Johnathan Ramsay - experiences please

[Ocean456]

Hi all

We are thinking of going to see Mr Ramsay based on two poor semen analysis, most recent has normal count but 29% progressive motility and 2% normal forms.

Please can you tell me your experience with Mr Ramsay and particularly if anyone has a partner with low morphology/motility please can you tell me the types of treatments he prescribes?

Thank you

Hi @Ocean456. We only had one (very) wonky parameter (motility) but he did go through a few parameters and said his count was good, and morphology not such an issue.

He physically examined him there and then and said he may have small varicocele and will arrange a scan, and then he gave him a form to request various tests at a testing place nearby. Said he could go today but DH needed to get to work so he's going to go tomorrow. The letter was for an IVF/gynae consultant at the Lister, we have an appointment with them next week so he said he'd write to her and tell her what we've discussed and they can convene when the results are in.

I found it useful to accompany DH because he asks for your history and story so far and I know much more about it than he does so I did the talking when it was about both of us. DH would have been fine on his own, but I think it was useful to me to go so I could talk about my history a bit. He described our situ as a "problem shared" which it is in our case so it was worthwhile for me to be there.

@Ocean456 how did your appointment go?

@thislittlebird
Hi there, it was a bit of a shock to be honest, I found the costs really hard to deal with - I think it was the idea of spending so much money and not knowing if it will have any impact...He said ours is a problem shared as well...I feel like we are none the wiser and £1000 down...I guess we will wait for the rest of the results x

How are you doing @thislittlebird?
We went away for three nights and it's done me the world of good, I was a crying mess last week but feel like the holiday really helped elevate my mood x x x

@Ocean456 have you had any results yet? His PA did warn me of the costs before hand so we went in knowing it was pricey. What’s your side of the problem, if you don’t mind me asking? My husband is going for the tests this week, including a scan. No idea what the results will tell us yet.

Glad the holiday made to feel better. We’re going to Cornwall for a week next month and I can’t wait.

I’ve been finding it all hard tbh. My period was late this week and then it came and it just upset me all over again. Even though I should know there’s little chance of it working naturally by now. On the plus side we had a really good consultation with the Lister clinic, was very positive. I just wish we could get on with ivf but there’s the sperm issue to work on first.

@thislittlebird DH did a semen test which will be sent for DNA fragmentation and a urine test. After the physical exam there was a visible vein and in the ultrasound the sonographer reported a 'minor varicocele'. Dr Ramsay said it was borderline whether it needed to be treated or not and we need to see the results of the other tests to determine whether that could be the possible problem weighed up against everything else... On my side, no ultrasound has shown it but endometriosis is suspected because I get ghastly period pains for three days before my period along with spotting.

Cornwall is wonderful, Thinking to go there in October..we will do IVF then and then whatever happens we want a holiday straight afterwards to look forward to. We are finding holidays offset the pain of all this and it's essential to feel like 'us' again after dissapointments otherwise it's just a continuous grind...I'm looking for another holiday to book for October this evening!

It's so upsetting when your period is late, no mater how long you've been trying, for us it's been over two and half years and I still hold onto the fact it MIGHT happen. But it's great news you had a really positive appointment with the Lister clinic. We had a positive appointment at the Create clinic. I also want to get on with IVF but we are giving ourselves four months for DH to take Proxeed before we (hopefully) improve morphology/motility.

What are your DH's and your fertility issues if you don't mind me asking please?

@Ocean456 I’m convinced our dna frag is going to come back high. Not looking forward to the results really. Are you going to have a laparoscopy to check for endo? I was told I could go on a list for one but not really sure why.

DH is from there so we’re combining holiday with visiting family, hopefully will see some sights as well. We’re similar. Going to need to have breaks I think. If it works that would be amazing and we could have a nice trip knowing it’s resolved, but I’m nervous it won’t work because it’s male factor mostly.

Dh’s issue is a normal count but low motility (9% last time), and mine is very low progesterone (10 last time), they’re not sure I’m ovulating I suppose. If his tests are good Lister want us to try for a couple of months with induced ovulation using Letrozole/scans/trigger shot but if no improvement then straight to short protocol ivf. I’m assuming Aug or Sept maybe even October realistically with whatever outcome there is for his tests. They want me to have a hycosy next week, have emailed to book in. I’m dreading it but it’s probably worse in my head.

I thought about Create. Went with Lister on this occasion because of a particular doctor, but if this doesn’t work I’ll likely try Create after.

Hi everyone, I hope you don’t mind me asking but my partner has had a terrible DNA fragmentation result and we’re desperate to see Dr Ramsay but we’re finding it really hard to make an appointment. We have tried both contact numbers for him but no response. Does anyone happen to know how best to make an appointment?

@Summer0101
DP and I have recently booked with my Ramsay and have an appointment in 2 weeks time (his waiting list is about 4-6 weeks at the mo). I emailed his PA (Alison) and she is very quick at responding.

**MR Ramsay that should say 😂 not my

Thank you so much WhiskeyInTheJar33! Your message actually made me smile which is the first time all day! I’ll be sure to type Mr when we contact him ;) We are absolutely devastated by these results so it’s great to hear it’s possible to book. I’ll check the email address we have and try again.

All the best to you and good luck with the appointment! Hope it brings positive results for you xxx

@Summer0101 good luck to you too. My DP has azoospermia (no sperm). Really hoping MR Ramsay gives us some hope 🤞🏻I've heard lots of good things about him.

Hi @Summer0101 Mr Ramsay is the best, defo hold out to meet him, we initially met with someone else because their waiting list was shorter but then switched to Mr Ramsay. My husband also had high DNA frag, Mr Ramsay is the best person to advise on this. Good luck x

Good luck everyone. We have an initial consultation with Mr Ramsay by telephone next week then my OH is heading to London for physical examination and testing the following week. I have to say, it’s a bit of a distraction not knowing what the outcome will be, but I’ve heard such positive things!

I've just read this thread. We are seeing Dr Ramsay next week. @Ocean456 have you become pregnant yet? Xx

Hope you all don't mind me asking. I have expected that it will be costly but would you mind sharing a rough idea of what it cost?

@Pudd1 £300 for a consultation. However I'd advice you get blood results / SA elsewhere before you go see him so he has results to look at on your first consultation. Also as well as the £300 id have at least £700 spare as well for other tests he might do.

I completely agree with @donnie12 - on our first consultation, we also ended up getting an ultrasound close by to the Harley Street practise which was a few hundred pounds. All tests were completely worth it!

Thanks both. We have had 2 SA. They are the only tests my husband has had, no physical no bloods etc. All other investigations have been on myself. The lack of investigation for the men is shocking even when abnormalities are identified. I feel we would be silly to go into IVF without even trying to find a cause.

Not sure if this helps anybody but we saw Mr Ramsay at the Beaconsfield clinic (he operates from 2 clinics). Below is the price list at the clinic from when we went in July - I took a picture on my phone.

Mr Ramsay is amazing. So kind and honestly the best there is in his field. His PA is also so nice, helpful and understanding.

Is Dr Ramsay still on sick leave does anyone know? Thanks!

Just adding a to this thread in case anyone finds it useful. We saw Prof Suks Minhas three weeks ago as Dr Ramsay's waitlist was 3 months long and I was very feeling impatient! Very underwhelmed with the consultation. He was arguing with his secretary when we arrived and he clearly hadn’t read our notes thoroughly beforehand meaning we spent most of the appointment educating him on our situation (Obstructive Azoospermia) rather than asking the questions we had for him.
His follow up letter was very vague and he hasn’t yet replied to my email asking for clarification on a few things. Our new clinic has also read his letter and has recommended that we see Mr Ramsay for a second opinion. So £300 wasted and we’re waiting to see Dr R now anyway - sure he’ll be worth the extra effort though

I'm sorry to hear that @Annab1984

We also have obstructive azoospermia. We were booked for our micro tese with Mr Ramsay however he went on sick leave the week we was supposed to have it done by him. He passed on our case to Ms Lona Vyas who did our micro tese and she was really good! I asked her a LOT of questions and she was more than happy to explain things to me in a simple and easy to understand way and she was very patient. Just sharing in case this helps anyone.

I hope you have a good consultation with Mr Ramsay.

Thanks @lemons44

I really hope so! We had tese at a clinic is Greece in November and managed to get 3 vials of sperm but our fertilisation rate is pretty terrible. 10 eggs fertilised and only one blastocyst by day 5, all the rest dropped off after day 3 which is most likely a sperm issue. Now trying to figure out if there's anything we can do to improve our results, even if it means ditching the frozen sperm in Greece and starting again with another tese or micro tese.

I hope you got good results with Mr R and the micro tese. I feel like he's going to be the man for us.

Hi @Annab1984

We managed to get 4 vials. We needed micro tese as my husband has a lot of damage to his testicles from a previous hydrocele surgery when he was young.

Just had our first round of ICSI which failed. That's interesting what you are saying about the embryos dropping off - I don't know if any of ours did as I think we had too few eggs to tell. We got 13 eggs but sadly 10 were immature and not usable. Of the 3 mature eggs, all 3 fertilised, one didn't make it to cell stage, we put our best one back on day 3 (which failed) and left the other one to see if it would get to stage 5 but it didn't. Hoping we get more eggs next time and so a better chance of getting a day 5!

I could be wrong, but isn't the issue with sperm in ICSI around DNA frag? If so, you might find this useful:

medicalxpress.com/news/2019-03-dna-sperm-testicles-infertile-men.amp

Mr Ramsay is talking in this article and it shows that sperm taken directly from the testicles has less DNA damage that ejaculated sperm. It's really interesting.