Azoospermia - no sperm

[littlesunflowers]

We've just found out - two hours ago - that DP's first semen analysis shows no sperm. (My first blood test results haven't even been completely processed by the testing lab).

We haven't quite worked out how to deal with this news. Support, stories, advice would be very welcome...

[nicole83]

Hi littlesunflowers. I am sorry to hear your news. But please don't give up hope. We were in the exact same position as you. I will never forget that day. But long story short, we have out beautiful 18 month old DD.

Your hubby needs to start taking some supplements. Which state are you in? Who is your fs?

I am in qld and see Wazza. His list of male meds are:

Zinc tablets
Berocca
Fish oil
Handful of goji berries
20ml aloe Vera juice

My DH takes a men's multi and menevit instead of plain zinc.

We had 2 samples with zero sperm. Yes zero! After taking the above for 3 months & loose underwear and regular DTD, we had 100,000 sperm come EPU day! First cycle and we got our baby. Please PM me if you ever need a shoulder to cry on. Don't give up hope, you will get there xo

[littlesunflowers]

Thank you so much for your story - I am so glad for you! DP has been taking menevit regularly for about 3 months, sporadically before that (now I remind him more often!). We haven't yet been referred to a specialist, we are in QLD though. We've opted to do some more tests and find out the cause if we can - it seems that even though the causes can be many, the outcome is either that DP is infertile, or can produce some sperm that can be retrieved for ICSI. We hope that it is the second, and will pursue what we can on that path first.

I can't believe that in the space of a few hours our conception plans could change from "romantic weekends away" to "needles and petri dishes". It's going to be a long few weeks to find out if a baby belonging to both of us will be possible at all - the GP said to expect a 3 week or more turnaround for test results. :s

[RunningWithScissors]

Firstly :hugs:

Its such crap news to deal with :( Its certainly amazing how your dreams can be ripped right out of your heart with one silly test result!
DH is azoospermic..caused by a chromosome issue. We (well HE!) did a bilateral testicular biopsy to see if we could find any for ICSI, unfortunately there was nothing at all.
Took a long while but we decided to go with a donor and are now 19+3 pregnant :) Couldn't be happier!

[littlesunflowers]

That's great RunningWithScissors. I imagine it was a hard decision. I've always been more open to the idea of adoption than DP is because he's more concerned about bonding than I am, but he's also one of the most caring people I have ever met and I think we could use a donor if it came down to it and we were prepared. Right now of course we aren't - I'd always thought I would definitely use a donor if needed but faced with it now the idea of anyone's sperm other than DP's is just not appealing. :( Early stages though - and thank goodness we know, now, we aren't just poking around the dark (so to speak!).

Do your family and friends know you used donor sperm - if so how did they react?

[nicole83]

If you are in Brisbane I highly recommend dr warren de Ambrosis. Google his name, I made a thread here a while ago about him. He is the number one ivf dr in Brisbane - hands down! But yeah I totally agree with finding out the cause first. Understand the issue can certainly help you deal with accepting the solution. For us, it was unexplained. It does often cross my mind if my husband being a significantly premmie baby himself has anything to do with it. I know how you feel about romantic weekends turned into Petrie dishes....and needles! It's not easy that's for sure. But you will get there, just stay strong and take one day at a time.

[nicole83]

Also I just want to add that you should get referred to a specialist ASAP because their equipment for analysing sperm is so much better than qml or the standard pathology places. Snp did our first two samples and said zero. Wazza looked at our third sample under his own microscope and said zero. Then told us to take it up to the scientists lab at Qfg. They "spun" it down and found sperm but they were dead. So that gave us hope knowing there actually was some, we just had to do everything we could to get the next lot healthy.

[littlesunflowers]

Oh thanks for that tip - I assumed labs were labs but perhaps not. DP's next tests will be blood tests to check for any illnesses and genetic stuff before we do any more SAs, and we'll go from there. Our GP already mentioned a FS that she has liaised with who is based really near us and who gets praise on forum threads - finding the praise made me feel better. Gah, long slow road of one-day-at-a-times coming up!

[RunningWithScissors]

Hey again,

It took us a VERY long time to come to terms with it, I won'r deny there were several times where I just wanted to throw in the towel, I wanted OUR baby, not some strangers. What you said about using someone other than DHs sperms really struck a cord with me... I remember having a HUGE breakdown one night over it.. I was so upset I almost vomitted. I could not fathom the thought of having someone elses sperm 'leak' from me. It was the closest we came to never going ahead. Thankfully, I brought it up with the counsellor and was assured that the sperm is 'washed' and separated into small amounts. I'd never see or feel it. And it was true! We did have to ID our donor number on the vial..but it was a tiny little grey straw. I won't deny that not having to see/feel it didn't make it SO much easier!
I'd encourage you to try every avenue you wish before deciding on a donor ..(We thought about adoption but the process is absolutely ridiculous in this country, and we couldn't afford $30,000 plus for ICA) I know for us it was a matter of exhausting every single option we had, supplements, the biopsy, searching online for trials etc, before we made peace with the fact that it was donor or no baby.
Theres a lot of stigma attached to sperm donation..people think its weird, wrong etc..its a real shame that its not the same as egg donation where its seen as a wonderful gift.

All my family know, all my friends know and most acquaintances know. We won't be hiding the fact from bub. It was decided very early on that there would be no concealing the fact from anyone..if we seemed reluctant to share the truth, I feel like the baby/child would pick up on it quickly and feel as if there was something weird or wrong with the way it was conceived, and we certainly didn't want that. I made it pretty clear that anyone who had a problem with it would be out of our lives quick smart.
Luckily no one gives a stuff :laughing: No one has even asked us anything aside from if we are telling bubs.
We have been open about our whole journey though..so people are just over the moon to finally have a bubs on the way :)

[RunningWithScissors]

Oh and just wanted to add, Nicole is spot on about getting the referral to a specialist! Their labs are better equipped and their staff are trained to find even one little swimmer that a basic lab would easily miss!

[littlesunflowers]

Thanks for your replies RunningWithScissors and nicole83 - it's so great to have words of wisdom from people who have gone through this. 48ish hours after finding out, we're doing ok. We know we still want to raise children together, and if we need a donor to do that then we'll come to terms with it. As DP pointed out, we have two fur children (cats) - they're two of the most precious things we have, we love having them in our lives, and they aren't even the same species as us. :D So many families have step-parents/kids these days, and no one thinks twice when the step-parents have a closer bond to the kids than a biological parent that doesn't have much to do with them. And in the case of a donor, not only have they 100% agreed to the existence of a child raised by someone else, there's also no access visits to worry about or arguing about child support - that's a better scenario than a lot of families I know!

We did have a moment last night when we realised that the family trees we'd traced recently might not be relevant to our offspring (we got back hundreds of years). That kinda hurt, and I suppose those little moments are going to keep coming for awhile. Still. We still have weeks before we know what we are up against, so for now we'll just wear loose underwear, keep taking menevit and elevit respectively, and see what happens!

[RunningWithScissors]

Good luck... its a lot to take in so take your time! It was about 16 months for us from finding out to actually going ahead with the donor...and about 13 months from a firm decision to actually going ahead with it.
We still have our moments now, not of regret, but a little sadness that things just won't be 'socially' normal, but we will do our best! And besides...this little nugget was so much more wanted and planned for than lots of babies out there. Thats one thing he/she will always know...we'd go the the ends of the earth to have his/her in our life, however he/she got here :)

[peoniesarepretty]

Hi littlesunflowers. So sorry for your news. I understand completely - we've been through exactly the same thing.

In fact, there's a thread going about this over in the Fertility Assistance forum.
Here (http://www.bubhub.com.au/community/forums/showthread.php?338326-Male-Factor-Infertility-Chat)

In my DH's case,they double checked the semen analysis result. Still zero. Then he had the fine needle aspiration and a biopsy, and still nothing - he was diagnosed with Sertoli cell only syndrome. But there is nothing to indicate why - no chromosome issues etc. We're now seeing Dr Golovsky (if you're in Sydney, can recommend him) and he is going to do a full micro dissection, and time it with egg collection on an ICSI cycle for me. We are hoping he finds something - he thinks it's a 50/50 chance. We had been previously given no hope by another doctor, so had already come to terms with it and decided we would go the donor path. But now we've been given hope there might be sperm found in DH. Who knows, but :fingerscrossed: !!

Good luck with everything. Happy to talk further if you want to!

[littlesunflowers]

Thanks peoniesarepretty, and I hope your new doctor is able to find sperm. I'm really quite amazed at all the stories I've been reading over the past few days - the number of times sperm just aren't where they're expected. When the doctor gave us the news I really thought that was going to be it for us but I have a lot more hope now. Is there an icon around here somewhere for sending someone sperm dust? :)

Thanks also for the pointer to the other thread, I hadn't managed to locate that yet but I will definitely be popping in!

[lego]

>littlesunflowers - I hope that things go well for you.

I've just received a call from a scientist at the lab, and they've asked me to provide another sample, as they weren't able to find any sperm. I knew that it wasn't a good call, so i did some googling and the info that i've found doesn't sound so promising. It was a bit of a shock to get that kinda news over the phone, and i'm a little shell-shocked by it.

>nicole83 - I'm really glad that you've posted your good news, and that you've been successful at changing the zero sperm count situation. I'll be regularly taking the ultivite now, and adding the goji, fishoil and aloe vera. I'm hopeing that things will be good in 3 months too.

[littlesunflowers]

Hi Lego. I am guessing you must be male! I can imagine what a shock it would have been to receive that news over the phone. Our GP called us back for an appointment to tell us in person, and also told us we still had options - and we were still shocked. So sad that you had to find out that way.

I've also done a lot of reading about causes of azoospermia - my DP has opted to wait and find out his actual cause rather than getting distracted by possible scenarios (and we should find out pretty soon now). But if you want to read up about it the best summary page I've found is at: http://sharedjourney.com/define/motility.html

[littlesunflowers]

Just a quick update from me...we got back DP's blood / chromosone / DNA fragmentation test results. Everything normal there.

Which is both helpful and yet not helpful at all.

We have a referral to a fertility specialist - which is both progress, and more waiting. Argh! :(

[RTT]

Hi littlesunflower... I hope your journey has turn to become a more positive one. My DH and I were in the exact same position as you and I'll never forget how heart breaking, scary it all seemed. We had to wait 8 weeks to see FS as everything shut down over Xmas. By the time the appointment came we were both a complete mess.
My husband ended up being a carrier of the cystic fibrosis gene which resulted in him missing the vas tube. So in other words he was born with a vasectomy. We were so lucky, this meant that we could have our own biological chn, the sperm was retrieved from DH via a needle to his testicals and icsi. We now have pur very beautiful 7 month old son.
I hope this post sees you well xxx

[dgl]

Hi everyone! I'm new to bubhub :)

My hubby and I found out last week that his SA result came back saying no sperm - azoospermia. We were both devastated :(

I have been doing a lot of Internet searching and been hearing stories which has given us some hope..

Hubby has done some blood tests on Friday, and we're meeting with the fertility clinic on Wednesday. We are in Perth so was wondering if any of you have any experience with clinics/specialists in Perth?

Thanks and hope there has been good news all round for everyone!

[littlesunflowers]

Hi dgl and RTT :wave:

dgl I am so sorry about the diagnosis - it's such a blow, isn't it, you never think it can happen to you. Make sure you look after each other whilst you wait for the test results. There are so many causes for azoospermia, and there is indeed hope, and even if the results are not what you think you want there are still other options open to you.

Thanks RTT for your story - ours is briefly summarised in my signature. We had a TESA (needle extraction) in June, but no sperm was found. A small biopsy found only spermatocytes (a few developmental stages before sperm). All DH's blood test results were normal, with no genetic abnormalities, and he's never had chemotherapy or worked with dangerous chemiacls - so essentially, his azoospermia is completely unexplained. The cells just don't mature.

We have chosen a donor that we are very happy with and very grateful for, so next IVF we know we will have some good sperm regardless. We're probably going to do a TESE (surgical biopsy) first; it's a difficult decision to make as the chances are low and no-one can say how healthy any sperm found will be, whereas we know the donor sperm is great quality. TESE or donor or childlessness are our only options now, and like most people in this situation we want to make sure we are making the right choice for our family. If only we could ask our future children which option they'd prefer!

[dgl]

hi littlesunflowers! what a true statement - if only we could ask our future children! at this stage i would love to know that we will have future children! any more updates your end?

i have tried to stay off the internet for a few days as i was starting to drive myself (and dh) a little nuts i think...

anyways, he has had a few more blood tests and we've got the hormone results back. we don't see the fertility specialist til the 17th of october as that's how long it takes for the genetic and chromosomal test results to come back.

I was hoping someone could help me interpret the results of the other tests though, based on your experiences?

testosterone - 11 nmol/L
SHBG - 22 nmol/L
calculated free testo. - 270 pmol/L
FAI - 50.0

haemoglobin - 151 g/L
white cells - 3.9 9/L (with a comment saying borderline low WCC - what does this mean??) http://tickers.tickerfactory.com/smiles/icon_confused.gif

FSH - 6 U/L
LH - 5 U/L
prolactin - 210 mU/L

treponemal serology - 'treponemal antibodies not detected' (what does this mean??) http://tickers.tickerfactory.com/smiles/icon_confused.gif

thanks everyone in advance!

i don't know how we're (i'm) going to get through til the 17th of october! http://tickers.tickerfactory.com/smiles/icon_sad.gif

[littlesunflowers]

Hi dgl

I'm afraid I can't comment on those results - all we were told is that DH's levels were normal. If you're still researching, I found a lot of info about male infertility at: http://www.ivf.com/ch8mb.html

I also drove DH crazy with reading about all the possibilities. There are many, there really are! I know you can't stop thinking about it and wanting answers, but if you've got a lot of the tests underway you may well have an answer at your appointment on the 17th and if they think IVF/ICSI is an option for you, you may find yourself doing that before the end of the year. The time before our first appointment dragged on forever...it got better once there was an action plan. In fact time went scarily fast once I realised how soon I'd be learning to give myself injections! (I'm a huge needle phobic...but I did it once, then was fine after that!)

Now is the time to throw yourself into other hobbies, or novels and DVDs if you can't face going out. Anything that takes the focus off the overwhelming possibilities. I put a lot of pressure on myself to search for answers...DH left it to the doctors...the outcome has been the same, but he got more sleep than me along the way. :)

Oh, if you have private health insurance, you might want to check now if your DH is covered for "pregnancy and birth services". He may be one of the small percentage of men to whom that category of cover is applicable. Depending on the diagnosis you might not need that cover (or be able to upgrade in time to use it), but I just thought I'd mention it.

Hang in there!

[dgl]

Hi everyone.
Well we got back from our appointment not long ago and the news is not good. DH has AZFb micro deletion which basically means he most likely doesn't produce any sperm. So no chance of having our own children, the doctor said the only option available to us is donor sperm.

I am not sure what to feel, actually think I'm pretty numb. It is heartbreaking especially as at our previous appointment the doc was certain it was obstructive and we had a chance at TESE and IVF/ICSI due to DH showing no physical or hormonal traits of genetic issues. As much as we said to ourselves that we weren't holding our breath til the genetic results came back, it's still such a blow.

I don't know whether I could go the donor sperm option. I think if it's not his baby then I'm not sure if I could handle it? I was actually thinking I could handle donor embryo better? When I mentioned this to the doctor, she said yes, that is like a very early adoption. That's exactly what I thought. Does anyone have any thoughts on this?

I am not sure where to go from here :(

[littlesunflowers]

dgl, I'm sorry for you and your DH. :hugs: It's so hard to hear news like that. The feelings you have now are probably shock and the beginnings of grief - just go with it, for as long as you need.


We had a similar experience; they thought TESA would be successful but it wasn't. Choosing your next step is very personal and it will probably take time for you to get there. Your DH might take more or less time than you and have different reactions along the way, and that might become almost as hard to deal with. Just keep remembering why you married each other!


You've already realised that even if you can't have your DH's genetic children, you can still have a family together, and that's good - there's a new journey to start as soon as you're ready. I'm pretty sure that no matter how you choose to bring a child into your family, you will love that child at first sight. But if you find yourself feeling uncomfortable with any option, don't commit to it until you've worked through it and become comfortable with it. Your clinic should be able to help you find information or even support groups if you need that - that's in addition to the support you can find on BubHub, of course. :) If you have a search of the Forums - or even back in this thread - you'll be able to find some posts that might answer some of your questions.

[peoniesarepretty]

Hi dgl - so sorry for your news. I understand how you feel. My DH definitely doesn't produce any sperm either. It was devastating to learn that, and we kind of went through the bad news/grieving process. After the biopsy & TESA we were told he had Sertoli-cell only syndrome and no sperm etc etc. We were devastated and dealt with that news then. A little while later it was suggested we see another doctor, who is the guru in this area. He ran some BTs and found that DH did NOT have those microdeletions, so he felt he had a 50/50 chance of finding some sperm by doing a microdissection. But he didn't find any, so after getting hopes up a little bit, they were dashed again.

Sorry for the roundabout way to say, I understand. You need to do what is best for you, but for us donor sperm was the answer. That way it would still be my child etc, and DH was quite adamant about that. As it happens, we haven't had success really with the IVF (well, 1st cycle worked but then miscarriage) - maybe there are egg quality issues for me, I don't know. But I'm feeling a little dubious about the donor sperm we had from the clinic. We are going another route (after wasting a lot of time & money on IVF), and I'm happy to chat to you more about that on PM when you feel ready. PM me whenever you like. But yes, it might take some time to adjust to this news & really think about your different options. *big hugs*

And I'm sorry I never really responded at the time for you, littlesunflowers. I was going through a rough time. xx

[dgl]

thanks littlesunflowers and peoniesarepretty.

i think we are both going to give ourselves some time as yyou say. we have a 4 day weekend trip that we had booked previously, and we leave tomorrow morning, so we are looking forward to that. will give us some time to get away, and enjoy being childless for now. there are so many things that you can do when it's just you two when you don't have to think of children, so we are going to be posiitive and do that for a bit and enjoy some us time.

we are both still in a bit of shock but i think we are doing ok, considering. i do feel terribly for dh as he mentioned last night that he won't be able to pass on his genes. i think more than anything i want him to be ok. whatever he is comfortable with is what i'm comfortable with.

i can sense my dh is so worried about me and how i'm dealing with this, that i think that he feels bad and guilty, even though he says it's not the case.
have you got any advice on how your dh's felt with the situation that donor is the only option? about not being able to pass on genes? i had a quick look on the internet for forums for men as i have found this so helpful that i thought maybe my dh might be able to vent some of his fears and thoughts this way as well. but there doesn't seem to be much out there for men?

thank you for all the support, just knowing we are not alone is a huge help. and also being able to talk to other people in the same situation.. thank you. :hugs:

peoniesarepretty, i will definitely like to know what the other route you are trying is.. i will pm you soon. thank you!

[littlesunflowers]

I haven't seen much in the way of forums of this nature for men in all the months I've been searching the Internet for information on this topic. But I've also realised that the number of men who can't be helped by TESE is quite small. Our FS said that azoospermia was probably more common than we realised, but even on BubHub I think I've only come across about 5 couples who have mentioned that their MFI is so severe that TESE can't help. Also I suppose many men don't really like to talk about it, even with other infertile men.


My DH wants us to be parents, and we're both grateful that a donor is willing to help us along that path (and meet our child/ren later in life if that is what they want). He is sad that he might not see his family's genetic traits in his children, feels guilty that I have to go through the IVF etc, and has worried that our children might say things like "You're not really my dad!" in arguments (our clinic counsellor talked about how to handle this). We have no doubt that the child will be loved by all our family, and we think that a child brought up by us is going to be like us in many ways even if different in some ways...just like any child, really! You and your DH might find the "Letters" on this site helpful: http://www.dcnetwork.org


peonies, I remember reading some of your other posts at various times - trust me you have been helpful to me (and probably others!) even if you haven't realised!

[MGC Bertie]

I've posted this elsewhere on other "Azoospermia" sites, but want to make sure that all with Azoospermia find this information quickly and don't just "stumble" upon it a year later in their journey, like we did :-))

Something interesting I read about "Inhibin B" levels fromhttp://www.ncbi.nlm.nih.gov/pubmed/12749428

They did a study on the effects of Inhibin B on the outcomes of testicular sperm extraction (TESE) and of intracytoplasmic sperm injection (ICSI). They looked at two groups of men with non-obstructive azoospermia
- group "A1" of 25 ICSI cycles from 42 men with Inhibin B <15 pg/mL = 21% fertilisation
- group "A2" of 35 ICSI cycles from 33 men with Inhibin B > or = 15 pg/mL. = 48% fertilisation

I know it's not definitive, but it sort of indicates why Dr Golovsky thinks highly of doing the Inhibin B test, and how those with levels <15 he gives 20% chance, while two others here on Bubhub have mentioned previously he gave them 50% chance (I'm guessing now that their Inhibin B levels were >15). Again, I wish we'd known the importance of that test, and would have asked to have had that done a year ago too!! Hindsight is great - I just hope that some others will read this in the future and get the test done as soon as someone mentions a sperm issue. Wish everyone luck :-)

Interestingly I only found out about those percentage chances after our visit to Dr Golovsky. He didn't give us a percentage chance, and instead used the words "very good" chance, a little later in the appointment an "excellent" chance, and later that we'd probably get straws to freeze!!

[MGC Bertie]

Quick update.... Dr Golovsky seemed quite dissapointed that he didn't find more than one "good" sperm - a lot of hard work for one. But that one has fertilised and will be transferred tomorrow.

[MGC Bertie]

Well, with just one sperm... I can say I'm PUPO!!! Kind of seems a miracle to get even to that stage, when the majority of men have 50,000 sperm each time, and here we are with an embryo from just 1 good sperm!! The other two eggs (which probably had the twitchers) didn't do anything.

I had my ET this morning, and unlike in my first cycle, that speculum thing hurt absolutely massively. I was in so much pain, and I told Prof I so. At one point I was hurting so much that I was about to faint, and thought I was going to mess up the whole ET. I mostly had my eyes shut, and only opened them briefly to see my beautiful 7 cell grade A embryo on the screen. Then I closed them again and instructed DH to look lots at the embryo and enjoy it for me!!! The ET was nothing like my first cycle ET, nor pap smears etc, but Prof I didn't seem fazed that I was in inordinate amount of pain, and just said it will be over soon. That 5-10 minutes was the longest ever. As soon as he took it out, it was fine, but I'm sure it wasn't in right or something. Anyhow, not withstanding excruciating pain, we have one beautiful 7 cell grade A embryo transferred, and Prof I seemed very happy about that. And so are we :)

[MGC Bertie]

IVFA has charged us $1400 for mTESE (which was what we expected it to be), but then they also charged us another $600 for "surgical sperm extraction" when obviously we didn't have that, since it was Dr G who extracted the one and only good sperm. I'm going to ring them tomorrow and see how they justify that.

AFM.... Unfortunately I think I'm bust. Yesterday (Sat) I had one spot of blood, today (Sun) another bigger spot, but that's it. It's like AF is teasing me - if you're going to come, just come and get it over and done with. What I'm so annoyed with is though I told my FS that my usual cycle is 28/29 days, I also told him that AF came early in both my previous IVF cycles (22 + 24 days), obviously due to all those drugs. This means that if yesterdays blood was the start of AF, then my beautiful embie may have implanted, but hadn't yet had any chance to send messages (hormones or whatever it sends) to keep AF away and will have been washed away now. DH is even more furious than I am, as he remembers me telling the FS this, and obviously the FS hasn't factored early periods during IVF cycles into the equation. Has anyone else experienced this? (ie. normal cycles, but early ones following IVF rounds).

[MGC Bertie]

Hi all.... I had my EPU this morning. We got 4 eggs, so I was pleased about that, since there were only 5 follicles in total (2x24mm and 3x10mm). We found out this afternoon that 2 were mature, so not surprised that the little ones didn't do much. Unfortunately the scientist who rang said there was no sperm from DH that was "of the quality we wanted", so they've injected both eggs with the anon donor sperm. So I had a nice cry, to finally get over not having any sperm from DH and not going to have his baby, but now feeling emotionally better having that finally out of the way and hopeful that the anon donor sperm is now going to work. It's good to be moving on.