Azoospermia support, stories and timelines

[Ljp2022]

Hi All,
Hoping to get a chat going with some advice. My husband and I started TTC 9 months ago but had an inkling something was wrong. We had a private fertility assessment which showed he had no sperm in his semen (azoospermia). We are incredibly overwhelmed and shocked but are keen to explore further testing.

We have gone to our GP however he has explained the wait will likely be several months until we are seen in infertility clinic. We have therefore decided to go privately. My husband has had blood tests for genetic testing and hormones this week (not sure how long it will be until we get results?) and he has a urology appointment in a month’s time for a physical exam.

Id be so grateful if people can share their experiences of azoospermia, outcomes, success stories, other options explored, tests but also timelines if private? How long does it take for tests to come back? How long until he has his sperm retrieval test? What’s next and how long?

sorry for all the questions - so overwhelmed and no one seems to have any answers…thank you in advance.

@lemons44 thank you and the clear out sounds great fun! We had to declutter our house last year ahead of renovating (still ongoing) and it was really freeing giving away so much and having more space.
Great shout on the vitamins, my husband is taking proceive max right now but we have proxeed too which he might take next month to mix it up. He also has extra vitamin C(so gets the recommended 1000mg), ubiquinol, ashganda root, Omega 3 (DHA as we don't eat fish) and lycopene. I went a bit mad in Holland and Barrett to be honest 😵‍💫. He was taking the pregnacare male equivalent before so we felt like we would try something else.
That is a great tip, I will get my husband to ask about centrifugation. Dr Pippa said this clinic's test lab is much better so hopefully we will know a bit more soon.

That's great news on your next IVF round. l have everything crossed for you. My friend (who had a lot of IVF) said the number of eggs can vary a lot and sometimes you just get unlucky so hopefully with the new protocol you will get a great Goldilocks number 🤞💪🙏

@lemons44 I'm so glad to hear you have a plan and something you can take control of. That's such an empowering feeling!

@TheFanciestPants have you heard CoQ10? It's just a vitamin but they've found great results in men and women for fertility.

Just got out of the clinic and now have 22 follicles. 13 on my left and 9 on my right. Largest is 14mm. If any more start growing or my estrogen levels get crazy, I'm at a high risk of OHSS and canceling my fresh transfer in favor of a frozen one in a few months. Fingers crossed for a healthy fresh!

@TheFanciestPants sounds like you're on it with the vitamins! Thank you I hope so. 🤞🏼

@Sleeter0893 that's great news. Keeping everything crossed for a fresh transfer for you xx

@lemons44 thanks! We'll see where blood levels are at today. So far, so good but just being cautious.

Hi everyone,

took a little break after my cycle was cancelled on Monday and I’ve made my peace with it now. I think it is so hard to process because through all of the male factor investigations, I just kept thinking ‘I just hope me can get to IVF’ and we did but I wasn’t expecting more hurdles. @lemons44 I remember thinking when you got your outcome ‘how the hell can she deal with that on top of the entire azoospermia journey before all of this?’ But I suppose we have no choice and we can overcome even set backs that we didn’t think we could. It’s just really annoying and feels very unfair that we have to!

Im generally ok. I started my oestrogen again on Friday and I’m due to recommend stims on 23rd. So at least the waiting hasn’t been too long this time. The doctor doubled my FSH drug (pergoveris) from 187.5 to 300. He went in tentatively as he thought I was at risk of over stimulating and the opposite happened!! So I’m hoping this dosage change is enough 🤞nothing is covered by our health system here so I am really willing this next round to work for lots of reasons!

@Sleeter0893 it sounds like after the polyp operation you have been on a much smoother journey and getting well-deserved news at scans. So happy for you! How were your bloods? What day is egg retrieval?

@lemons44 what did they change about your protocol? Are you happy with the changes now? Now that I actually understand more about it all, what sizes were your follicles for retrieval? Were they all good sizes in mm so it was a surprise that so the level of maturity was a surprise to doctors? Were your follicles slow growers and had just crossed the 14mm line before egg collection? Ignore all these questions if they are too probing- just trying to understand as when I was a looking at my follicle map, I said to my doc that I thought I might get 7/8 eggs and he said no it would be 3 because the others will have only just reached the threshold and were at risk of being immature.

thinking of everyone this Father’s Day. Hopefully it’s our last not being able to celebrate our strong men x

@IslaO I'm glad you're doing well and starting a new cycle soon! I am also at risk of over responding because of so many follicles. 15 were in the 7-12 mm range in Friday and I go again tomorrow morning for an update. From there it's a day by day review to determine when the ER is. I had one follicle at 14.6mm Friday but they think we'll lose that one just because it's maturing much faster than the others. They're hoping for at least 3 at 18mm before a trigger. We'll see what happens this week!

Hi @IslaO so glad to hear from you. I'm glad you're making peace without and glad you haven't got long to wait before you go again! 💗 I hope you're looking after yourself.

I've attached a picture of my follicles at my last scan (scan was Friday, trigger Saturday, egg collection Monday). So After this scan was taken I had two further doses of stims (Friday night and saturday night) so they would have grown more.

The two biggest (28 and 19) I think are the two that they are referring to in the 'cut off size' box as they are too big. The 28mm was actually a cyst (not some weird super egg) so not sure why it's on here. I was told if the follicles get too big the egg is likely over mature or I think it can release by itself. That's why they book the collection ones a few start reaching that threshold line.

Then I was expected to have 7 mature eggs, which I can only assume would have been the 16, 15, 3 x 14, and 2 x 13.

Instead I obviously just got three mature eggs (13 collected, 10 immature).

In terms of changing my protocol. They have increased my stims dose to 225 instead of 150 (I'm on ovitrelle), they are adding in LH hormone and are going to get me to do a double trigger shot instead of a single trigger shot. The trigger shot is what signals to the egg that it's ready to be mature so I am hoping the double trigger shot helps me. Oh am I am changing from long protocol to short protocol, so I won't be having down regulation this time.

The LH is an interesting one. I used to take those cheapy ovulation strips when we were TTC naturally before the azoo diagnosis and they meassure LH peak. I very rarely got an LH peak at all, I am wondering if my body has issues releasing the LH and maybe adding LH to my treatment will help.

I'm hoping these changes help but it is all trial and error. I've read horror stories of some women just always having an issue getting mature eggs and I'm really hoping that mine was just a protocol issue instead of it being me. I've even started mentally preparing that if we have more issues with my eggs we may end up needing a second micro tese on my husbands other testicle. We have 3 vials left and I really hope it works out for us though. As you say, we don't have a choice but to push through and somehow you just manage.

IT'S FRIGGIN HARD THOUGH 🥴🥴

This journey is aging my face terribly.

@lemons44 i was thinking back and they upped my stims after a couple of days to 225 started on 150 on short protocol and she said to me at the time (I was worried there was something wrong) that’s fairly standard and what they expect so hopefully it was something as simple as that (which would be super frustrating but at least easily rectifiable). I will be keeping everything crossed that it all works out for you both this time x

I've attached a copy of my main 20 follicles today. I've got 26 as of this morning but not sure why the other 6 are left out of the report. I think I'll be triggering tomorrow or Wed with Lupron. They think I'll have 15-17 nature at the egg collection so fingers crossed for good news this week!

That's good news @Sleeter0893 I'd be interested to see how big they get just before trigger as I do sometimes wonder if mine should have been left a day or two more before I triggered. I was told once some start getting a certain size they have to trigger you but I'm wondering if mine could have gone a bit further.

Thanks @Carla2601 you are our ultimate cheerleader 💗 xx

@Sleeter0893 that's an amazing clutch of eggs, fingers crossed for your collection🤞🤞🤞
@lemons44 I am not sure and the literature isn't clear (as far as I can see!). There is an egg collection technique where they collect some, leave you on STIMs and collect more a few days later when they have matured so as they have developed a technique, it seems like there must be demand.
When do you start your next cycle?
I don't know if it helps but one cycle my friend only got 2 eggs in total, the cycle that worked she ended up with 5 fully tested embryos so must have been much more successful.
@Lp96 how are you getting on?

@lemons44 what day of stims were you on when you triggered? I now have 32 follicles 😱 and 11 are mature (>15mm). Largest is 20.2 and 4 are 18mm or larger. They are having me come back for another scan tomorrow but no trigger tonight. We'll see what galena tomorrow. Starting to be really uncomfortable with how much tenderness is in my left ovary. That one alone is growing 19.
I'm getting close to the cutoff estrogen levels for a fresh transfer, so we're just focusing on growing as many mature follicles as possible. They do say after 22mm, they risk being overmature and they won't fertilize either, but I've heard that also be 25-28mm.
@TheFanciestPants thanks! We're trying to not have to do the egg retrieval again since it's so expensive, but whatever happens, we'll have to tackle.. just ready to get these eggs out of me! Lol

The more u update the more I think I was triggered too early 🤔 really keen to know your follicle size on trigger day.
I had 9 days worth of stims and triggered on that 9th day.
How many days have u been stimming now?
Is IVF really expensive in America? (Think that's where u said you lived?) xx

Sorry forgot to take you @Sleeter0893

Tag*

@lemons44 it's very expensive. Nothing is covered by my insurance or the government so we're paying out of pocket the $30,000 (roughly 27,000 euros) for the first round of stims and a fresh transfer. We've had other appointments, but all in, that's what we're around for this first round. I couldn't imagine having to pay to stim again... I'm on day 11 right now and think I'll be triggering tomorrow or very latest, on Thursday.

@lemons44 another thing to mention is they discussed many elements to know when to trigger. It's not just the follicle size, but they look at your hormone levels too to see if they start to plateau or the rise slows down. All I know... I'm ready to stop cooking eggs lol

Spent the past half hour crying and having a panic attack... my estrogen plateaued today so trigger tonight... the pharmacy didn't full my HCG, only the Lupron so was freaking out how to try to get that to trigger tonight at 11:15pm... hormones and stress are a bad combo. Now to drive to my clinic to get everything on loan.. lovely

@Sleeter0893 argh, that sounds really stressful. But, you have got this 💪
Massive good luck and I have my fingers crossed for a great batch of lovely 🥚s xx

@Sleeter0893 oh no what a stress! Did u get hold of the trigger?! x

@lemons44 @TheFanciestPants I did get the meds for trigger in time and my procedure is tomorrow at 10:15am... getting nervous now! All I know is that Lupron trigger burned so bad and had a hard lump for about 2 hours... I don't ever want to do that again!

@Sleeter0893 that's amazing news! Fingers crossed with that many eggs you won't have to ever do it again🤞

Good luck today @Sleeter0893 ! Let us know how it goes xx

Good luck @Sleeter0893! 🤞 for you xx

@TheFanciestPants @lemons44 you ladies are so amazing... 30 eggs collected today and we find out how many were mature and fertilized tomorrow! In a fair bit of pain so going home to sleep a much as I can now.