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Original poster

MFI Urologist appointment

20 replies

alt22 · 15/02/2023 19:27

Hi everyone

My husband has a consultant urologist appointment tomorrow following a v low sperm count SA.

He's had a couple of SA, an ultrasound as well as a blood test. I suspect there is a varicocele following the feedback at the ultrasound scan.

I am writing down a few questions (so I don't forget anything!) and just wondered whether anyone who is/has been in a similar situation had any advice on what to ask etc. Want to make sure we are covering all bases!

Thanks so much!

OP posts:
Olivia199 · 16/02/2023 16:15

I've only just come across this and realise little point in any suggestions now it's probably been and gone... just wanted to say I hope it all went okay!

Original poster
alt22 · 16/02/2023 18:21

Olivia199 · 16/02/2023 16:15

I've only just come across this and realise little point in any suggestions now it's probably been and gone... just wanted to say I hope it all went okay!

Thanks so much @Olivia199!

It went well thank you- as suspected there's a grade 3 varicocele so surgery has been recommended to try and remove that. Feel a lot better now we have some sort of plan of action!

OP posts:
Olivia199 · 17/02/2023 19:41

alt22 · 16/02/2023 18:21

Thanks so much @Olivia199!

It went well thank you- as suspected there's a grade 3 varicocele so surgery has been recommended to try and remove that. Feel a lot better now we have some sort of plan of action!

Show quote history

So glad it went okay and you've got a plan in place! Wishing you all the best.

Galaxys18 · 04/04/2023 22:53

Hey, hope you are well. How did it go? We’ve been told that we should see urologist before heading into ivf with icsi, appointment is about 3 months down the line? What can you expect at the appointment..count is very low. 0.3 million - sorry just super stressed out as we thought we could go ahead and start treatment but doesn’t seem that way so really disheartened..

what did the urologist say?

marshk · 05/04/2023 06:54

Galaxys18 · 04/04/2023 22:53

Hey, hope you are well. How did it go? We’ve been told that we should see urologist before heading into ivf with icsi, appointment is about 3 months down the line? What can you expect at the appointment..count is very low. 0.3 million - sorry just super stressed out as we thought we could go ahead and start treatment but doesn’t seem that way so really disheartened..

what did the urologist say?

Hi @Galaxys18 - I'm sorry you're in a similar position. It really is not nice and there have been plenty of tears!

It went well - we had our initial fertility test results back at start of Jan. they wanted to wait another 3 months to do another SA but with the count being so low, that just seemed pointless as there must be something causing it. We pushed for an appointment which we had in feb but before that my husband had a blood test and an ultrasound.

The urologist then went through the results. He said that my husband had a grade 3 varicocele and thought it was likely this may be causing some issues. He advised my husband to have an operation to fix it - albeit he did say that we didn't have to and the alternative was to go straight for ICSI. We thought it was worthwhile having it done - even if it doesn't improve the count hopefully it improves the overall quality.

We decided to have the operation first which he had at the beginning of March so it's just a waiting game for us at the moment.

Have they suggested any other tests?

Galaxys18 · 05/04/2023 10:56

It’s just crazy atm, I feel so disheartened because I actually thought we could start treatment but when we had our consultation they sort of said the chances are very low and it’s best to see the urologist first..luckily well I don’t know if it’s lucky as it still seems a while away but we have an appointment on the NHS to see the urologist in July..we don’t know what to expect or anything so it just seems like a waiting game now and I have been so emotional since yesterday…

SA is exteremly low to the point where they said we wouldn’t recommend icsi at this point as we may not get good sperm and if you decide to go ahead with it you’ll have to freeze sperm beforehand so it’s a bit of a rollercoaster just feels like it won’t ever happen tbh.. I guess we are just gonna wait until July to see the urologist and then see what happens but yeah all hopes have been dashed so feel really disheartened!

how are you getting on? How did the surgery go? Was your other half okay with? Did they say it will increase over time and you can conceive naturally or would you still need treatment?

marshk · 05/04/2023 12:29

I'm sorry - it is really hard. Hopefully the urologist will be able to help you in terms of trying to improve things. Is your partner on supplements etc? I'm not sure if they work but worth a try! At least you have a plan of action - I'd see that as a positive although I know all the waiting is so hard. I'm very impatient!

The surgery went well thank you - it was a little painful after but he's fully recovered now. He was hopeful it would improve things but to what extent I'm not sure. There's a chance it may not increase the count at all but could improve the overall motility etc. I'm preparing myself for the worst mentally but would love it to help - just keeping our fingers crossed

olivetulips · 17/06/2024 18:33

@Galaxys18, how are you getting on? I thought I'd message as we are in a similar situation, so I fully empathise. Was it your GP that did the urology referral or the fertility clinic?

waitingforourmiracle · 19/06/2024 14:29

Following

Galaxys18 · 19/06/2024 19:44

olivetulips · 17/06/2024 18:33

@Galaxys18, how are you getting on? I thought I'd message as we are in a similar situation, so I fully empathise. Was it your GP that did the urology referral or the fertility clinic?

@olivetulips hey so our referral was by our fertility clinic but we didn’t actually go ahead with the private appointment as we had a cancellation for our nhs one. Tbh it was very pointless, consultant didn’t really say anything he was very direct and somewhat emotionless saying it is what it is and I can’t prescribe anything. Just make lifestyle changes etc. we had to forward the letter to our clinic to move forward with the cycle.

the clinic did ask us to freeze sperm before our cycle but due to costs etc we decided not to, as husband doesn’t have a problem ejaculating but yeah it was pretty pointless we just done it as a tickbox exercise so we could move forward with our cycle - hope that helps

Anniekent1 · 20/06/2024 07:15

@olivetulips
I am so sorry to hear of your experience. My partner has had a test and he only has 100,000 so even less. We are on a waiting list to see the fertility clinic which can be at least 6 months. Seems mad we might get there and then have to go on another waiting list. Now really worried we won't even be able to go for ICSI as his numbers are so low

We have done our own research as no one seems to be able to help us and he is on imperol tablets , cut out alcohol and caffeine and generally trying to be healthy.

Hope your cycle goes well you will have to keep us updated!

olivetulips · 04/07/2024 11:11

Galaxys18 · 19/06/2024 19:44

@olivetulips hey so our referral was by our fertility clinic but we didn’t actually go ahead with the private appointment as we had a cancellation for our nhs one. Tbh it was very pointless, consultant didn’t really say anything he was very direct and somewhat emotionless saying it is what it is and I can’t prescribe anything. Just make lifestyle changes etc. we had to forward the letter to our clinic to move forward with the cycle.

the clinic did ask us to freeze sperm before our cycle but due to costs etc we decided not to, as husband doesn’t have a problem ejaculating but yeah it was pretty pointless we just done it as a tickbox exercise so we could move forward with our cycle - hope that helps

Show quote history

Ah, sorry the appointment wasn't very helpful @Galaxys18 . I did my own research and it seems like most urologists are unable to help, maybe consider seeing an andrologist or fertility expert? Urologists generally don't have the knowledge to advise on these issues.

I've heard from people who went to an NHS urologist, got completely dismissed and were told there's no significant varicocele or other issue and then went to Dr. Ramsay in London who took them seriously and was able to advise properly and do the right tests. A few of them were then able to conceive naturally.

We have the urologist appointment today after the ultrasound but we will do further investigations with an expert, no matter what we are told today.

olivetulips · 04/07/2024 11:16

Anniekent1 · 20/06/2024 07:15

@olivetulips
I am so sorry to hear of your experience. My partner has had a test and he only has 100,000 so even less. We are on a waiting list to see the fertility clinic which can be at least 6 months. Seems mad we might get there and then have to go on another waiting list. Now really worried we won't even be able to go for ICSI as his numbers are so low

We have done our own research as no one seems to be able to help us and he is on imperol tablets , cut out alcohol and caffeine and generally trying to be healthy.

Hope your cycle goes well you will have to keep us updated!

Thanks @Anniekent1 . The whole process is exhausting isn't it?

We also have low count and overall low quality. We are waiting for our first fertility appointment, but like you, it might take quite a bit of time. We have chosen to go private in the meantime and investigate male factor further as it seems like the fertility clinics are not helpful with male factor anyway. A lot of people go through wasted cycles because the clinics don't focus on finding the underlying issue, they seem to be just pushing people to do ICSI.

Do you mean Impryl? We were considering trying those but decided on Proxeed for a few months, to see if it makes a difference.

Have you thought about doing your own investigations privately?

olivetulips · 04/07/2024 11:20

@alt22 @Olivia199 @marshk

I was wondering how you all got on after the surgery and if you saw any improvement in the semen results? Hope you've had good results, looking forward to hearing from you! 💛

waitingforourmiracle · 04/07/2024 11:57

We had our first round of ICSI this year, out of 21 eggs only 1 made it to a day 5 blast and was considered "poor quality" the embryo did implant and I did get pregnant but sadly at our first scan found out I'd had a missed miscarriage. Now trying to focus on my partners side of things as the clinic are more concerned about him rather than me, had had a referral for a urologist in March, he rang last week to see where they was up to and was told there is a 57 week waiting list!! He has a GP appointment tomorrow to see if this could be pushed through as urgent as we don't want to go ahead/can't really go ahead with paying for another cycle of IVF if there is something that could be improved, a scan in Feb showed 1 mild varicocele and 1 moderate varicocele on the other side, does this sound similar to anyone else?

Anniekent1 · 04/07/2024 12:43

Hi @olivetulips
Thank you your your reply. We are looking to go private for a specialist urologist. We did look at Ramsey but he has quite a long waiting list so going with another male fertility specialist urologist. My concern ( always think worst ) is that they still won't be able to do much and we will have to go for an mTESE. Yes Impryl as was recommended by the urologist but have another semen test in August so can't say if it's made any difference. We had a call with Claire Mooney who said lifestyle / supplement wise won't make much difference with our numbers but still trying to do what we can

olivetulips · 05/07/2024 10:33

waitingforourmiracle · 04/07/2024 11:57

We had our first round of ICSI this year, out of 21 eggs only 1 made it to a day 5 blast and was considered "poor quality" the embryo did implant and I did get pregnant but sadly at our first scan found out I'd had a missed miscarriage. Now trying to focus on my partners side of things as the clinic are more concerned about him rather than me, had had a referral for a urologist in March, he rang last week to see where they was up to and was told there is a 57 week waiting list!! He has a GP appointment tomorrow to see if this could be pushed through as urgent as we don't want to go ahead/can't really go ahead with paying for another cycle of IVF if there is something that could be improved, a scan in Feb showed 1 mild varicocele and 1 moderate varicocele on the other side, does this sound similar to anyone else?

Hello @waitingforourmiracle! Sorry, to hear about your situation. It seems to be very common that they only investigate after a failed IVF/ICSI. Do you remember how big the varicoceles were in diameter and does your husband have one each side? It does sound worthwhile to investigate further, but I'd recommend you find a specialist as most urologists/radiologists don't know varicoceles well.

waitingforourmiracle · 05/07/2024 10:48

Yes we've learnt that the hard way! We literally said the same thing this morning wish we had known about all this before our first round! Yes one on each, 3mm on one and 4.4mm on the other, it's frustrating that the tests for my partner were done once I had already started my medication for our first round! When you say specialist, would a private urologist not be much help?

olivetulips · 05/07/2024 10:49

Anniekent1 · 04/07/2024 12:43

Hi @olivetulips
Thank you your your reply. We are looking to go private for a specialist urologist. We did look at Ramsey but he has quite a long waiting list so going with another male fertility specialist urologist. My concern ( always think worst ) is that they still won't be able to do much and we will have to go for an mTESE. Yes Impryl as was recommended by the urologist but have another semen test in August so can't say if it's made any difference. We had a call with Claire Mooney who said lifestyle / supplement wise won't make much difference with our numbers but still trying to do what we can

Aw, it's so easy to think of the worst. I find myself doing that too, to avoid disappointment, so I understand.

However, I wouldn't worry that much about ICSI not being an option, I've spoken to many people who had even lower numbers than yours and did ICSI successfully. It's not the count that matters with ICSI but the quality...

It sounds like we are both at the same step of the process, happy to keep in touch if you want. 🙂

Anniekent1 · 05/07/2024 11:46

Hi @olivetulips that's really reassuring. I know it just the most craziest rollercoaster and I switch from being positive to being in a really dark place. So hard as you also have to be supportive of your partner as they also going through it too! You sounds like you are doing well though with everything both practically with seeking out info and mentally so well done that's definitely an achievement. Would love to keep in touch and find out how you get on so def let me know :)

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