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.

@HR01 hi. Sorry you find yourself in this situation. Mr Ramsay is a urologist specialising in andrology. He will run tests to look at the root cause of the problem and potentially treat to put you in the best position before going for IVF. He's one of the best in the field.

Hi everyone.

another Azoospermia-hit partner here.

@IslaO sending best wishes. Here if you need to talk.

Hi everyone,

sorry about my above post- I obviously started, didn’t finish and pressed send by mistake 😂

how is everyone doing? I love hearing success stories from women is similar positions. We are waiting on GP bloods to come back- really hoping they come back with good news. However, DP has a varicocele and some epididymis cysts that I would like to get treated first before we go down the SSR route regardless.

can anyone explain to me the difference between a M-Tese, a Tese and a SSR?

we are booked in with a Ireland’s version of Dr Ramsay in December and Dr Ramsay himself in January. You’d swear we are rolling in cash but we are willing to use everything to sort this out (wedding savings, life savings, help from parents etc.). Basically we are desperately throwing money at the problem in our panic and upset!

really hoping for more positive stories of retrieved sperm and BPFs after ICSI.

what a journey ladies, what a journey!

Hi @IslaO

My DP has varicocele which he had embolised. We have appointment in couple of weeks to see if this has improved things as all bloods and tests are normal.

From what I understand m-TESE, TESE, TESA, PESA and MESE (think that's all of them, keep coming across more acronyms) are all forms of SSR. The differences between them are the technique used and/or location of where they look for sperm.
Depending on the cause of Azoo, obstructive they go for TESE OR PESA. Non-obstructive they recommend micro-TESE.
I could be wrong. But hope that helps a little x

@WhiskeyInTheJar33 you were so helpful on another thread as well- thank you again!

I have everything crossed for you following the varicocele treatment. Did he have azoospermia before or just a crappy count? Did you get the embolism done with dr Ramsay? If so, how long did you need to wait following your initial appt? Please keep us posted on results in a few weeks!!

@IslaO DP had azoo before the embolisation (did 3 samples over the course of 6 months). He's been diagnosed with non-obstructive with no obvious cause. Had the embolisation done on the NHS as our IVF referral went through much quicker than Mr Ramsay expected. We had our initial assessment end of June and embolisation was done end of august.

@WhiskeyInTheJar33
NOA- so his bloods all came back good but he has a varicocele? Are the doctors hopeful that the embolization could perhaps lead to some sperm in his sample that could be used for ICSI? Or am I jumping the gun?

@IslaO so yes, all bloods normal - hormones, chromosomes, y-micro deletion. Our NHS IVF clinic are hoping that some return in sample (think it's a 10-20% chance this may happen) so can go ahead with nhs funded ICSI. If still nothing we don't qualify for NHS funded treatment so they are hoping it puts us in a better position for SSR and then ICSI privately. Micro-TESE in NOA has success rates of finding sperm between 40-80%. Quite varied! So really hoping the embolisation has pushed us nearer that 80% 🤞🏻

@WhiskeyInTheJar33 well you’ve done what you can to put yourself in the best possible position! Hoping beyond hope you come on here in a few weeks with good news xx

@IslaO thank you!! We can't do anymore. It's been a long 18 months to get to this point! But will definitely keep this thread updated with what happens after our next appointment.

Wish you the best of luck with your upcoming appointments too x

Hi all, how's it all going?
We have our surgical sperm retrieval booked for 1st Dec with Mr Ramsay. So nervous and preying they find something. Mr Ramsay said we have about an 80% chance of success. This whole thing has taken such a toll on my DH's mental health. He is really not in a good place with it all so I hope we find sperm ☹️ such a hard journey to be on.

Hope the IVF is going well @Ljp2022 x

@lemons44 finally it’s booked! Not long now, the 1st is just around the corner. I’ve got all my fingers crossed for you! It’s a really tough time, I can promise you that once you have the results, either way, it’s like a weight is lifted because you know where you stand. It’s the waiting that’s the worst. How are you?

I had egg retrieval two weeks ago. They got 18 eggs, 17 of which were mature, 14 went on to be fertilised and we now have 7 healthy blastocysts in the freezer! Best possible result. Unfortunately they had to cancel my first transfer as I developed ovarian hyper stimulation syndrome so now giving my body (and mind) a rest until the new year - very much needed as it’s been such an emotional rollercoaster (as you know) especially on the injections x

Thanks @Ljp2022 I'm so relieved we have it booked after how much our old clinic messed us about. I will keep u updated on the outcome. Just keeping everything crossed!

Yay !! that is such amazing news about how many embryos you got. You must be so relieved. I hope you feel better from the OHSS soon I've heard it's really horrible to have ☹️

@lemons44 good luck!

@lemons44 great you have a date to work towards! Did dr Ramsay find the cause of your husbands azoospermia? Do you mind me asking for a rough price of the sperm retrieval with him and how long the waiting list was for that after your first appt with him?

my partner got some basic GP bloods back and testosterone, LH and FSH all seem to be within the normal range. He does have epididymis cysts on both sides and a varicocele on one so im dying to get to the root cause can see what our likelihood of a positive sperm retrieval is. The waiting process is a KILLER!

@Ljp2022 what a result for you! So sorry about the bad reaction to meds but having a rest knowing you have such a positive outcome in the freezer isn’t the worst thing in the world but I know it will just be so frustrating having to do even more waiting!

@WhiskeyInTheJar33 how are you holding up?

@IslaO I'm ok thanks. DP has his repeat SA in 10 days time to see if the varicocele embolisation has worked. I've prepared myself for no change but hoping for some improvement. If there's some sperm then we will qualify for nhs funded ivf (hopefully) if not then we will be looking for private clinics and potentially back to mr Ramsay for microTESE.

@IslaO tell me about it, I am so so sick of this process and waiting around.

So we was with a normal private fertility clinic and the cost of surgical sperm extraction was £2050. However they really messed us about and in the end refused to do it because my DH has a mild medical condition that they think he would be higher risk under aesthetic. The clinic is only small so they don't feel they have the right equipment for someone who is higher risk. Obviously we understand this but it took the clinic 4 months to tell us 🙄🙄 so we wasted loads of time.

Mr R can do it because he works out of a hospital so it's better suited for us as they have more equipment, staff etc so they are willing to take on my DH who is a higher risk. But it is much more expensive. I think it is costing us £6000. For us it is the right decision because we had such a nightmare with our previous clinic and I'm assuming other clinics would refuse us too so unless we wait for NHS I don't think we have a choice.

In terms of waiting, the original clinic was supposed to be a 7week wait time (obviously didn't work out for us!). With Dr R we had our appointment last week and SSR is scheduled for 1st December so 3 and a bit weeks from appointment to SSR.

I don't know what the wait would be on NHS as we still haven't even got our initial referral through ☹️

That's great news about your OH's bloods. Another box ticked off. What is your next step?

Honestly this whole process is SO FRIGGIN HARD just the not knowing.

Keeping everything crossed for you @WhiskeyInTheJar33 for the next SA. Really hoping you get a good outcome xx

@WhiskeyInTheJar33 I am hoping that this sperm analysis shows something in the way of positive change- it would be such a good boost for all of us!

@lemons44 £6000 is huge but I’m in the same boat as you- willing to throw as much as we can financially muster in order to get the best and cut the risks etc.

remind me ladies, did your DPs have bad sperm results or complete azoospermia? Mine has azoo and I’m just desperately waiting to get to a specialist to hear what they think our chances of finding sperm are. Tempted to get straight to a retrieval if rate seems good but my gut is telling me we should embolize the varicocele first.

so hard to know!!!

Also @lemons44 that’s a great waiting time for Dr R- I am not in the UK and I heard that waiting times for us could be 9 months after initial consultation and that news was nearly as hard to process as the bloody azoospermia diagnosis!!!

Hi @IslaO

My husband had two semen analysis results of azoospermia (zero sperm!). We then had a third semen analysis with Mr Ramsay who did something called centrifugation. It basically means they spin the semen around really fast in this machine and if there is any sperm it clumps together so they can spot it easier. In this sample with centrifugation my husband still had zero sperm.

All my husbands bloods are ok and his scan showed something called tubular ectasia, which is basically lots of little cysts in his tubes. This is why Mr R thinks it could be a blockage. Because we have narrowed it down by having the hormone and genetic tests, it is now one of two things. A blockage OR something called maturation arrest. Which is basically where he has a production problem and is just not making any sperm. There's no way to know which one it is until our sperm retrieval procedure ☹️ Mr R said there is still a 1 in 5 chance we won't find any sperm on the day.

I have read that even with maturation arrest there can be success with a micro-tese procedure as even if the man has maturation arrest this can be in pockets so there can still be small sections of the testis that still produce sperm. So if our straight forward surgical sperm retrieval fails, it means we have maturation arrest and our last chance will be a micro tese.

My husband does have a varicocele too by the way but Mr Ramsay didn't seem concerned about it and actually didn't even really mention it, so I suppose it depends how bad your husbands varicocele is? I think they can be quite common and only sometimes affect fertility.

Half of me wishes that instead of all the tests/scans and samples we just went straight for the surgical sperm retrieval as we've had loads of tests and still don't know if there's sperm until he's had the procedure! So maybe consider if you just want to go straight onto that step.

Hi - new here but have been following this thread for a while. I was wondering if anyone had experience with y micro-deletion (AZFc) and M-tese?

@lemons44 this is so interesting! I have everything crossed for this sperm retrieval!! That would be good news so so deserved after this journey you’ve been on. How long have you been TTC? Keep us posted on how you do. I am with dr R in the new year and hoping he can narrow things down for us too. He sounds like a great guy. All of the stats and the x% chance of this and that not working are terrifying though aren’t they?! It does sound likely that your OH’s azoospermia is down to a blockage so I have high hopes for you guys!

@Flumps75 no experience of this. Is this what you are doing through?

Thank you @IslaO
We have been trying since January 2021 so will be 2 years for us just after Xmas. How about you? Do you mind me asking how old you and your OH are?