Azoospermia - Anyone dealing with this?

beach17blonde

I used to be a regular on thebump message boards when my husband and I started TTC in 2008. Now, 2 1/2 years later we went in for some testing because we accepted that we were having an issue and thought it was time to find out what's going on. Yesterday we both went in for testing. I had a HSG and everything came back clear. My husband had a SA and it came back with zero sperm in the sample.I'm in complete shock and it's extremely hard for us to process all of this. I was wondering if anyone else is dealing with this? Any information would be very appreciated right now. Thank you! 

Yellow_Daisy

There are actually quite a few ladies on the board dealing with azoo.  I am so sorry that you and your DH have to tackle this hurdle, it is a devastating diagnosis.  We have a check in every Thursday for the Azoo ladies, I usually post it in the afternoon Pacific time.  Please check it out tomorrow you will see that you are definitely not alone.

As for where to go next I think most of the Azoo ladies would agree that you should start looking for a urologist that deals with male factor infertility, if you don't already have one.  There are lots of urologists our there, but you really want one that specializes.  Most uros are going to want at least one if not two more SAs from your DH.  If they come back at zero they will check for a blockage, maybe do an u/s, run b/w to see if the problem is hormone related and then if they don't get an answer from one of the non invasive tests many uros will do a testicular biopsy or mTESE to see if there is sperm in the testes.

My best advice is take it one day at a time, find a doctor you trust and start with the easy tests.  You could get lucky and find that the lack of sperm is hormone related and your DH just needs some meds to balance things out, it may not be that easy, but focusing on the next step rather than the everything at once will at least make it manageable.

How is your DH taking the news?  My DH took it very badly and ultimately we went through a lot of counseling, I can't say it enough, but if you or your DH needs to talk to someone about the diagnosis make sure you do.  Counseling helped us tremendously.

Let me know if you have any questions.

dejavu

i don't have much to add since YellowDaisy summed it up very well.  There is a check-in on Thursday that I suggest you check out.  Unfortunately, (and I am very sorry for your diagnosis) there are quite a few of us dealing with Azoo (myself included).  At this point, like YD said, you need to see a urologist and get more answers.  We used donoer sperm to conceive our son and are currently trying for #2.  If you have any questions you can email me dejavu10806 at yahoo.com

GL!

beach17blonde

Thank you very much! I will definitely check back tomorrow. 

I'm trying to do my research on what the next step should be. It just hard to accept because I really was praying for the issue to be with me and not him. I spent 2 1/2 years preparing myself for the tests/procedures I would have to go through and I accepted that. And now the news we got yesterday changed everything.

DH is taking the news better than I thought. It's hard to tell if he is just trying to be strong, or if he has really accepted it so fast. I guess time will tell. I'm just trying to be strong because when he sees me breakdown he always says "I'm sorry" and it just breaks my heart!

theworms

there are a few of us, as yellow_daisy mentioned.  please join the check-in, it really helps to feel less alone.

i want to echo what yellow said, please make sure you find a Uro that specializes in male infertility and preferably has done their fellowship in male micro-surgery and has performed successful mTESE's (procedure where sperm is asperated from the testes, usually done after Uro has done lots of other testing and believes that there is sperm being produced).

if another SA comes back with 0 they will do additional testing and will want to determine if there is a blockage or if he has non-obstructive azoo (NOA)

this is a great site about male infertlity

https://www.maleinfertility.org/

our uro was dr.schlegel and sadly our mTESE did not find sperm and we have moved onto DS

there are so many advances in male infertility and with IVF and ICSI there is hope.

GL cutie and ((HUGS)), this is a really hard d/x but you and DH will get through it together, just make sure you both keep communicating and if you need a counselor go see one.

 

 

SLPMel

It's such a tough diagnosis.  We don't have true azoo, but we have no viable sperm to use, so we are/have done things similar to those needed for an azoo dx.

I totally recommend a good male infertility specialized Urologist.  And to have bloodwork done for your DH to see if it's something that can be fixed.  DH's issue is due to a surgery he had when he was younger.

Welcome-I hope your stay is short here!!

Eriksgal

So sorry you guys got this news.  I know how shocking and devastating that can be and it sucks not to have a lot of answers in the beginning.  Ditto everything that Daisy said.  Especially the part about meeting with a urologist that specializes in male infertility if you can find one.  Did they do any additional blood work on him to check for hormonal things-testosterone, etc? 

My DH had no sperm in his first SA in July 2010 but they also discovered he had very low testosterone.  He saw a urlogist who put him on HCG injections and Arimidex.  In Nov his counts were up to 8 million, 33% motility, 4% morph...still abnormal but way improved. 

yarnymommy

We have. First off, I'm sorry you are dealing with this. I'd say just be sure to be very sensitive to your DH right now. I think most times it is expected that the female is the one with the issue. I honestly think we are better equipped to deal with it. Men (in my experience) feel immasculated by such a diagnosis. There is hope though! My husband ended up having a severe defect where one of the tubes from the testes to the penis was totally collapsed. But, he had a TESE (Google that) where they extracted the sperm directly from his testicles. This sperm isn't as mature as what would come out naturally, but ICSI levels that playing field. So, we're doing IVF with ICSI using my DH's sperm harvested in the TESE. That all said, there is a possibility that he may respond to medication. Men take the same stuff we do (Gonal-F, Novarel/Ovidrel, etc). I'd recommend him seeing an endocrinologist of his own. he may have an underlying issue that may have his meds covered. My DH has low testosterone as an underlying condition, so all of his procedures/appointments/medication were all covered under insurance as a non-fertility related issue. But, you have to be very careful with what the diagnosis is... One wrong form and you're in insurance He'll! What to take from all this is that there IS hope. LOTS of it! Good luck! PM me if you have any other questions

Yellow_Daisy

beach17blonde:

 

I'm trying to do my research on what the next step should be. It just hard to accept because I really was praying for the issue to be with me and not him. I spent 2 1/2 years preparing myself for the tests/procedures I would have to go through and I accepted that. And now the news we got yesterday changed everything.

I also spent years preparing for it to be something wrong with me.  Even my doctors just assumed because of other medical problems that the issue was with me.  It was devastating to find out that our IF was all MFI.  I felt like I was ready to take this on and strong enough to do it, I really worried about DH.  The first time my DH apologized to me was horrible.  I didn't blame him anymore than he would have blamed me, but I think society in a way prepares the woman to take and handle the stress of IF because no one ever talks about MFI.  I think it comes as a huge surprise to men that MFI is 35% of all IF cases.

My DH didn't deal well at first, but after counseling he became a rock, in a good way.  Once he had time to process things he dealt with everything really well.  We used donor sperm to conceive this baby. 

gidge

I just wanted to ditto what the other ladies have said.  I also hoped that the problem was with me ...

 When we got the dx, dh had some hormone and genetic tests and a karyotype.  The only things found were low testosterone and high FSH (and smaller test.icular volume).  It was really hard to deal with for a long time and I know DH just wanted to fix it for me.

DH has had 2 mTESE procedures and they found sperm both times, unfortunately we haven't had sucess yet.  It could be that the sperm are no good or they just don't work with my eggs (we've found my egg quality isn't very good).  We're going to try ds soon, to see if that will work.

big ((hugs)) and good luck!  If you ever wand to PM me, feel free!

NicoleeBonsai

my husband was diagnosed with azoospermia as well. it's very scary when you first receive the diagnosis. i'm so sorry you are going through this.

be sure to see a urologist who specializes in infertility. it is very important to see a specialist.

in case my story will help you:

my H was born with one undescended testicle and after extensive testing and exploratory surgery as a child, it was never found. then when he was 13 he had surgery to prevent torsion on his descended testicle (it was causing severe pain and the doc did it as a preventative measure). so we still don't have an answer for exactly why he has azoo, but we can guess that it was either his anatomical issue or his surgery as a 13 year old.

my H's urologist said that based on all of his physical exam, hormonal and genetic testing, he was 70% confident that my DH was producing sperm, they just weren't coming out. my DH had a TESE and they found, to quote his urologist, "plenty, and it will never be a problem." we had enough for my first IVF-ICSI cycle and froze two vials.

good luck. please feel free to ask any questions you have.

alclements85

I don't really have too much more to add - the pp have summed it up well. I just wanted you to know that there are actually a lot of people going through the same thing as you. I know when we first got the azoo dx I felt so alone, but this board has helped when I have questions and advice. Also, the testing usually takes a long time, as they have to go through a process to find the cause of the azoo. I am definately not a patient person, so the hardest part has been waiting to find out the results of tests and what the next step is. Please feel free to PM me if you have any questions or need to talk!

manu1

am dealing with it as well. we turned to donor after he failed his biopsy as well. we have done 7iui total with miscariages and negative. not to discourage you but i had other issued that led to the negatives till they were corrected then the ms started. so just wanted to let you know we are in this together.

amy1004

You have been given some great info.  These ladies are fantastic!

I really hope that your husband is handling this ok.  It is hard when the diagnosis is one sided. Please make sure to take the time and reassure your husband that he is a man (DH told me he feels like less of a man now) and this dx has no reflection on who he is as person and what he is capable of accomplishing.

Good luck!  We are so lucky that even though we have a dx of azoo that ART has come so far and when you join the check in you will see there are success stories.  This dx is not the end of the road.

beach17blonde

Thank you all so much!!! Reading everything has really made me calm down and see that there is hope. I think it will take some time for DH to come to terms with everything. He is acting so calm with all of this, but right now he is not accepting the fact that he should see a urologist or that there is any hope to have a biologically child. It's like he is giving up on conceiving all together and it's a little scary. I'm just hoping that this is part of the process and he will come around and be more open to seeking answers. I will defiantly be checking out the azoo check-in tomorrow! Thank you all again!!

SLPMel

beach17blonde:

Thank you all so much!!! Reading everything has really made me calm down and see that there is hope. 

I think it will take some time for DH to come to terms with everything. He is acting so calm with all of this, but right now he is not accepting the fact that he should see a urologist or that there is any hope to have a biologically child. It's like he is giving up on conceiving all together and it's a little scary. I'm just hoping that this is part of the process and he will come around and be more open to seeking answers. 

I will defiantly be checking out the azoo check-in tomorrow! Thank you all again!!

It took my DH about 7 months after his diagnoses for him to even look past our ability to use other means to get pregnant (primarily DS for us) but that was only after our mTESE and failed IVF.  6 months ago he was in a completely different place than he is now, so give him time. 

miesl

beach17blonde:

I think it will take some time for DH to come to terms with everything. He is acting so calm with all of this, but right now he is not accepting the fact that he should see a urologist or that there is any hope to have a biologically child. It's like he is giving up on conceiving all together and it's a little scary.

There are other possible problems related to an azoo diagnosis, such as cystic fibrosis - both carriers and those who are mild and undiagnosed and low testosterone - which can cause other health issues including bone loss.  Those are both good reasons to meet up with a urologist. 

More importantly, there are a lot of cases of azoo where the male DOES produce sperm and it can be used with IVF/ICSI to have a bio-child.  It might be a good idea to seek some couples therapy (ask your RE clinic for a referral to one that specializes in IF).

In our case... we had additional issues (sperm dna issues + PGD) and after two failed IVF cycles we switched to DS and IUI.

kyna81

I think everyone else covered all the basis.  I just wanted to say I'm sorry you have to deal with this too. 

Big Hugs and hang in there.  I remember how devastated I was (we were).  But we have a great urologist and some hope.  

whitewave26

I understand how devistating that is to hear.  We don't have azoo, but have severe MFI.  It's really a tough pill to swallow. 

There are several ladies on the board with this diagnosis, I'm sure they would be happy to answer any questions you have. 

Are you scheduled to see a Urologist for your DH to see if he maybe has some kind of blockage?