@DeterminedOne: i know someone had done the hyscosy with monitored cycle. Let me ask her and get back to u.
Hi all, I'm brand new to forums and just getting a feel for this. My DH and I are still processing the information that he has NOA. Our story is that we were trying for about seven months, when we thought it might be worth just getting some tests to check everything was ok. When all of my bloods and FSH/LH tests came back normal we sent my DH for a SA. It was the biggest shock of our lives to find out that there was no sperm in the first SA test. We then did a follow up SA, and still nothing, so we were referred to a urologist who requested a SSA which again found nothing, and all bloods tests came back "normal". So we were then referred to a micro surgeon to under go for a fine needle aspiration and possible biopsy. The specialists were absolutely positive there would be sperm and even suggested we go straight into a cycle of IVF so we went through the whole application process, police checks and everything to be ready. Something stopped us from starting the IVF stimulation process, as we wanted to be absolutely sure they would find something first. On the day of the needle aspiration unfortunately after three attempts under a local, my poor DH was told he was going to be given a general for them to complete a biopsy in the hope they would find something. Again they didn't. They told me the news first whilst he was in recovery and I just cried. It was the second biggest shock after having so much hope since his chromosomal tests, bloods and hormones all appeared normal. We have now been told he has germ cell arrest, which basically means he is attempting the production of sperm but it is arresting at the primary stage giving us a near zero chance of conceiving a biological child of his naturally. They have suggested for us to do the mTESE procedure to rule it out once and for all but we have to wait six months for this. In the meantime, we are wishing to seek a second opinion on the results and wondered if anyone could recommend someone. We have made an appointment to meet Dr David Golovsky in Sydney (we're in Melbourne), but we're now also turning our heads to international prospects. The reason being we have to know if Germ Cell Arrest can be cured, if there is a way to stop the arrest and if there are studies of successful sperm extractions with this condition? Obviously we want to exhaust all possibilities first and then we will have to look at other options like sperm donors or adoption, all very daunting right now. Does anyone know anyone with a successful story with this problem? I would love to get some advice from those who may have been through this or know someone who has. My DH also has a 4.5 FSH level and we have read in some reports that this is borderline "normal" and we have wondered if this could be a hormonal related issue afterall? Apologies for all the questions, but we have been told that seeking a second opinion is a good idea, but unlikely to see a positive response.
Jennywithanl: sorry to know that you have to join us. You are not alone. This thread has given me so much information and support. You are in good hand with Dr Golovsky. Our FS here in perth offered us TESE (not fine needle aspiration as the FS doesnt think it works for NOA patient) but only if we have a donor back up. Even so, the FS gives us zero chance of finding any sperm. The waiting period is 2 yrs in WA and we didnt want to be in the limbo land for that long. From what i read, there is still chance for finding sperm with my hubby pre existing condition so after reading so much about Dr G here, we did a phone consult with him for a 2nd opinion. If your DH hasnt tested his inhibin B level, i would recommend to have your GP order it, get the result before seeing Dr G. He uses it as a marker for chance of finding any sperm, especially other tests come back normal.
From what i read on this thread, each case is unique. Some ppl have normal hormone level but no detectable inhibin B level. Some ppl have sertoli cell only etc. While there are many markers, no one knows the outcome of micro-TESE until it is performed. If it is genetic cause, the percentage chance of finding sperm is known. If it is sertoli cell only or maturation arrest, there is also published percentage on cornell urology website. My hubby didnt do any needle biopsy etc prior and went straight to mTESE. As you already know, it is once and for all surgery. Another Dr who does mTESE in syd is Dr Lok at genea.
You can read back my story back in December when we finally moved on to mTESE and IVF. It was a roller coaster ride from having hope to no hope and repeat. It is heart breaking and i am working on the next step while hubby is not yet ready to talk about the next step in a sensible way. The chance is in fact near zero (so far on this thread) -- less than reported on the scientific journals.
My DH diagnosis is maturation arrest (no idea which degree). He did produce minimal amount of sperms, just not mature enough to come out. Repharsed from Dr G. There is no cure in this age and technology to fix this. It is still an active research. Nobody knows why some men have this problem. It is some sort of genetic misfired.
All the ladies hubby on this thread who had done mTESE/TESE biopsy and found no sperm, have moved onto donor. You never know......you might be the lucky one. We are lucky but not lucky enough to the end (hopefully not yet).
I have read many scientific journals and websites. If you want international prospects, have a read on cornell urology website (dr schegel is tge pioneer of mtese), dr turek in california and Dr Seber(?) of missouri website. We are lucky to have few surgeons in the country who do mtese so we dont have to travel far.
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Last edited by bbhope; 13-03-2014 at 01:44.
Hi BBhope, thank you so much for your reply. I have taken a few days to respond because I wanted to say the post and thread with my hubby when he was ready. I can't begin to tell you how amazing it felt to read your response and know we weren't alone. We are heading to Sydney on Friday and will let you know what the Dr suggests. On the back of your suggestion, we asked the current specialist for Inhibin B but he doesn't do that test so I guess we'll need to wait.
I will definitely read your story BBhope - and I am so grateful to know there are others just like us. It has been a very challenging time but made better knowing this forum is here.
Your story sounds identical to ours. DH had numerous tests, a TESA with a biopsy and an mTESE. I think our journey is best summarised for you like this:
- A few weeks ago our baby boy was born,. He’s beautiful and precious and we can’t believe how lucky we are to have him.
- Our first IVF was done in conjunction with a TESA with our FS certain there would be sperm as all the tests were normal. When they diagnosed maturational arrest, we were referred to a urologist who told us we could investigate further if we liked but based on his knowledge of similar cases, DH can simply never produce mature sperm. He was right, and in the mTESE we opted to try they found nothing. But our IVF could still go ahead, using our backup option of donor sperm.
It took a lot of time to come to terms with not being able to have a biological child together, and more time to become accustomed to the idea of using a donor. My best advice is to take things one step at a time, and weigh up the emotional/physical/financial implications of the options you’re presented with as you go through the journey. I’ll send you a PM so you can ask me more questions there if you like.
*Edit: Looks like I can't private message you as you are too new! Well you can ask me questions here, and when you get PM permissions you can do that too.
Last edited by littlesunflowers; 18-03-2014 at 21:30.
Littlesunflowers... it's so lovely to read about your beautiful baby, and how happy you are. I can't wait to get to that point too :-))
AFM.... Unfortunately I was a BFN today - my number was 0.6. The nurse made particular mention of it, saying it proved that something started, but not for long. I don't know if that means that it must have started implanting (as surely that's how anything gets into the blood), or whether it just grew for a few days then gave up? So neither the donor sperm nor Dr M's immune treatment (intrallipids) were the magic cure we needed, so I guess now we'll have to presume it's old eggs problem. Next step is using my sister's eggs, so maybe the donor sperm and intrallipids will work with better/younger eggs??? I still feel quite devastated, but sort of at peace, knowing that I have done absolutely everything that I could. Now we move on.
littlesunflower: congrats on the baby! So happy for you!
Bertie: I am so sorry to hear. You are a strong woman. I am not as strong as you. One could never tell what had happened with the embryo. I sort of need a closure for my miscarriage but the more I dig into about it, the more I am blaming myself and losing hope. Thanks for telling me your ANA value on the other post. Mine also came back 1:80. I am yet to have a follow up with Dr. M about the additional tests that he ordered.
Hopefully with better egg quality, intrallipids would work for you. FX that the next round is the one!
Jenni: feel free to PM if you want to know more or prefer to say in priv.
So sorry Bertie. Take some time out and look after yourself xx
Me: 34, hypothyroidism
DH: 33, azoospermia
Nov 2013 ICSI #1 with frozen TESA. 8 EC, 2 fert, transferred 1 day 3 embryo, BFN.
Jan 2014 ICSI #2 with fresh TESA. 7 EC, 3 fertilised. Transferred 1 day 5 blast - BFN. 2 x day 6 frosties
Little Sun Flowers: Thank you so much for sharing your story. Again I shared this with my DH and it has given us such a boost. We realise that this may very well be our path, and we are now feeling ok about it. We ended up seeing Dr G in Sydney last Friday - a week ago - up from Melbourne. After he went through the results and the biopsy we had done in Melbourne, he has agreed it is Germ Cell Maturation and has given my DH a 20% chance of success through mTese, however this reduces to less than 10% if they find nothing in one side, and they move to the other side. The reality is that we must prepare for the worst. So after reading the stories here from all the ladies, I think we are going to follow the same path and book him in for mTese procedure just to be sure, and at the same time, I'll go through a full cycle of IVF stimulation and on the day that we both go in, we'll have a donor sperm as a back up. We have decided to go away on a trip to Europe prior to this and aim for an October procedure. In the meantime, we are going to press ahead on researching donor sperm. It's taken some time to get our heads around it, but we are ok with this now. I have to say we arrived at this faster than I though and my DH is ok about it. I think because we now know the reality of the situation. Dr G said they will find a cure, but they are only at the stage of research in mice, then they move to rats, then apes and then humans before they will find a known cause and cure. It's unlikely it will happen in the time we wish to be parents. So ladies, I will keep you all posted on our journey. In the meantime, Bertie, I am sorry to hear about your situation which puts our situation in more perspective. As BBhope said you are a brave woman. To be honest, every woman on this thread is brave and I feel so lucky to be part of it now. I'm so glad I stumbled across this and found you all. I will honestly say this has been a life-saver for me and a major part of why I've been able to be strong for my DH through this. I owe this thread and you all for that. Take care. (PS I can't find the return key on this thread - I'm clearly still too new to have the private messaging and the return key options)
Jenni: I am glad that you guys have come to a conclusion and are moving forward. I think Dr. G gave me a similar percentage in the end. DH didn't do any biopsy prior and based on his pre-existing condition, he gave us ~50% chance. It is quite similar to what i read. Some people aren't azoo with this condition. Once he opened hubby up, he delivered the bad news of 1 sperm found, moving but abnormal (couldn't use it). I know exactly how you felt back then when yours did the biopsy. I was still trying to process the information so couldn't remember the exact percentage that Dr G quoted me. 10% sounds about right. He didn't cut open the 2nd one because of poor prognosis. I was, of course, in tears when I woke up from the EPU and didn't even bother to took at how many eggs they got.
It is good that you guys have come to term for the donor as a back up. It is a long road for the azoo patient to become parents. It would be at least 6 months before we are moving forward again (assuming we would get medicare by then). We are just not mentally and physically ready to go through the roller coaster again (OK, busy work traveling isn't helping). Besides, hubby and i are still trying to work things out. I have spent a lot of effort investigating the immu problem at this stage anyway.
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