Azoospermia support - Part 2

[WhiskeyInTheJar33]

@2022ttc
@Ljp2022
@lemons44
@IslaO
@Carla2601
@TheFanciestPants
@HoustG
@Sleeter0893
@Creatingspace
@Nats140
@pomdownunder1
@Annies1992
@Lily1994

As the old thread is almost full, I thought I'd start up a part 2 so that we can all continue our journeys together!
Apologies if I have missed anyone x

We got 7 vials amazingly - used 2 for the 1st cycle. I'll tell him to take a look and share - not really his thing but will try!

Really happy for you @lulu899 ☺️ massive congratulations!! I love to see another success story, and great you got 7 vials!! Was your transfer a fresh or frozen?

@donnie12@Runner77@lulu899 congratulations! hearing these success stories gives me a lot of hope that we can get there too!

We have now also our MTESE booked in 6 weeks, which is great news and sooner than expected, but I am starting to be really nervous about it. I really want us to have this done and move forward but I am really worried about the outcome at the same time...

@Magix86 MTESE was the only option offered to us. My husband has unexplained NOA and on these cases MTESE is the best option in my understanding.

Also in case it helps anyone, my ovarian reserve is normal but lower than the average for my age (I am 33). The fertility clinic advised me to take 25mg of DHEA three times a day and 400-600 mg of CoQ 10 daily. They told me that this can help with ovarian reserve. I dont like at all taking DHEA having read the possible side effects. However I am following the doctors advise..

Hope everyone is doing OK. We finally had our first appointment today! My partner has been given clomid to take for the next 3 months and will then have an mtese. They spoke about his low testosterone level and that clomid would hopefully improve it, as well as give the mtese a better chance of success. I was initially a bit frustrated that it's another 3 months, as I'm very aware I'll be close to my 38th birthday by the time we're able to get to an egg collection for me....but I guess it's only 6 weeks longer than I originally hoped for. Has anyone's partner had clomid, and if so, did it help? The doctor wasn't able to give any clear figures on how much it may help/success rates, and said the research has been a bit sparse, but that it's basically worth a go. He said that generally with an mtese we'd be looking at 30-50% chance of finding sperm

Hi all 👋

@Blue234 exciting that the MTESE is booked in, I understand the worry. It always finds a way in, how are you doing this week? Thank you for the supplement recommendation too, I’ve been taking Vitamin D, Folic Acid, Fish oil and COQ10, but found it harder to find DHEA so I’m awaiting our appointment next week to see if it’s recommended. Where did you get yours?

@Magix86 I’m so glad you had your appointment, how are you both feeling? It’s great you have a plan of action now 💖

Hey @Magix86,

We were given similar instructions! My partner has been on Anastrozole for 6 weeks now and his testosterone has gone from like 12 to 35! His FSH has also increased.

It's not resulted in sperm returning to ejaculate but good his hormone levels have increased.

We should get our date for MTese this week but haven't been given a % chance. I'll ask when we get the call I think.

Good luck with it all and keep us posted over the next few months.

Thanks @Disco24 😊 feeling OK about it. I'm just so incredibly impatient with this whole process!
Hi @StarJasmine93 - that's so good that it's increased his levels. Has he noticed anything different in terms of how he feels? My partners testosterone was around 8 so really quite low. Hope you get your date for the mtese soon.

@Magix86 no he says he feels normal! I was a bit nervous that he would feel low or have mood swings but it doesn't seem to have impacted him in that way.

Don't worry about being impatient... I think we are all within our rights to feel this way! Especially when it's NHS timelines 😴

@StarJasmine93 thanks 😊 my partner is already quite low in mood and has mood swings. After hearing how low testosterone can impact yesterday, we felt he ticked every box! I'm hoping the clomid might improve things but they also mentioned maybe needing testosterone replacement therapy after the mtese as it can make testosterone levels even lower.
I'm kicking myself a little bit as I think if we'd gone for a private consultation he could have started the medication sooner and we'd be having an mtese sooner. But nothing we can do now lol, at least the ball is rolling!
He's going for a blood test in 2 weeks to see if there's been any difference so will know more then. In the meantime I might ask if they will do an AMH test for me, it might put my mind at ease while we wait...or it could make it even worse if I get a bad result 😫

I agree @StarJasmine93 i don’t know how you can’t be impatient, especially when most of us have already spent time in the journey before even getting to this point. And I’m patient at the best of times 😂

@Magix86 I’d definitely ask. Knowledge is power and at least you can get started on supplements etc if required in the meantime

xx

@Disco24 I am trying to keep myself busy and luckily I am not doing bad this week! Thanks a lot for asking! :)

Re- DHEA, the funny thing is that when they told me to take DHEA they didnt mention at all that this is not sold in UK. After doing some online research, surprisingly I found that actually DHEA is not allowed in the UK and hence why I couldn't find it anywhere...

I finally got it from a US page (iHerb - Vitamins, Supplements, Natural Health Products). Actually I was surprised by how quickly it was delivered (just 6 days) and also price was quite decent.

In case it helps, this is the one I went for: Life Extension, DHEA, 25 mg, 100 Capsules (iherb.com)

Morning all! Sorry for the lack of replies here. Trying to keep our heads above water and finding it is taking its toll.
We are seeing Mr Ramsey in three weeks for a final check on medication and then to book in an FNA almost straight away before a MTese in September/October However, my husband has caught covid again.
Mr Ramsey felt that it was covid and weight gain that had likely taken his sperm count from extremely low to complete azoospermia.
Has anyone had any experience with catching covid so close to a retrieval? Do you have to wait a certain amount of time to be Covid free to ensure it hasn't impacted on any potential sperm count? We both have public facing jobs and I don't think between us, we been more than 6 months without catching it!
Hope that makes sense, sorry for the rambling. Just feel like something always slows the process down.
Hope you are all well xx

@sackofpotatoes123 sorry to hear that! Re:Covid, dr Ramsay said the same to us about it potentially having impacted the sperm. I can't help but think the strains of Covid back in 2020 were much stronger than the one recently (completely my own observation having had it once in 2021 and once this year - it was really mild second time). Did you say you're having an FNA before the MTese? Why is that? I'm asking because dr Ramsay offered the FNA as option B to us when my husband was struggling to get his head around the MTese, but he said the results of the FNA are accurate so if it shows no sperm it means no sperm. The downside he said would be that it would cost double

Hey

All of my medication was delivered today to start IVF in a week. Do you know if the needles and the tips are kept with the ovaleap medication in the fridge?

I was given a bag that all needed to be refrigerated and a box that consisted of the ovaleap pen, lubion, cyclogest, diclofenac and ovamex. Does anyone know medication is used for the trigger shot? Is it Ovitrelle? Feeling a bit overwhelmed with all the medication.

@Nats140 Ovitrelle is the trigger I had on my first round. Yes I did keep all the needle tips in the fridge for my ovaleap pens as I just kept the whole box in there but not sure if that's right 🤔

Try not to panic, the clinic should give you a very detailed timetable that will tell you exactly what you need to take and when. Stick it on the wall and just tick them off one at a time as you take them. They will also tell you how to take them but there's brilliant YouTube videos showing how to take different IVF meds if you are not sure. xx

@sackofpotatoes123 hope you're ok x

@lemons44 thank you. Its just a little overwhelming, but the clinic are lovely and the nurses explain everything. So ovaleap is for stimulating ovaries. What is Ovamex and lubion for? Is Ovitrelle the trigger shot you have to take before your egg retrieval and lubion what you take after the transfer? They did go over everything, but it went over my head a bit.

@Nats140

Yes so ovaleap is a stim drug that stimulates the ovaries to make follicles (which grow the eggs in).

Lubion is progesterone which helps to thicken the lining of the womb. Cyclogest is also a progesterone so you may be on two lots of progesterone to thicken up your lining after egg retrieval, in preparation for a transfer.

I think I've had diclofenac on one of my rounds before but I can't remember what it was for. It might be a pain killer or antibiotic to take before your egg collection?

I haven't had ovamex before but it might be to stop premature ovulation as they normally give you something to stop ovulation so this doesn't happen before egg collection.

X

@Nats140 I’m on day 8 of stims and also taking Ovaleap. Like @lemons44 I’ve been keeping the tips in the fridge as I just keep it all in the same box. Once you’ve done your first shot with the cartridge can just keep the cartridge/pen outside of the fridge for the rest of the days until you use the whole cartridge I believe.

my nurse has always been on the other end of the phone to help with any questions we’ve had along the way and they went through everything again on the day of my baseline scan as I felt like I’d forgotten everything they’d said already by then

@2022ttc thank you so much for replying and thinking of me x we are ok, just fed up with the (potential) set backs. We are waiting for Mr Ramsey to get back to us but my husband really doesn't want to go to see him if there is any chance covid may have had an impact on his levels as it won't leave us any clearer about what we are working with.

I don't know if his advice is relative to just with our stats and individual situation or generic advice but he felt that we should have an MTese timed with a fresh transfer but obviously this means me preparing for a IVF cycle that may not happen. He said that to avoid the heartbreak that comes with that, we should either have donor sperm as a back up or an FNA so that he can be confident that sperm can be found. My husband would rather go for the FNA option although like you said, it sounds expensive.

Hope you are keeping well. How are you both feeling about things now? Sending you love xxx

Hope everyone's other halves are coping ok today on Father's Day.

I'm so annoyed with my FIL. He decided today was a good day to tell my husband that his cousin (who has three adult children) had his vasectomy reversed and is now expecting a baby. 😡 seriously of all days to tell him that? My husband is acting fine but I'm so upset for him on his behalf. I know he puts on a brave face.

So sorry you've been struggling @sackofpotatoes123 has the covid been really bad? (Temperature etc.) I hope Mr Ramsay can provide some reassurance around it. xx

@sackofpotatoes123 I would try not to worry too much, the way covid is affecting people is changing so much, I had it a few weeks ago, and it felt like a completely different illness to what I had first time, and I shook it off really quick this time, as did my husband, when previously we were fatigued and generally unwell for weeks, so id say the likelihood of him being affected the same way is pretty low even if he feels like hes been hit hard with it, but maybe just to be on the safe side just fill up with things food for the immune system, plenty of greens, bone broth, fatty fish etc.

@lemons44 that is really unfortunate timing, I suppose this information has to be passed on, but pick your timing!

I don't mean to be doom and gloom, I just find it therapeutic to have an outlet for my thoughts, even if no one reads it.

I think it's starting to feel real now, only a few weeks till my DH's surgery, I managed to put thoughts about it all aside for a while, but it's creeping back to dominating my thoughts.

I don't like to be doom and gloom, but what I have been thinking about is the very real prospect that it won't work.

I've read some threads on Mumsnet, where there are couples who have been struggling with infertility for years, and honestly it scares me a bit, they get trapped in a cycle of 'just one more go' and then are 6 years down the line, and 100k plus in debt. Is it worth having the conversation before even starting to decide what your limit is? when to give up altogether or when to consider other options? I sound ahead of myself, but I think it almost brings comfort if you give yourself a finite window of trying, before moving on and then having a plan for what 'after' consists of. - Moving away? changing to jobs you enjoy and not care about the money? travelling for weeks, months at a time? The thought of being 2-3 years down the line and still having fertility issues dominating my thoughts and life just depresses me so much, it is not living.

We have tentatively had the discussions on the following situations.

-His surgery does not work, and no sperm are found. Husband is open to sperm donor route, he says he struggles to view a future without children involved, even if they are not biologically his. It's me who is so far not comfortable with this (I won't post my reasons why as they are illogical and only apply to my way of thinking). I ruled out adoption, I just can't see myself doing that, husband is also open minded to this.
-Surgery does work but the three NHS rounds fail, we said we would want to try private, but I would want a cut off to establish when 'enough is enough', 2 rounds and one donor round (if we agree to try that).

Ultimately, I don't know yet but I think they are conversations I want to have, and will bring up over coming weeks, we have already touched on them. I am just wondering if anyone else is the same or is just taking it a one step at a time approach?

@wateringcanface
I don't think your message is doom and gloom, I think these are thoughts that we all have in some way 💗

In terms of whether I am the same, honestly I have found that i flit between both. Sometimes, I want to map out a plan of next steps, how many rounds etc (I'm naturally a planner!). And then sometimes I can't bear to think beyond the next step.

One thing I saw though that has stuck with me was this guy on Instagram who said (along the lines of): if you spend a lot of time thinking about everything that could possibly go wrong, you owe it to yourself to spend the same amount of time thinking about 'what if it all works out?'.

This really resonated with me at a time where I kind of felt like my faith in it working was dwindling, because it is very true.

Thanks @lemons44

I like that quote, though it probably doesn't come accross this way in my post, I'm more of an optimist than pessimist. I do think it'll work for us, there's just that painful niggle.

I think with us, and I'm assuming others too on the thread, it's the vulnerability and lack of control. Me and DH are at the complete mercy of assisted reproduction, we have a 0% chance of natural conception. There are no lifestyle changes, medications or anything that will reverse surgery induced anejaculation.

I know a few people who went for ivf, my friend and her husband tried 4 years naturally to no success, he had low sperm count (not azoo) and she had some ovulation issues, they had 2 unsuccessful ivf rounds, then fell naturally before their third. Another friend of mine tried for 2 years, and fell pregnant just before she was due to start treatment. Another person i know had ivf for their first, but had a natural twin pregnancy after! That 'miracle' story is an impossibility for us. Whether we have a baby is completely determined by both the success of medical interventions, and how much we can access those interventions. It's daunting.

I suppose you could argue that having the pain of trying and failing naturally every month is more painful than knowing absolute that it won't work I guess.