SA results: NO SPERM in semen

iVillage Member
Registered: 02-21-2010
SA results: NO SPERM in semen
9
Sat, 05-22-2010 - 9:46am

We just got our SA results back today and apparently, DH produces NO SPERM....there is nothing we can do.

We're still confused and this all feels 'unreal', but I am so proud of myself for not listening to all those people saying I was too stressed out and that we should just relax and wait and it will happen, and for starting the fertility checkups after 5 months of TTC.

I would have never thought DH has a problem. He's the most health-conscious person ever.

We've never had a problem with adoption, and wanted to adopt anyway, so we will try adoption. But DH really wants me to be pregnant and experience all that, so he suggested we find someone we know who would be willing to 'father' our baby.
We already have a couple of 'candidates'. Now we just have to ask them how they feel about it.

I know this all sounds crazy, but I'm happy we found out what the problem was, and that we already found a solution.

What do you girls think about this? I'm really confused.
This means DH will never have a child of his own. He'S feeling ok, he really doesn't mind someone else being the biological father.

Well, lots of baby dust to you. I guess I could say I'm on hold until we find someone.




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iVillage Member
Registered: 08-20-2009
Sat, 05-22-2010 - 10:08am


I'm so sorry about that diagnosis, but you sound like you and DH are coping pretty well with it. I want to first say that I also went to a fertility specialist a bit earlier than women are supposed to because my intuition was telling me something was wrong. I was right- I had a problem with the end of my fallopian tubes that were surgically fixed, and the surgeon told me after the surgery I would not have gotten pg with a viable embryo without the surgery.

Anyway- I think adoption is a great option, as is donor sperm, BUT, I wondered if you were given any follow up on DH's diagnosis. On another board I'm on, the woman's husband was diagnosed with azoospermia but there were further tests that they did to see if it was caused by a blockage or repairable duct or if there was a chromosomal issue or an issue that could actually be treated by medicine. I also read about a few women who also have DH's with azoospermia who were able to get sperm from them through a grafting process. There is an infertility support board that is very active and very informative about these kinds of things, and some of the women there are using donor sperm. There is also a donor egg/donor sperm board on ivillage as well.

Whatever you decide to do, I hope you get your child! Hang in there!

Andrea

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May Baby

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iVillage Member
Registered: 02-21-2010
Sat, 05-22-2010 - 10:25am

Dear Andrea,

Thank you so much for the message. I really need this, as we are not telling anyone yet, until we decide exactly what we are going to do.

The urologist said it was untreatable and that the only way we could try was ICSI, but that it would be very difficult to collect any sperm.

I will try the board you told me about, as soon as I come back from work.

So what is your story?

Thank you,

Eliza




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Avatar for trinigirl2010
iVillage Member
Registered: 03-26-2010
Sun, 05-23-2010 - 2:01pm
I know its alot but I thought this may help you....
What is azoospermia and can a person with azoospermia have biological children?

back to FAQ list


Azoospermia is the term used when there is a complete absence of sperm in the ejaculate. Most patients assume that this diagnosis would rule out the possibility of his ever conceiving a child; if there are no sperm how can there be conception? However the reality is that a semen analysis which shows the absence of sperm in the ejaculate does not rule out either the possibility that sperm is being produced and not delivered to the semen, or that interventions may help the man produce sperm. Even in those cases where after intervention there is still no sperm in the ejaculate, there may be a possibility of harvesting small amounts of sperm, which have been produced in the testes as a result of the interventions.


A Production Problem or a Delivery Problem?

The primary question, which needs to be answered when faced with azoospermia, is whether the problem lies in the sperm production or in the delivery. That is, are the testes simply not producing sperm or are they producing sperm but unable to deliver it in the ejaculate? The purpose of an initial evaluation is to distinguish between these two alternatives. If the testes are making sperm but none are in the ejaculate, the sperm must be retrieved by some other mechanism, either by restoring the normal flow of sperm or by circumventing it. If the testes are not producing sperm then we need to explore whether the problem can be reversed. Even if the problem cannot be reversed, there are a number of cases in which the level of spermatogenesis is advanced enough to allow sperm "harvesting" in conjunction with advanced reproductive techniques (ART) and micromanipulation. The following paragraphs briefly describe causes for both production and delivery problems.


Production Problems

The three major causes for lack of sperm production are hormonal problems, "testicular failure," and varicocele.


Hormonal Problems: The testicles need pituitary hormones to be stimulated to make sperm. If these are absent or severely decreased, the testes will not maximally produce sperm. Importantly, men who take androgens (steroids) either by mouth or injection for body building shut down the production of hormones for sperm production.


Testicular Failure: This generally refers to the inability of the sperm producing part of the testicle (the seminiferous epithelium) to make adequate numbers of mature sperm. This failure may occur at any stage in sperm production for a number of reasons. Either the testicle may completely lack the cells that divide to become sperm (this is called "Sertoli cell-only syndrome.") or there may be an inability of the sperm to complete their development (this is termed a "maturation arrest.") This situation may be caused by genetic abnormalities, which must be screened for.


Varicocele: A varicocele is dilated veins in the scrotum, (just as an individual may have vericose veins in their legs.) These veins are dilated because the blood does not drain properly from them. These dilated veins allow extra blood to pool in the scrotum, which has a negative effect on sperm production. This condition may be corrected by minor out-patient surgery.


Sperm Delivery Problems - Ductal Absence or Blockage

Sperm delivery complications are generally caused either by a problem with the ductal system that carries the sperm, or problems with ejaculation. The sperm carrying ducts may be missing or blocked. Thus the patient may have bilateral (both sides) congenital (from birth) absence of the vas deferens. Or he may have obstructions either at the level of the epididymis (the delicate tubular structure draining the testes) or higher up in the more muscular vas deferens. He may have become mechanically blocked during hernia or hydrocele repairs.


Sperm are stored in sacs called the seminal vesicles, and then are deposited in the urethra, which is the tube through which men urinate and ejaculate. The sperm must pass through the ejaculatory ducts to get from the seminal vesicles to the urethra. If these are blocked on both sides no sperm will come through.


Finally, there may be problems with ejaculation. Before a man ejaculates, the sperm must first be deposited in the urethra. This process is called emission. There may be neurological damage from surgery, diabetes, or spinal cord injury, which prevents this from happening. Also, for the sperm to be pushed out the tip of the penis, the entry to the bladder must be closed down. If it does not close down the sperm will be pushed into the bladder, and later washed out when the patient urinates.


Evaluation of Azoospermia

Determining which of the above causes, or a combination of them, is the reason for the patient's azoospermia is often complex. Following is a brief discussion of some of the available tests and how they help in determining the cause.


Physical Examination

The simplest test is the physical exam. Since the bulk of the testes is comprised of the sperm producing elements, (the seminiferous epithelium), if the size of the testicles is severely diminished, this is an indication that the seminiferous epithelium is affected. Follow up hormonal profiles can determine whether this is a primary problem or caused by inadequate hormonal stimulation.


The scrotum is examined for the presence of dilated veins (varicocele). Their presence can be confirmed by an ultrasound probe placed on the skin at the scrotum.


During a physical exam, the ductal systems can be felt. If they are absent, the patient has what is called congenital bilateral absence of the vas deferens, (CBAVD). In most cases this is considered to be due to the patient's genetic make-up and requires chromosomal analysis as part of the evaluation and treatment.


Finally, during examination of the ductal structures, the epididymis may feel as though it is dilated. Generally, it is flat and the middle cannot be felt. Thus, a dilated epididymis may be indicative of a blockage.


Hormonal Evaluation

Follicle stimulating hormone (FSH) is the hormone made by the pituitary, which is responsible for stimulating the testes to make sperm. When the sperm producing capacity of the testes is diminished, the pituitary makes more FSH in an attempt to make the testes do its job. Therefore, if a man's FSH is significantly elevated there is a strong indication that his testicles are not producing sperm optimally. (Testosterone polactin, leutenizing hormone (LH) and thyroid stimulating hormone (TSH) are also measured to assess a man's hormonal status. These may reveal problems that can significantly impact sperm production).


Genetic Testing: This is an area of active research. At this point it is recommended that all men receive basic genetic testing, measuring the number of chromosomes and looking at the blocks of genetic material. Screening for the genes that can cause cystic fibrosis is sometimes suggested. There are tests for specific genetic abnormalities on the male chromosomes that can cause azoospermia. If a son were to inherit this, he may have the same problem.


Transrectal Ultrasound

In order to rule out a blockage of the ejaculatory duct, an ultrasound of the ejaculatory duct and seminal vesicles is often. performed. In this test the ultrasound probe is placed in the rectum since the ducts lie near its wall. Also, the ejaculatory duct traverses the prostate, a gland which can be felt through a man's rectal wall. If the seminal vesicles are dilated, this indicates that they may be full of semen because they cannot empty properly. Cysts blocking the ejaculatory ducts by exerting pressure on their walls, or calcifications in the ejaculatory ducts themselves, may also be noted. A cyst in some cases may be unroofed by operating through the urethra to open it thus decompressing the ejaculatory duct. If the blockage occurs within the ejaculatory duct, the blocked part may be removed in a similar operation.


Urinalysis

It is possible that ejaculation is occurring "backwards;" the sperm is being pushed into the bladder, and then washed out when the man urinates after ejaculation. To test for this we have the patient empty his bladder, and then ejaculate into a cup. He is then asked to urinate again into a different specimen container. If there are sperm in his urine, he has ejaculated backwards. Sometimes this can be corrected by oral medication. If not, the urine can be prepared so that it does not damage the sperm as much, and the sperm is then harvested from the post-ejaculatory urine.


Testicular Biopsy

Finally, if a primary testicular problem is suspected we can perform a testicular biopsy. A biopsy simply means obtaining actual tissue for laboratory/microscopic examination. This may be done using a needle through the skin, or by an incision.


In the past, indications for testicular biopsy were few. Through a combination of some tests outlined previously the problem could often be pinpointed as a primary testicular problem which had no treatment. It did not matter if a biopsy could identify whether the patient had absolutely no sperm production versus very low production because no treatment was available for either. However, recently that has changed as testicular sperm have been used to achieve pregnancies when coupled with in vitro fertilization (IVF) combined with intracytoplasmic sperm insertion (ICSI). In this procedure the sperm is harvested and then injected directly into the egg).


Conclusion

Most men facing a semen analysis fear the diagnosis of azoospermia. However, that diagnosis does not necessarily mean that the man produces no sperm or can never be made to produce any sperm and thus will never have a biological child. Accurate diagnosis of azoospermia is complicated. Correctible causes must be found and treated. Even then if there are no sperm in the ejaculate, sperm can often be harvested and used to achieve fertilization.


GOOD LUCK YO YOU!!!!!

TRYING TO CONCEIVE BABY #1

Me - (Amanda 27) My dh-- 26 We have been ttc # 1 for 3yrs 5mths My dh has severe oligospermia, Ivf with icsi is our only option. Ivf # 1--- failed Ivf # 2--- failed Ivf # 3-- hopefully in March 2013 at a new clinic!

 

iVillage Member
Registered: 05-20-2004
Sun, 05-23-2010 - 3:26pm
Wow, I can't imagine how devastating that would be. I agree that you're coping really well with the news. I don't know what I would do, but I just thought I'd show my support and send out a (hug). I hope you are able to find the best option.
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iVillage Member
Registered: 02-21-2010
Mon, 05-24-2010 - 4:39am

thanks soo much.. it really really helps.

The best part is that here in Germany, the insurance pays for 50%-100% of any infertility treatments. Even if they didn't, they'Re way cheaper than in the USA. IVF costs about 2500 Euro, for example.

I will call our insurances tomorrow and ask if they cover anything and I'll try to get an appointment with my Gyn to talk about options, but I think we'll try IUI with donor sperm and at the same time, apply for adoption. We always wanted 4 kids, so it's going to be a huge challenge.

On the other hand, it's exciting that maybe I will be pregnant in 2-3 months and DH really wants us to experience pregnancy too.

Anyway, thanks a looot for writing me
hugs back and lots of baby dust!




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iVillage Member
Registered: 02-21-2010
Mon, 05-24-2010 - 4:41am

Thank you so much for the info. It'S really helpful. I think I'll maybe send DH to another urologist and start all over again, because this one did not even suggest having the rectal ultrasound or the urine test.

THANKS
hugs and lots of baby dust!
Eliza




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Avatar for Cmmelissa
iVillage Member
Registered: 11-13-2008
Mon, 05-24-2010 - 12:37pm

I'm so sorry about your dh's diagnosis, but it sounds like you are both doing well with it.

Avatar for trinigirl2010
iVillage Member
Registered: 03-26-2010
Mon, 05-24-2010 - 5:00pm

hey Eliza,


Me - (Amanda 27) My dh-- 26 We have been ttc # 1 for 3yrs 5mths My dh has severe oligospermia, Ivf with icsi is our only option. Ivf # 1--- failed Ivf # 2--- failed Ivf # 3-- hopefully in March 2013 at a new clinic!

 

iVillage Member
Registered: 06-11-2008
Wed, 05-26-2010 - 10:57am
I have a very close friend who had the same problem. They opted to use an anonymous