Azoospermia support - Part 2

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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

Hi all.
We have our mtese booked in now for 3rd September! Partner taking clomid until then. I messaged the clinic to ask about next steps for me and I just got a reply saying to let them know when the mtese is done.
Is this usual practice for those of you that have been through this? I just assumed that at least I'd be seen before then, and have an idea of medication/treatment for myself, and to think about starting dates? I'm worried that if I call them after the mtese is done they won't have any appointments available and it's another delay.
I hear of people synchronising egg collection with the mtese, although i do understand that's potentially risky if the mtese is unsuccessful. We are willing to go with donor sperm if it doesn't work so I thought an option might be to have 'back up' sperm available. Although I'm not sure if they would agree this via the NHS route, and they would probably say to wait for results of the mtese first?
Just wondering if anyone can share their experiences in terms of timelines and the order of things happening, so I can contact the clinic and ask some questions.

Hi @Magix86 amazing news you’ve got your date booked in! Hope the next few months fly by for you.

My bf has his mtese done at the beginning of April. We weren’t offered the option of doing a synchronised egg collection. I told my clinic when the surgery was scheduled and they booked me in for an appointment a week after his surgery to get the ball rolling with next steps whatever the outcome of the surgery was. We were definitely just taking it one step at a time so hadn’t decided yet if we’d go down the donor route if needed.

Luckily his surgery was successful so we got to start IVF on my next cycle which started the beginning of May. They put me on norethisterone first so then stims started for us the first week of June. We’ve gone with a private clinic though so not sure if timings may vary with NHS but hopefully this helps in some way.

@Magix86 Hi, I saw your other post about Clomid for men and thought I'd reply here. It sounds like we are at a very similar stage with things.

My DH was first thought to have obstructive azoo but a failed TESA/PESA meant it is likely NOA. However both NHS and private docs found his hormones to be normal (no issues with anatomy or chromosomes either) so I don't think they know what the cause is to be honest. DH is a CF carrier but neither Dr thought that had much to do with it. My DH was recommended to take 3 months Clomid by the private doc anyway but no one knows if it will do anything.

I saw that you are wondering about getting an updated AMH done. I decided to do that on the basis that it was low over a year ago and if it was really bad then we would have second thoughts about going through with the microTESE. (Not sure if it helps to know or not but I'm 36 and I had AMH of 5.6 in Feb 2023 and it is now 3.1). So not amazing but still worth it to go ahead and give it all a shot.

Unexpectedly, my DH had his pre op for the NHS microtese the week before last. We don't have an op date but it is expected to be around 10 weeks from now which, ironically, is too soon to be able to take 3 months of Clomid. Given the normal hormone results in our case, I think we will go for the NHS op even if it is before the 3 months Clomid are complete. If he had low hormones then we would do the 3 months and try to postpone the NHS op (and probably end up paying private as we wouldn't want to have to wait again).

Like your fertility clinic mine (NHS) isn't interested in me until they know whether the microTESE is successful. However they did tell us there is no further waiting for IVF and we could get going right away if all goes well. It is definitely worth checking that with them though.

@24b this is a great help, thank you. Really good to hear the mtese was successful for you, that's a huge first step! Apologies if you've already mentioned it in any earlier messages, but have you had your egg collection now? I'm imagining now we are in the system the timings should be similar for nhs vs private. I'm going to make a list of questions and try to call the clinic to get some clarity. I still want to ask for an AMH test and also want to understand how they decide on the right protocol when this is the first time for us? I'm scared about having a cancelled cycle or there being no eggs/no good eggs etc. We're only entitled to 1 round on the nhs so really want it to go as best as it can. I've probably read far too many pages on mumsnet that are contributing to anxiety about every single scenario! 😅

No problem @Magix86 :)

Egg collection is scheduled for Thursday so we’re doing the trigger tonight 😬

They’ll definitely want to do an AMH test on you and also do an internal scan and blood tests etc I imagine to determine the right protocol for you.

I had the exact same worry after doing way too much research into everything but it’s all been going well so far so hoping Thursday goes well. They monitor you so closely so sure they’d amend your medication etc if your body wasn’t responding how they’d hope. I think once you’ve been given such a big knock back with something like Azoo it’s so hard not to think the worst is going to happen at each next stage but try to say positive and just take it one step at a time. Sounds like you’ve got all the right knowledge to be able to advocate for yourself to have the best chance ❤️

@24b thank you. Will be thinking of you on Thursday and hoping for lots of lovely eggs!

Hi @BlueberryStar for some reason your message didn't show earlier. Thank you for sharing your story. It does sound like we might be on similar timeframes! I've never had an AMH level and to be honest the thought of having it done is scaring me. I will be nearly 38 by the time we get round to an egg collection and I've wanted this for so long now every month that goes by seems a month too long 😞 I'll call the clinic and ask for an appointment to be booked in for after the mtese, and also ask if they can arrange in advance any further bloods I'd need etc. I want to be as ready as possible to get going after the mtese.
It's great you've been told there's no waiting time for your ivf. Hopefully u get a date for the mtese and it aligns with the clomid treatment

Hi ladies, I hope you're all doing well.

@24b i hope your collection went well!

Update from us which will hopefully help with understanding nhs timelines, I’ve really struggled to find this online!

We had our first NHS fertility clinic appointment Wednesday (reminder my husband has complete Y deletion so donor is our only option). Internal scan all good so our timeline looks like:

• Bloods as soon as my next period starts on day 2-5 for AMH and hormones
• 3-6 months wait for Hycosy and counselling. Buy sperm at that point as we will discuss everything donor.
• 4 weeks after that we’ll have a Nurse appointment to kick off treatment, which will be IUI

So maximum 7 months! I’m also going to keep calling for cancellations. Love that we have a plan now 🥳

@Disco24 so happy for you that you’ve got a plan!

thank you so much, it went well :) we got 12 eggs, 9 were mature and 7 have fertilised so keeping our fingers crossed over the next couple of days.

Also in case anyone has an egg collection coming up, I haven’t had any pain following the egg collection. All I heard was horror stories about how awful I was going to feel so just thought some positivity was worth sharing!

Congrats @24b !! Those numbers are amazing.

Also great to hear you aren't in any discomfort.

Would you mind re sharing your story? Sorry it's quite hard keeping up with which stories match which people!

Thank you @StarJasmine93

Of course - we went to see Dr Ramsay when he got the diagnosis. From all the test results he thought he had OA and so we did the microtese with him at the beginning of April.

He definitely had an obstruction and he has tried to do a reconstruction but we won’t know if that’s been successful until the end of the year - think there is a 35% success rate so we were advised to go ahead with IVF in the meantime.

Where are you on your journey?

@24b ah the famous Dr Ramsay. We've met him too!

So my husband has NOA - no real reason has been highlighted as to why. His genetics all came back normal, normal testosterone, high levels of FSH etc... We've just been added to the waiting list for an MTese with Kings Hospital in London. We were told it's likely to be end of July / Start of August.

He's had 4 semen analysis over the last year and one showed half a million immotile sperm so I'm hopeful they find something but you just never know.

Mr Ramsay put him on anastrozole which he's been on for a month so hopefully that helps too.

We were told once the MTese is done (providing they find sperm), we just call up and get an appointment so that we can start the IVF/ICSI process 🤞.

If we don't find sperm, we are both open to donor so that is plan B.

@Disco24 so pleased you have a plan and timeframe to go on! You must be relieved.

@24b amazing news! Keeping everything crossed for you for the next few days. So pleased you have not suffered too much with the collection x

@Magix86@OfTheForest

Please ignore my comment above! Not sure how it was sent and I cant see how to delete it! Sorry!
@24b congrats! Thats amazing news!
@Disco24 I havent heard about Hycosy. Is this something that everyone needs to do or is it related to something specific to you? Just asking as I thought when we do MTese, if we are not successful, i thought next step would be just finding the sperm and start IVF.

Re-update on our side, looks like our MTESE is being delayed at least one month, they still need to confirm the date. Keeping finger crossed its just one month more.

Many thanks!

Thank you @24b and @Magix86, very happy to have a plan. We’re going to really enjoy summer (get my fill of beer gardens 😂) then hopefully it’ll all come together in autumn 🤞

@Blue234 the hycosy will be to check the health of my tubes and uterus. As the hope is for me to do IUI, they want to ensure everything is all in perfect working order. Not sure if it’s common, it’s a good question.

Are you NHS or private? I’m sorry your appointment is delayed again, do you know why? X

@Blue234 When I first came off the pill my cycles were all over the place for 18 months. They sent me for a HyCoSy to make sure all was well with my uterus and that there were no blockages in my tubes and that everything looked as it should to be able to do IVF.

I had assumed it was something you did ahead of treatment but I don't know for sure as I don't have lots of close friends/family going through treatment to ask.

@Disco24 thank you for clarifying! I see maybe its because you are doing IUI. I will be doing hopefully ICSI and so far they havent told me about this (but will see when the time comes).

We are NHS. We believe the doctor/surgeon has been on sick leave and they have had to reschedule surgeries. I really hope no more delays and specially that they finally confirm the date.

Ah thanks @StarJasmine93 thats good to know you had one too.

@Blue234 yeah I didn’t know I needed one until Wednesday, so once you get to the next step maybe you’ll find out. Good that you have a reason why your mTese was cancelled, but annoying nonetheless! I’ve found calling helpful for getting cancellations too so not sure if you can chase, hopefully not too long.

Hi everyone!

I'm new here, well been following people's stories in the background but finally feel brave enough to share ours. I'm sorry we all find ourselves here, but I'm so pleased for some of you and your successes.

Yesterday we were hit with the devestating news that my other half has AFZa complete deletion meaning sertoli cell only syndrome. This was privately through Mr Ramsey through an email with just the results. As you can imagine we are besides ourselves and yesterday was just a blur.

I'm a little confused though, probably the denial in me. There are studies showing successful SSR in SCOS patients but then everything says AFZa wouldn't be considered for a microtese.

We have what feels like a very long wait to make it to the 2nd August to discuss this all with him. I'm guessing there's not much to discuss other than this is the end of the road for us.

We don't know how we feel about donor sperm. I've also been looking into the ROSI technique in Turkey but don't know if that is an option.

I just feel lost. Trying to stay strong but really struggling.

Hi @Jesse32 I’m so sorry you find yourself here, it really is a difficult place. But I hope we can offer some solace, and thank you for sharing.

We have the exact same diagnosis so I understand the pain you’re both currently in. The research I did, and the results from the doctor, state that as it’s AZFa not AZFb/c/d a microTESE won’t work as a man will never product sperm with it, so it’s a procedure and pain for your OH that in their opinion is unnecessary (that’s what we got told anyway).

I assume Ramsey will explain everything properly, but arm yourself with questions over the next 5 weeks so you get everything you need in that appointment 💖

Here should you need anything else! Xxx

Thanks @Disco24 I will send you a private message if you don't mind please. X

@Jesse32 of course! I don’t mind at all x

@Jesse32 So sorry to hear this....it sucks it really does but it does get easier with time. Partner had Non obstructive Azoospermia caused by Mumps. The devastation when we first found out was like someone close to us dieing....2 weeks after finding out we went on a holiday to Greece which helped settle us down massively. Only thing that got us through it was being busy, researching source papers, spoke to 3-4 of the leading urologists in the UK....the best source of help was the male fertility page on Reddit. Id highly recommend you go on there as lots of people on there with the same condition so you will learn way more on there. Sertoli cell only is mentioned quite often on there.

The way we come to terms with it was accepting Donor Sperm because at least we had an option. Id highly recommend you look more into donor sperm, get your head round it and it will make it so much easier knowing you have options whilst you still see what the odds are.

Thanks @donnie12 I'm hoping it does get easier with time. I'm sorry you had to go through the journey but glad you found your way! 😊
Thank you for the Reddit suggestion, I've been reading lots today. There seems to be some success stories with a Dr Peru in Turkey which I will look into further but taking each day as it comes at the moment. X

Hey everyone

Hope that you all are okay.

Quick question about Ovamex. I have been taking Ovaleap for 5 days and just about to start Ovamex. Did you have to get rid of any bubbles in the syringe before using? I spoke to my fertility nurse who said that the air bubbles are already at the top, so no need to flick the syringe to remove them. You can literally keep the needle upright, pull the plunger to prime the needle and start the injection.

Just want to get it clear in my head.