a private consultation at a fertility clinic when your blood results come back? It costs around £150 but they could go through everything with you and let you know what the options are. You might be happy with the waiting but I know for me it's the hardest part x