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

That's so exciting you're moving forward @WhiskeyInTheJar33

My AMH is 15 and AFC was 17. My eggs collected were:

1st round:

• 19 follicles (one was a cyst)
• 13 eggs collected
• 3 mature

2nd round:

• 20 follicles
• 16 eggs collected
• 13 mature

I know it's easier said than done but try not to worry too much about numbers. Has your doctor recommended any supplements for egg quality?

@wateringcanface i think its because OHSS develops some days after the trigger injection, which usually coincides with the embryo transfer. So they don't always know if it's going to happen before transfer. I've actually been told we are a freeze all this time too. However not very hopeful we will get anything to freeze after the last 2 rounds anyway 😔

@wateringcanface as lemons said, think it occurs nearer embryo transfer so you don't know if you'll develop it or not. I've heard stories of small numbers of eggs collected and women still develop OHSS. The doctor kept saying my AMH is "excellent" for my age but because it is on the high side, she'd rather not risk it and just let my body and hormones settle before transferring an embryo.

@lemons44 it's soo hard not to worry about numbers when that's all I've done up until now with DP lol 🤦🏻‍♀️
The doctor didn't say anything about supplements. At the moment I take coq10 which is meant to help with egg quality.

Unfortunately it was a BFN for us. It hit me fairly hard as I had a feeling that this was going to be the one. I know its silly, but it just felt like everything was aligned for us to get a BFP this time around. We will look to do a frozen transfer in Jan/Feb so still have something to be hopeful about. I hope this doesn’t come across as insensitive as I appreciate how lucky we are to have embryos.

I know that someone asked recently if anyone had a successful micro tese (apologies I can’t seem to find the post). Yes, my DH had a successful microtese in July. He was given a 50-50 chance of finding sperm as there were indications it could have been a production problem but also signs it could have been a blockage. My advice is not to spend too much time with investigations and try to get referred to someone who does the surgery. We saw a urologist a few times and while she did a few investigations and the necessary genetic tests, we felt like we were going no where. Once we got the referral to the IVF clinic/surgeon, things moved much faster.

@Runner77 I'm so sorry 😞 can't imagine how you must be feeling. Sending you lots of strength and I hope and pray the next round is successful x

I'm so sorry @Runner77 ☹️ I too found the second failed transfer harder. Give yourself some time to grieve and look after yourself ❤️ sending a big hug xx

Thanks so much for your kind words @2022ttc @lemons44. I’m feeling a lot better having put it all in perspective. We will go again in Jan or Feb. Hopefully 2024 will be the year for all of us.

@Runner77 glad to hear you're feeling better ❤️ and yes I hope and pray 2024 is the year for us all! I've been feeling the stress of all of this recently and it turns out my blood pressure is high for the first time ever. I've been asked to monitor it for 2 weeks and see if it goes back down but I think it's all this overthinking worrying and stress getting to me

I'm sorry @Runner77, you seem to have handled it impressively well! I guess for now just focus on yourself and relaxing as much as possible between now and new year.

What are people's techniques for not letting this journey take over? I am finding work such as struggle, I'm self-employed and work from home, and I am just losing interest. I am fine when I have plans, if me and my husband watch a film, go for a walk, go for dinner, I meet friends for drinks, go to parties/events etc, I have fun then, but if I'm just sat at home I ruminate constantly. I have a very nice life and I keep feeling I should give my head a wobble that needing fertility treatment and having to wait isn't the end of the world, but I just can't seem to shut my mind off from it. I think a big part of it is I just feel vulnerable, with other infertility cases there is always a chance of it happening naturally, even if the chance is low, two of my friends were going through IVF for unexplained, and one fell pregnant the month before IVF, and the other fell pregnant after the second failed cycle. I am 100% dependent on fertility treatment to get pregnant, and apart from keeping myself as healthy as possible, I have 0 control of the situation and it makes me very anxious.

Also, has anyone else known about or heard of someone who managed to use vasal sperm for IUI? I read a few studies, one UK based but most from China and Singapore and saw some clinics in America where they mention it on their website, that if they are able to get sperm from higher up the tract with surgical sperm retrieval where it gains more motility, it can be successfully used in IUI. I would like to push for this if it is an option, but I think doctors can be quite dismissive if it deviates from their typical protocols.

@2022ttc thank you, I do still have a few tears every now and then but overall I’m looking to the future positively. Sorry to hear about your blood pressure. This process is an incredibly prolonged stressful event. What do you usually do for stress relief?

@wateringcanface thanks for your kind words. Yes, this process can be all consuming and dominate so much of our thoughts. I find exercise is a big stress reliever so I made sure to keep up my usual gym routine. I also did a marathon recently, which may not be advisable for everyone, but it was more to do something for myself and achieve something that was within my control. I’m also trying to schedule in catch ups with friends, fun activities and plan a trip to have things to look forward to.

sorry I haven’t heard of that process, but would love to know more if you obtain further info.

Hi Everyone, I messaged on here a few weeks ago with my TTC story and are currently looking to start another round next year. From what the embriologist told us Micro Tese opp collected some sperm but they recomend having back up donor sperm as the quality and cuantity is not great. Dr Ramsay recomends using all 4 Vials we have to let the embriologists pick the best quality sperm and give us the best chance.
We are now wondering if we should switch clinics to give this one go the best chance. We are currently at Chelsea and Westminster where we did our 1st round on the NHS. I have read some messages on here that some of you went to CRGH and some to ARGC. I would be interested to hear from you how it went and if you would recomend these clinics? Are there any other clinics which are specialised in ICSI?

We had our post Micro Tese appointment last week. We were told abnormal cells were found in his biopsy and my partner has now got to check himself every month and have scans every year as they could develop into cancer. He has unexplained infertility. Just wanted to pop it on here in case it helps someone. Really not what we expected to hear.

@Nilu17 hi, just read your message but not sure I can shed any light as we are not so advanced in the process. We have our first consultation with Dr Ramsay next week

Hi everyone,

Firstly, thank you all for being open in your posts it's been really useful to read from the sidelines. But I thought it was time to jump in as I feel next year we're going to need some people who knows what it feels like.

We started trying at the beginning of this year (2023), we didn't want to waste any time (my OH is 40) so I had a private hormone test and he did a private sample and we found out my OH had zero sperm. We've since moved into the NHS side of things. His ultrasound all seems fine, although volume on the small side. However his hormones are raised (his most recent numbers below) which for me suggested NOA. I'd be really keen to know if anyone else has similar hormones raised as I can only see other combinations of hormone levels.

FSH: 18.2 - raised (range 1.2 - 12.4)
Prolactin: 740 - raised (range 86-324)
LH: 7.2 - normal (range 1.7-8.6)
Testosterone: 15.7 - normal (range 7.6 - 31.4)
Other bloods all normal, but Creatine slightly higher (111, range 59-104)

We have our follow up at UCLH in January where hopefully they'll give us next steps (since August they've done a retest of hormones, genetics, US and another sample). We've since booked our wedding for next year, so it's lovely having a positive distraction, but I'm still keen to have an idea of next steps. E.g. will they try us on medication first, or go straight to TESE.

Thank you for reading my essay, I'd really appreciate any similar stories 💖

Hi @Disco24

Sorry you find yourself here!

If it's NOA i'd recommended pushing for an MTESE. I think there's only a handful of consultants who do this so I'd get on a waiting list.

If there's medication/ life style changes that can be trialled during the wait list then its worth a try while ttc naturally. But I personally wouldn't want to wait several months to trial medication, then be put on a waiting list.

It seems like the nhs pathway has moved quite well for you! We are almost a year down the line of dh becoming infertile and only just have our first Fertility appointment in Jan 🙃

A lil update on me - I'm doing well, a lot less obsessive with googling/researching things. Looking forward to Christmas. Not too long till our first appointment where hopefully we can discuss a plan.

Thank you @wateringcanface , a pretty crappy place to be but nice to have a space to help each other. I'm really sorry it's taken so long for you, I read you've been sent from pillar to post which is just so frustrating. I really think it's a postcode lottery, we live in London with access to various services, which is just not fair for equality.

Getting a plan is the thing I need now, so I'm glad you're also close to getting one. I just want a timeline! I'm also having to lose some weight before the referral so I know it'll be a little time until we can apply for funding, but hoping the MTESE can be done whilst all that is going on.

I had a bit of a meltdown last week, just with frustration (we now have friends on their seconds) and I'm really glad you've found some positivity and you're looking forward to Christmas. I think I read on a previous post you were looking at just enjoying a Christmas for yourselves and that's a great way to look at it. I'm going to really enjoy my work Christmas party, having a few drinks and travelling to family. And really get the most out of this life, as hopefully there'll be a time in the not too distant future where this all changes forever ❤

@Disco24

These forums and groups are really helpful. Sometimes I don't even mind If no one reads them, even just the act of typing out my issues seems therapeutic for some reason 😆

Yes, we have had a bad time with it. I should go through pals really I just don't have the mental energy for that right now.

I'm the same, even though I'm inpatient I can handle a bit of a wait as long as I have a month and a plan established. Its been the waiting to even start the process that's infuriating. I hate having so little control of the situation, our ability to have a family is completely in the hands of others.

Have you got any particular diets in mind? I've heard keto is meant to be good for Fertility, I know your Fertility isn't the issue but if you can give it a boost while loosing then that's a plus.

Yeah I've got lots of lovely plans over Christmas and New year, which I'm looking forward to. I went out with a pregnant friend the other day, and she said she's desperate to be able to dress and have a few drinks. Said she basically doesn't enjoy anything apart from sitting on the settee and eating as she feels sluggish and uncomfortable. So, she said to enjoy life while feeling good. I'm happy to take her comments as non condescending as she took 3 years to conceive.

Well we're all here for your therapeutic offloads!

Hopefully your plan is just a few weeks away. It's definitely a control issue for me too, it's what I hate. Are you still NHS yeah? It would be good to keep updating each other with our processes.

Diets wise, I'm just calorie counting. I'm already half way there, so I'll shift the rest over the next few weeks. Hoping it all aligns with OH test results and then we can magically apply for funding at the same time. Simple right 🙃

Sooo true! You absolutely should enjoy it, dress up and have a good time. We're going to have a year of it next year, so I'm ready to let my hair down.

@Disco24 Yes, therapeutic offloads are great!

We are NHS for now, we did originally try going private, but the consultant we saw basically strongly recommended we go NHS and not waste funded rounds.

We will see what happens come January with our NHS appointment, I cannot pull a time frame out of my head which I deem too long to wait. I think anything less than 6 months I am fine waiting. Much more than that? I'm not sure.

if it is looking towards 9 months and a year to get started with NHS, we would perhaps look at doing one private round, though we would want the SSR on NHS, and save the other 2 NHS rounds.

My absolute ideal is that we can do IUI if they are able to retreive semen through vibratory stimulation or SSR done higher up the tract. But that is a long shot.

Hello everyone hope you're all well!

So my husband and I finally had our first appointment with Dr Ramsay today. We had all his hormone, genetics, Y chromosome and micro deletion tests done beforehand so he had seen those ahead of the appointment today.

In summary, my husband has had a long and complicated medical history including cancer as a child so our worry was that the chemo may have caused his azoospermia, which is non obstructive.

So in terms of next steps are that he has been given Anastrozole to be taken for 1 month following which dr Ramsay would like him to have his hormone and semen tests re done to see if it changes anything.

I wanted to ask if anyone else has tried this and whether it made any difference x

Hi @2022ttc it must have felt nice to see some small progress in investigating your DHs issues. Sounds like he has been through a lot. I really feel for our partners who have a difficult medical history and now have to deal with another obstacle. Hope you both have some success with the Anastrazole. We don’t have any experience with it I’m afraid.

@2022ttc glad you've had your appointment with Dr Ramsey and have your next steps in place.
DP had anastrozole and responded well to it. It improved his testosterone levels. He momentarily had 2 sperm in his SA which went back to 0 when he stopped the anastrozole. We fought to get him back on it before his micro tese (which was successful - 3 vials are in the freezer!). Fingers crossed it works for you x

@Lily1994 how are you getting on?

For you and @lemons44, I have posted my husband's regime below. For those who don't recall, my husband has testicular failure so not fully azoo but rapidly heading that way and these vitamins made a massive difference to his results (at latest fertility preservation about 10* motile sperm, so still very very low but a MASSIVE improvement) so thought it would be useful to share.

1 * proceive max men sachet
500mg ashwaganda
200mg omega 3
15mg lycopene
2 * 100mg ubiquinol
305mg fenugreek
1000mg vitamin c

I have been taking a prenatal + selenium and vitamin e, vitamin b complex and the same ubiquinol and omega 3.

We also cut out all emulsifiers, caffeine, alcohol and refined sugar and had cooler showers.

I had acupuncture and drank a litre of organic semi-skimmed everyday of stims and cut out all strenuous exercise (started yin yoga). This may sound extreme but we really really wanted to give our NHS IVF cycle our best shot. My AMH is 4.7 so quite low and it felt like we were very up against the odds the whole way through. I remember waking up from egg collection and the people in the booth next to us had 14 eggs and 2 MILLION sperm, which felt like so mhch to us (even though i found out more than 50 million is normal) and that we were no hopers...

I know @WhiskeyInTheJar33 you asked about this so our results were:
7 eggs
4 mature
3 fertilised with ICSI
3 perfectly symmetrical 8 cells at day 3
2 AA blasts at day 5 and one poor graded blast

We went to King's fertility (CRGH and ARGC also have the specialism for male factor infertility) and we felt that although the stims section of the cycle could have been better (for various specific reasons to our situation) the sperm selection and embryology was amazing. Also, relative to other stories on this forum they were very thorough and the standard of care was high.

I had one AA transferred and one frozen which for our circumstances is an incredibly positive result and we were so shocked to have anything to freeze.

I don't want to be triggering for anyone as I know how hard and lonely this journey is. But, I always want to know how things turn out. I am now 10 weeks pregnant with our first transfer. I feel like I won the lottery so I wanted to share what we did (in case it wasn't just luck) to try and help a really kind group of people who helped me when I was at my lowest.

@LIVFingOnAPrayer19 thank you so much for replying, I really hope it works for my husband too! Do you mind me asking where you are in your journey x

@TheFanciestPants many many congratulations to you! So lovely to hear positive news - I pray you have a happy and healthy pregnancy ahead of you. Thank you for sharing your happy news x

@TheFanciestPants thats amazing news, congratulations!!! Thanks for sharing

We had our appt at Kings, and are just waiting for a date for the MTESE, so things are slowly moving along.

@2022ttc I believe @WhiskeyInTheJar33 said that Anastrozole helped her DH. JR also prescribed this to my DH and testosterone has improved slightly.

Hi everyone, It seems like such a long time since I posted anything. How is everyone? It's lovely to hear some positive news from @TheFanciestPants - congratulations! I will definitely start to look into the supplements as need to start prepping for this.

It has been a really rough couple of months for us. First there was the diagnosis of azoospermia which as you know hit us really hard as it did for all of you guys. Then 2 weeks ago my nan passed away which was a big shock. Then my cat (our furbaby!) was diagnosed with diabetes. We took him into the vets last week to start him on insulin and to be shown how to inject however he went absolutely mental and bit the vet really badly! So we have decided to go down another scarier route of a new oral drug. It means that we have to test his blood glucose and ketone levels twice a day using a little needle and force him to take medication every day. My husband has been sleeping on the sofa for the last 5 nights to make sure he doesn’t die in the night! This has definitely stolen the limelight away from the fertility issues but is causing us unbelievable stress! And then out of nowhere, my dad had a heart attack last Wednesday! He is fine now and has had a stent put in but we just can’t believe how much shit we’ve had thrown at us in the last couple of months! We’ve had to cancel all our plans and struggling to look forward to Christmas!

We had our first fertility appointment on Monday. It went OK-ish. I had bloods retested and my AMH done. This came back as 10.2 – is this OK? Seems a bit low? I also had an US which came back as all OK – apparently I had 14 follicles on one ovary and 11 on the other. Husband has had genetic bloods requested and has been referred for an US which should be done in the next few weeks. They have requested a HSG for myself.

We have an appointment booked with Dr Ramsay in mid Feb so we are just trying to figure out whether all of our results will have come back by then so that we can go prepared.

@Runner77 - I'm really sorry to hear you had a failed round. Try to stay positive and look forward to the next round - I know this is hard to do however people keep telling me to stay positive so I'm trying to take some of my own advice!

How is everyone else getting along in their journeys? Is anyone looking forward to Christmas? I'm really trying - I've got a xmas jumper on today however my smile is plastered on in a bit of a fake and anxious way! x

Congratulations @TheFanciestPants

It's not triggering for me, and I would hope not for others. What's the point in this process if there are no success stories? Your experiences and struggles to get to your end point still have a place here. Hopefully, we are all posting that update at some point in our journey (Also - I really hate referring to this as a 'journey' but I can't think of a better phrase - ordeal? Maybe).