Anyone trying after varicocele treatment?

[Luz192]

Hello,

My husband and I paused TTC after we identified MFI, and in November he was treated for a varicocele. It's been just under 3 months since the procedure so this is our first cycle of trying again (oh the joys of ovulation sticks and the 2WW are back!)

Has anyone been in a similar situation and managed to get pregnant? I'm half really optimistic..because lifestyle-wise everything is ticked, and this was the only thing that was identified.. but I'm so used to it not happening that I actually can't picture it working..

Hi,

My husband has just been confirmed as having a varicocele through a urology referral but his semen analysis was cancelled back in October and still hasn’t been rescheduled 😔 but pretty sure after over a year of trying the results aren’t going to be good.

Did they advise you to wait three months after the procedure? Was he just in for the day for the surgery?

@Lilyduke hello- i hope things go well for you and your hubby! How long have you been trying before the diagnosis?

I don’t think they specifically said not to try before 3 months (my husband had the appt without me), but I preferred to wait because I know varicocele can also impact DNA fragmentation & I wanted a full fresh cycle of sperm before we try again. At first I was a bit frustrated about waiting but the time goes quick. If you have age on your side, I’d probably wait but don’t think it’s too risky to try before if not.

Yes it was a day procedure- embolisation. He was in and out within about 2-3 hours, very little discomfort.

It really depends on how the varicoele affected things. My DH had a sperm count of 1 million DNA frag of 52%. After varicocele embolization things improved massively to a 8-10 million sperm and 23% DNA frag however that’s still too low of a count for a natural conception (bar a miracle!) so we’ve proceeded with IVF.

What are your DH before and after stats?

@FitzsimmonsMarvel Thanks for the reply! Did you have success with IVF? Did you do ICSI?

My hubby's first was 7m count and then second was 3.7m count (both before varicocele embolisation). Low morphology on both. Motility was okay(ish). He's not had DNA frag test yet. We're on IVF waiting list too, so I think we'll wait for the results and try for ~3 months and if not, the move on to IVF..

It sounds like you will need IvF with that count unless you get lucky which is always a chance. It’s unlikely from what I’ve read about varicoele that you would get from 3.7 to 20 million plus (which is what’s considered needed for natural conception)

We haven’t had success yet but for a myriad of reasons. Usually male factor has quite good success rates with IVF

Oh and we did IMSI so a better magnification than ICSI

@FitzsimmonsMarvel thanks for the advice... useful to hear someone's perspective who has been through this! I've heard with high DNA frag, other methods such as PICSI or TESE are recommended. Did you look into those at all?

And also, did you mean sperm count per ml or total? His count was 3.7/ml and 7/ml so total sperm count were 17.8m and 18.2m. But I know closer to 40m is needed for 'normal' levels. This round I just had AF show so hasn't worked at least immediately! We'll await his retest results.

@Luz192 My hubby had a varicocelectomy about 2 weeks ago. We went for the 3 incision in the stomach route where the veins are tied off. He has a grade 3 varicocele. I will be playing the waiting game now too. My hubby's sample before surgery was just 26 sperms. Beyond shocking! I'm all ok apparently so just hopefully the sperm to fix. I'm trying to stay positive. He's also had genetic testing and he was normal on that front. I hope we both succeed!!!!

@Catsnkidsistheplan good luck to you - let's stay in touch here and see how things go! We're waiting for the results of my hubby's re-test - he has a follow-up appt on March 1 so not sure if we'll get the results in advance of that or not. But last month's attempt at trying naturally didn't work! Will try again this month.

@Luz192 I think we were told next analysis would be 6 months down the road. Seems like they wait a good few months to see a 'result'. Feels like an eternity to me lol

@Catsnkidsistheplan oh really? Ours they told us to retest at 3 months. So perhaps there is more improvement that is still to be seen for us, even after this test. It definitely does feel like an eternity.. but time does go quick (it seems like my hubby's procedure was only a few weeks ago).

If the results still aren't great, I'm at a complete loss as to what the cause of MFI can be - I do most the cooking in our house, so I know he's eating healthy, he barely drinks (maybe once a month), he is active/fit, not overweight or anything, no genetic or hormonal imbalances... I even had him remove his amalgam fillings last year and do a detox to ensure no major toxins in his body... like seriously, what else could it be?!

Yup 6 months the urologist said to us. So yes, don't get too down if it's not the best after 3. I've read some women have got preg after 3 tho so who knows! But some women say it gets better as time goes on. Our urologist said he's treated some blokes and they have achieved pregnancy naturally after treatment. He then stressed this doesn't happen for all but depends on where your husband is on the 'spectrum'. So who knows!!! Yep I agree. My hubby is ok health wise, doesn't drink or smoke. We are boring people to be honest ha! It bums me out when other people with crap lifestyles achieve pregnancy. I was told it'll be sperm retrieval as the next option then ICSI. But the urologist will only do that as a 'last resort' so I'm keeping my fingers crossed. I still might be looking at ICSI anyhow. Just depends on the sperm production. I've also put hubby on Proceive tabs to try and help. My only back up is donor sperm but that's a different road altogether! X

Thought I'd update on my hubby's test results after 3 months.

Concentration has gone from 3.7m to 15.3m (should be >15m). Total count 17.8m to 27.5m (should be >40). The concentration is the biggest win I can see as it's the first time we've seen it in the 'normal' range. The total count is low, but I believe would vary depending on volume of semen on any given day (and he's had higher in the past).

Motility has actually fallen to 21%, but I'm wondering if this was impacted by him having to do the test at home and then take the sample to the hospital 45 mins away on the train because of Covid...

Morphology has increased from 0% to 2% (should be >4%).

20% sperm antibodies also found.

So definitely some improvements, but still some below the 'normal' standards. And antibodies which we hadn't considered before. We have the follow-up appt next week so will discuss further then.

@Catsnkidsistheplan

@Luz192 that's all very promising stuff! And with each passing week that should continue to improve I would hope. What's sperm antibodies. Is that a good or bad thing? Let us know how your consultation goes if you can - I would love to know their thoughts!

@Catsnkidsistheplan thank you :) I'll definitely keep you updated after the consultation next week.

Antibodies aren't a good thing - I wasn't too familiar with them, but from a quick search yesterday, apparently it is some kind of protein that fights the sperm or stops it from getting through the cervical mucus/fertilising the egg. On the results, it says >50% is bad, and my husband's was 20%, but I imagine 20% still is having some negative impact. However I'd assume ICSI could bypass this by choosing from the pool which aren't impacted.

I am debating whether to have my husband do a sperm DNA fragmentation test. I don't believe it's covered under NHS and is a little costly, but would be additional info that could help (apparently ICSI doesn't help against DNA frag as it's not 'seen' - and in these cases, surgical removal is recommended because sperm get fragmented when they are ejaculated. So by surgically removing the sperm, you bypass the fragmentation that would have occurred). All so much information and 'what ifs!'.. it's really hard to know the right next step.

Saying that, we're not out this month for trying naturally.. my period is due next week so I'll keep a little hope alive for that too!

@Luz192 Yeah I was thinking about DNA frag the other week. Didnt know it became fragmented post ejaculating. Interesting. Sperm is a bloody nightmare. I'm surprised the human race exists at all the more I learn about reproduction! If we end up needing ICSI then I will mention the DNA frag test for sure. I think it's a few hundred private from what I've read. Well fingers crossed for naturally too! I think you have had really positive results post 3 months so you never know!!!

@Catsnkidsistheplan We just had the update with consultant. He did say there's improvement but that still not great for natural conception - he said it can happen if we wanted to keep trying, but could be a while and IVF may be better option.

He didn't really advise much more, he said it the low overall numbers could be from a past infection, injury etc and if he's already eating well and doing everything else right, there may not be much more improvement.

We have our IVF appt next month so think we'll be proceeding with that - I'm unsure how quickly after that appointment we'd actually get started, so will keep trying in the meantime

@Luz192 thanks for letting us know! I suppose it's worth carrying on trying in the background whilst u wait for ivf. Are u going for ivf on the nhs? I've given up with them at mo as I'm supposed to have a hsg next but I refused as it seems a bit pointless when I'm most likely going to need ivf due to mfi. So prob just go private for ivf. We only get one cycle on the nhs anyhow and I'm 34 so cannot deal with a wait list with them. But first I need some decent sperms!!!! As you know! Anyhow I'll keep in touch if there's any decent news to share. I'm keeping my fingers crossed for us both.

Hello lovely ladies,
Could you please tell me where did you husbands had their varicocele treatment, what kind of treatment exactly and how much you paid?
We are desperately trying to find a private clinic but all the quotes are over 5k which is too much for us. We are best in west London.
Your help is much appreciated,
Thanks 😊
Marijana

Dear Ladies,

I am not sure if this thread is still active but I am jumping on as my hubby and I are currently also considering if he should have his borderline varicocele embolised. We are currently seeing Mr Ramsay and he has recommended we do TESE and test the fragmentation of the sperm and freeze if its lower before proceeding to ICSI. His current fragmentation is 43% and we are currently taking Doxicyline after Mr Ramsay ran some tests and found an underlying infection. Any updates on your journey's with info on clinics/price etc.. will be appreciated!

Hi @principlewoman,
Just seen your post and wondering how you are getting on? We are due to see Mr Ramsey next week after DNA fragmentation test/ varicocele diagnosis. Thanks

@Mar6 did you find anywhere privately that was cheaper?

@principlewoman @ReadyForTheAdventure I'd be interested to hear your outcomes with mr Ramsey. My DP has been diagnosed with azoospermia (no sperm) and has a varicocele. His GP has said the varicocele is not severe enough to cause the azoospermia so are in limbo. Currently waiting for nhs urology appointment which won't be until the middle of next year! So considering going privately. We won't qualify for nhs IVF either if it is the varicocele causing as they don't cover non-obstructive azoospermia. We don't want to use too much of our savings to see mr Ramsey as we want as much money for ivf as we can.

Hello ladies,

The cheapest varicocele embolazation I could find was in Royal Berkshire Hospital in Reading with Dr Archie Spiers for roughly £2600.
London prices were around 5 k so it was worth driving 1 hour to Reading.
Dr Archie is highly experienced and I would highly recommend him.
My husband’s procedure was done in a few hours and he could go home straight afterwards.
They do it via a vein In the neck, apparently that’s a preferred way to do it because it’s less risky.
We had to wait 3 months before we could continue with IVF.
I had 3 failed Ivf’s before this. My fourth IVF worked and I’m 5 weeks pregnant, finally!! I was about to give up..
we didn’t test for fragmentation levels afterwards but we think the procedure really helped.
We had our first ever 4AA embryo, the only embryo this time but really good quality.
We also went for IMSI procedure which was recommended to us in Lister clinic where I did my last 2 rounds.
Good luck everyone xx

Just wanted to spread a good news story re varicoceles, my DH had extremely low count and we too went to Mr Ramsay. He diagnosed a large varicocele and through tests high DNA frag, but as we were nearing the top of the list for IVF (NHS round 1) he put us on a course of antibiotics and recommended to proceed with the first round to see if we get any good blastocysts, and if not then we know surgery is required before a 2nd round. Thankfully we did get good blastocysts and are expecting our baby in February.

Every case is individual but just wanted to share that it isn’t all doom if high DNA frag is identified or indeed if a varicocele is.

Hi all, looking for the most efficient and cost effective way to sort male fertility issue - bilateral varicocele. Would be helpful to know where you did it as we are desperate, we can’t get to blastocyst even though using ICSI! I never knew that dna fragmentation can’t be resolved by ICSI. We were suggested to do multiple freezing and try Imsi but would rather sort the root cause first. Thanks for your tips. I guess NHS will not treat it and we have to go privately?