TTC w/zero sperm count, low T & Testicular Biopsy

maya1023

Hi there! New to this site...

Me and DH have been TTC since Feb 2013. In Dec 2013 DH had a physical, checked hormones and an SA. Turns out his Testosterone is extremely low (in the 100's, his age should be 700-900's) and he has 0 sperm. His FH level is a little high so his brain is telling his body to produce sperm but it just isn't working....looking like testicular failure. Other SA's have been done, and we have been told that there is "rare sperm with no motility." 

DH's Doctor/Urologist put him on Clomid in an effort to boost T production which would maybe promote sperm production but so far is not working. Anyone have any luck with this?

We are now talking Testicular Biopsy in December, but we aren't very hopeful  Not to mention our Insurance covers ZERO for fertility! Doctor is pretty honest which I like, but speaks very fast and always seems to be rushing us out. It's almost like we are inconveniencing him to ask questions. But we've tried other Doctors and havent had much luck, also we feel as though time is running out and we just want to move forward!

This whole thing is so frustrating. And OF COURSE everyone is pregnant right now, you can't help but wonder what you did to deserve this, why this is happening to you, etc. It's hard for me to keep my chin up, and it's completely devastating whenever we start discussing Donors.

Honestly any advice would be so appreciated. Any DH's on Clomid? Had Testicular Biopsy and found anything??? Just trying to wrap my head around everything...

Thanks!

tweetyknicks

MH is on Clomid after a somewhat successful vasectomy reversal and it has raised his T level and sperm count. Unfortunately his numbers are still too low for IUI, so we're moving on to IVF. No experience with biopsy.

mariana81

My DH is on Clomid for the same reason as yours.. So far what we know is that his testosterone level increased (from 100 to 400s) but it is still too soon to know about the effect on his sperms, it takes at least 10 weeks to show any improvements in the SA.. and DH has been taking Clomid for only 5 weeks so far.. However, his urologist told us that only 50% of the cases on Clomid shows better results in the sperm production. Let's hope we are the 50% that it worked, right?

I have the same problem with my RE, she is very nice and she explains everything BUT she speaks so fast that usually I get lost.. 

Best of luck!

Sigh202

DH took meds and was monitored by his urologist and was able to increase his count. Fortunately we froze because his count eventually dropped for no reason. He did the biopsy as a last resort but nothing was found. It's a really short procedure but he was a bit of a wuss. :-) Good luck!

Cindal

My DH was on clomid for about 9 months. We didn't see any positive gains on any of his numbers, but all of his hormone levels were fine prior to the clomid and were really supped up during.
No perspective on the biopsy mine refused to have any further testing done.  Good Luck!

 

erbear84

My H couldn't go on Clomid as his IF is due to cystic fibrosis.  However, he did just have a testicular biopsy that found 16 million sperm!  He's missing his vas defrens as well as his epididymis and they were still in there.  We also have no insurance coverage on this, so I know how you feel!

amyalbert

Hi there, my good friend had azoospermia (0 sperm). Not sure about his testosterone levels, though I believe they were normal. So I'm not sure if this has anything to do with your DH's case, but I just figure I'll throw it out there.

In his case, they found out he has a really really mild case of cystic fibrosis (he's perfectly healthy, but the sperm he produces just can't make it to his semen). They were able to retrieve sperm by getting them straight from the source -- which I assume is the same as a testicular biopsy. He was conscious for the procedure, they just used local anesthetic. Ended up being successful for them in the end. 

maya1023

Marianass did you DH have 0 sperm count as well? Good to hear about the Testosterone!!!!

Sigh202 do you know what all the Meds were he was on? My DH  is just on half Clomid pill a day. He was on it before for a few months and the SA was still nothing So we are skipping the smaller procedures and just going straight to the actual biopsy. The RE said it's pretty simple, but that my DH will be out of it and have to lay low for about a week after. 

erbear84 that is great that they found such a large number! Did you know prior that he was missing vas defrens as well as his epididymis? Also, do you remember how much the procedure cost? I am still waiting on quote/estimate!

Thank you amyalbert, good to hear a successful story! Good that he was producing sperm, that is the biggest question we have and are hoping to find soon!

tptbabe

Welcome!

 

We're not azoo, but very low counts across the board, partially due to low T as well. We were very fortunate to have fantastic results with Clomid (a 600% increase in numbers!) but it still wasn't enough for IUI. Thankfully we didn't require a biopsy, so I don't have any info about that, I just wanted to wish you luck!

maya1023

tptbabe that is great! What a huge increase! Not being able to do IUI, did you have to do IVF?

mariana81

At the beginning his counts were 0.6million, but then it started to drop till 1000 nowadays It is not zero but it is like pp said very low counts across the board. His urologist has checked for varicocele but no enlarged veins have been found so he believes the problem is in his testosterone.. I guess we have done the biopsy yet because we are waiting to see if clomid works..

tptbabe

maya1023 said:

tptbabe that is great! What a huge increase! Not being able to do IUI, did you have to do IVF?

Yes, we were able to do IVF and ICSI this past spring. Unfortunately the cycle didn't work as we had hoped, so we're looking at doing PICSI and a different protocol next time DNA frag tests came back "normal" but we figure that PICSI can't hurt?

Sigh202

@maya123 It wasn't Clomid but something similar.  Can't remember the name.  Sorry!

erbear84

@maya1023 we knew the vas deferens was likely gone (it's a genetic defect in men with CF) and a sperm sample confirmed azoospermia.  The epididymis was a surprise when they went in for surgery!  The entire thing was about $1000.  

maya1023

erbear84 - Well $1000 isn't too bad, not when it helps give you answers for your future anyways. How miserable As far as we know, his deferens, veins, everything is normal, just the Low T and zero sperm. The RE did say that his testicles are slightly smaller than average but nothing to be concerned about. Maybe it is all related? 

tptbabe - Sorry I'm new to all this, what is ICSI and PICSI?

tptbabe

@maya102 -Sorry, ICSI is Intracytoplasmic Sperm Injection. Basically, they wash the sperm so that they have the best possible swimmers, then instead of just placing the egg with a drop of the washed sperm, allowing for spontaneous fertilization, they selet a single good-looking sperm and inject it directly into the egg.

PICSI is Physiological Intracytoplasmic Sperm Injection. It works the same as ICSI, except that instead of randomly picking the best looking sperm by sight, the washed sperm is placed in a dish with a special medium that mimics the protein surrounding the egg (or something like that anyways!) and the sperm that attach themselves to the medium are supposed to be the most genetically sound, so they use those ones for ICSI.

ICSI is reccomended for MFI issues, as you can select the best possible sperm and you will have a better chance at fertilization than if they were left to their own devices. (It's used quite often for non-MFI issues as well, since it generally has better fert rates than traditional IVF.) PICSI is used in cases where a previous cycle yielded low fert rates, and/or there is high sperm DNA fragmentation. In our case, we had great fertilization and DNA frag; however, all our embryos arrested by day 5. We think this might help?

Pcmay20

Hi...MH has a sperm count of 0.01 or 10,000. His testosterone is 130, his FSH and LH are both elevated. We tried Clomid but unfortunately after six months the numbers didn't change. We are now trying hsg/hmg injections hoping there is some improvement. The urologist didn't seem to certain it would help but we're trying anyway. Either way we're planning to do IVF with ICSI in November...hoping the Clomid works for you

maya1023

@tptbabe thank you for explaining everything. It's so crazy all the options and procedures there are! I hope they work for you, and for all of us!

@Pcmay20 we have been told that injections hinder sperm production - so it may increase testosterone, it will make having a child all the more difficult. Unless maybe we are talking different injections?

Pcmay20

I think we are talking about different injections. If it was testosterone injections then yes, the testosterone count would go up but it would make having a child more difficult. Hmg/hcg injections are used in men with low testosterone and FSH. However MH has elevated FSH levels but we're still trying it. From what I understand HCG acts like LH and HMG and FSH are essentially the same. Sometimes they are prescribed together to promote sperm production. Since starting the injections MH had bloodwork last week. LH is low now, FSH is normal and testosterone is normal. We have no idea if it's helped in sperm production and won't know for three months. And unfortunately that may be our max amount of months being that the injections are pretty pricey. Hopefully this helps

maya1023

Oh ok got it! Well I hope it all works out! Let us know in 3 months if you could