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  1. #31
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    @Malak: I am so sorry to hear the news. What the urologist said is somewhat true. If your DH has smaller testicles, you want to avoid cutting as many samples as possible. BUT this doesn't prevent you from doing the mTESE, which is the whole point! With mTESE, the surgeon has to look for a good sample to minimize the damage. After the procedure, it is encouraged to do BT to make sure hormones are all normal.

    @DeterminedOne: I'm happy to hear that it is a good outcome with DrP. It makes such a different with a positive Dr and a dr who is on your side it, doesn't it? I figure he would give you 50/50. That's what they have been doing to everyone. I thought you got my email about all the BTs. Inhibin B isn't normally done (no medicare rebate) but Dr P is absolutely right that CF is the first thing they would have checked! However, given the biopsy result, i doubt that it could be CF.
    Last edited by bbhope; 19-02-2015 at 17:16.

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    DeterminedOne  (19-02-2015)

  3. #32
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    DeterminedOne.... that is all excellent. I so agree with everything your new Dr is saying.

    Malak... I'm shaking my head here. The mTESE, the most invasive of all procedures is the "last ditch" attempt to know definitely. Even though we weren't successful (just one OK sperm found), it totally put us at peace, knowing that we have tried everything and never had any doubts or "what ifs". It's a very invasive operation and took my DH 2 weeks to be feeling semi-normal again, but nothing that didn't heal up. No problem DTD, everything works normall (apart from no sperm in it!!). You really need to go and see the specialists in this field (the two in Sydney who we saw for consultations are Dr Golovosky and Dr Lok - you'll have to ask others who the specialists are in their cities)

    AFM.... rather freaked out again, as on way home (5.30pm) was listening to all my phone messages from the day, and there was one from the U/S place where I had my 12 week scan and NT BT on Tuesday - it said, "Can you come and pick up your NT results and take them to your specialist as it's high risk?" OMG, who leaves a message like that - now I have to stress all night, as the place was already closed at 5pm, so can't go and get them until tomorrow, before I go to my ob appointment. I first had a cry. Then I composed myself, saying that this was the whole point of doing these tests, was to find out now. Then I got mad and googled, and found that NT thickness should be under 3.5mm, and my baby was measured at 1.7mm, so from what I've read, that's not "high risk". Or maybe, it's got a "high risk" of something else? I know there's nothing I can do, but gosh, it's going to be a long 18 hours until I pick up those results.

  4. #33
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    The urologist has scared the living daylights out of hubby. He is scared something will go wrong again and he won't be able to walk.

    We are getting a referral to Dr Chung in Brisbane but DH thinks he might try to sell it to us. I thought maybe doing a Skype consult with Dr Golovosky.

    The urologist made it sound like it they don't find anything and keep going he will end up with no testicles. How much truth is there to this?

    Do they usually do Inhibin B tests? I am not sure if DH had that done or not. He definitely had CF done because the lady asked if we were sure because it isn't covered by Medicare. I am going to ring QFG tomorrow and get them to mail or email me the test results.
    @MGC Bertie ... usually high risk is people that are over a certain age and I believe that all IVF pregnancies are high risk anyway.

    Funny sperm was mentioned the urologist also said in alot of cases there aren't any good sperms found. I asked him about the success rate of mTESE and he said it was low and I had to tell him about research I had read that said it was around 24%. He did ring Dr Chung while we were there and he said he has done 6 for people with sertoli and found sperm in 2 cases.

    @DererminedOne since your DH has sertoli as well did they find any baby sperm at TESA or was it all sertoli? Great news you are heading in the right direction now.

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    MGC Bertie  (19-02-2015)

  6. #34
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    Malak... don't know where that urologist got the idea that they keep cutting until there's no testicle left!!! What the procedure is that the skin is sliced open and kind of folded back to expose the inside - there's no cutting away of anything. Once opened up, then Dr G looked in the tubules for the sperm (fat ones are the likely ones to contain sperm).

    Dr G said that Inhibin B is one the greatest indicators for success so your DH definitely needs to have this test - we got ours done before we had the consultation with Dr G and Dr L, so that they could base their diagnosis on as many BT results as we could get a hand on. If you have a consult with Dr G without the Inhibin B, then he'll refer you to have that done, and then will need to see him again before agreeing to the mTESE, so it's better to be prepared.
    Last edited by MGC Bertie; 19-02-2015 at 19:17.

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    DeterminedOne  (19-02-2015)

  8. #35
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    He explained something totally different which confused the hell about of me. At first said it was only done in the US. He said that they take out the entire testicle and then cut bits out until they find something. He said in the TESA (or is is TESE) he said 4 samples were cut out so when they do a mTESE they cut away more. As you can imagine this is why DH and scared of dying! Or having issues.

    I need to go to the FS anyway to get all the tests done for me since we would want to do IVF on same day. So I will ask her for a referral if it hasn't been done yet.

    Part of me wishes we had have gone straight to do DrC since he does all of the sperm surgies but we were referred to the urologist and didn't hear about DrC until near the TESA when I was googling for mTESE.

    The urologist said he has never had a complication like this before. He said the worse he has had is bleeding for a couple of days.

  9. #36
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    Malak... oh my gosh, that urologist doesn't know what he's talking about. There is not cutting away of the tissue, only cutting open and then sewed back together. Basically think on an orange - slice the skin of the orange half way around (ouch), peel back the skin of the orange (double ouch), perhaps slice into a segment (triple ouch), take out a pip (OK you get it, the sperm), wrap the skin back around and sew it up. Very painful, because, yes, the skin is cut open, and then peeled back. But no cutting away of the tissue or taking samples (except taking out some precious sperm from inside the tubules.

    You really should google some of the medical websites that explain it more technically than my orange example!! Also, there are some YouTubes, that I know my DH did check out briefly beforehand!!

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    DeterminedOne  (19-02-2015)

  11. #37
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    In short, TESE cuts away a larger sample than mTESE. Just like Bertie said, the whole point of mTESE is to look for the good one before cutting the sample. Any skilled surgeon won't just cut randomly! What your urologist said is nonsense. If he is randomly cutting, then i won't even call it mTESE. Go and watch youtube if you are curious. In our case, DrG found one sperm (abnormal unfortunately) and then that particular sample was processed in the lab. That's when they found few more. If you do mTESE once, fine. If you do it twice, three times then I would say that the risk of having hormone therapy is certainly high. It really depends on how much they are cutting. You need the tubules to produce hormone...... I don't think anyone wants to go through mTESE more than once! It is such an invasive procedure. It is the last resort and you want a closure.

    In regard to the quality, your Dr is somewhat right but again if you don't try, how do you know? My DH case is poor prognosis so the sperm quality is in question. I've two chemical pregnancies with no live birth with DH sperms and the fertilization rate is very low as compared to this cycle with donor (40% vs 90%). However, there are few lucky ones out there according to my FS. When she gave us the option of doing mTESE again, she did say that the quality can be a problem. And when they do it the second time, the percentage drops it down further. ie. 5% for us. But at that time, we have moved on and no regret. We just want to be a parent now. Another mTESE will put us back another year and might end up more tears. We are at peace and we will not trade anything for this baby who is growing in me. BUT YOU DO NEED CLOSURE and you are NOT there yet!

    I'll type more later tonight.
    Last edited by bbhope; 19-02-2015 at 19:16.

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  13. #38
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    Thanks guys for that puts my mind more at ease. DH will be alot more happier about this. We will be having a consult with DrC hopefully within the next month so that should help get some more information about it too. He did seem really nice from what I could hear when the urologist was talking to him.

    Personally this time I want to be comfortable with who we go with which means I will do a consult with one in Sydney too before deciding if we will do it in Brisbane or Sydney.

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    DeterminedOne  (19-02-2015)

  15. #39
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    @Malak no DP didn't have any sperm at all found in the TESA so yes just sertoli when we spoke with DrP today he said he couldn't recommend anyone in QLD or WA to perform the mTESE but I didn't question him either as I have read about Dr C. I think that the urologist you seen today was way out of line and unprofessional to tell you that?! I don't blame you or DH for being very concerned about this procedure especially from what has happened in the past. All surgery has its negatives, I guess is like anything you run the risk.

    Have your appointment with DrC you will know if he is trying to sell it to yous or not. After my appointment with DrP today my gut was telling me I was right about DrR here in Perth.

    What I would make sure you have is the inhibin B for DH and for you AMH, Cystic fibrous all the other tests are important but unlike me they have been missed and are critical. Im not sure about your weight (its probably fine) but unlike me again (jus another hurdle) Im overweight he did say it would be good to be under 90kgs Im 95 but shinking slowly ive lost 19kgs

  16. #40
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    @bbhope I realise they probably give everyone he 50/50 chance hey would have to until they done the procedure to get conclusive findings. What I am most happy about is this is what they do and its has given me great HOPE that even if they prognosis is poor we had the best


 

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