Post # 1
Some of you may remember that Darling Husband and I are planning to start and IVF soon. DH is scheduled to have sperm extraction surgery NEXT WEEK because he hasn’t been able to ejactulate since his accident.
Well…we’ve settled into a routine in the past few months and we’ve both been too exhausted and stressed to try to be intimate. Honestly, I didn’t even want to try because I was afraid of the disappointment. Until last night. He was able to finish! But now what the heck do we do?
My first thought was to cancel his surgery, of course. We know that he has low testosterone which indicates he probably has a low sperm count. He wasn’t able to be treated for it because Clomid made him crazy irritable and made it really hard to live with him.
So I’m guessing my RE will want a SA. Does anyone have experience with MF infertility? What would be the first course of action for a low count – IUI? Should we just try naturally? I’m so confused and excited!
Post # 3
I’m sorry I don’t have any advice but wanted to say WOOHOO!!! That’s awesome news!
I think 2014 is going to be a great year for you both! 🙂
Post # 4
@Macintosh: Congrats! I am so happy for you. I know what a tough journey you have had.
If it were me, I would call my doctor and ask about it before the surgery. Maybe you could delay the surgery a few months to see if he can ejaculate regularly and if there are less invasive options. There may not be, but it is good to check!
Who knows, depending on your timing, you could have made a baby last night. Problem solved 🙂
Post # 5
Hey there, I’m glad to hear things are improving. I’d definitely start with a SA, ifs it normal and checks out fine I don’t see why you wont be able to try naturally with careful charting and OPKs. If not, maybe an IUI according to the numbers. I think most REs won’t do IUI with a sperm count of less than 5M with good motility and morphology.
Post # 6
@Macintosh: we have a little bit of experience… Darling Husband had problems finishing 🙁 he was always in the mood and could go forever but almost never finished inside (TMI I’m sorry!!)… It took us 13 cycles of trying before he went in for a SA but his numbers were perfect… The day we were supposed to be seeing the fertility clinic about what issues *I* might have we turned up pregnant… We are 17wks now with a healthy baby boy…
My point is though, that it could happen naturally… And when Darling Husband and I are ready for a second we might try on our own for a month or two, but since his problem won’t go away I will be looking into IUI ASAP… You should be able to do it yourself at home to start… And it will make things so much more relaxing for you to know you aren’t missing your window for a month because Darling Husband couldn’t finish one particular night… TTC was extremely hard on our marriage and my self confidence… Extremely hard! And it didn’t have to be that way…
good luck! and lots of prays for your hubby’s continued recovery!!!
Post # 7
@Lyndzo: Thank you, I was so I over the moon excited when it happened! Congrats on your upcoming delivery 🙂
@Pollywog: You read my mind. Of course I’m still tracking my CM because I’m crazy and I think I ovulated yesterday. It’s exciting to have a chance to try again, but I just hope I don’t go crazy symptom spotting.
@picturemeurs: I think you’re right, SA is the next step. Depending on those results, we may still want to do IVF.
@MySunshine: What a great outcome for you! Thanks for your support 🙂
Post # 8
Ugh, so my husbands urologist office wasn’t as thrilled with my news. They tried to convince me to go through with the surgery anyway! I’m sorry, I thought this surgery was a last resort. Grrrrr…so I cancelled it.
My RE’s office now wants us to come in for another consult appointment. She said they may want to change the protocol. Eek!
Post # 9
Aww thats great, I’m so glad he’s able to do it on his own!!! FX 2014 is your year!
Post # 10
@Macintosh: Thats a bummer that they were so insistant on the surgery… its not the end of the world if you delay for a few months to get a few more medical opinions… The more i think about it, seriously sketchy… I am interested to see what your RE says for the updated protocol… you’ll have to keep us updated 🙂 *fingers crossed*
Post # 11
@Macintosh: I agree that a SA would be the next step, and would also be put off by anyone insisting on surgery. My Darling Husband underwent that surgery (twice!), and was very banged up for a few days. He was even walking with a cane for a few days after the second one. I’m also wondering if they considered doing at TESA (aspiration) rather than TESE (extraction). The aspiration would be a whole lot easier on him. Though it’s not as telling as an extraction (had my Darling Husband done an aspiration, they wouldn’t have found anything). But he also had several SA that showed a 0 count and elevated FSH, so they knew an aspiration would be useless. If your DH qualifies for an aspiration (I don’t know his condition, other that the horrible accident last year), that’d be much easier on him. My understanding is that PP is correct that you’d need a minimum in the millions to be a candidate for IUI. But since we were never in that boat, I don’t know the details. Also, one word of warning– some men’s surgically extracted sperm doesn’t survive freeze/thaw. That sperm is not as mature and hardy as ejaculated sperm (which also affects fertilization rate– DH’s urologist says only 40-50% fertilize, and that was accurate based on our experience– yet another reason that surgery should be last resort). My Darling Husband had a varicosele repair and diagnostic biopsy, where we were shocked to learn that they found sperm, which was frozen (this was surgery #1). After waiting 3 months to see if the varicosele repair did anything (it didn’t), we had a post-thaw analysis. And nothing survived. So then my RE coordinated my IVF egg retrieval to be for the same day as DH’s TESE, so we could use fresh specimen. Had we only counted on the frozen sperm, we’d have had to use our donor back up (which we haven’t had to use because everyone did such a great job during the TESE and in my RE’s lab- yay!). Unless there’s some reason for doctors to believe that he’s making very, very few sperm, I think he should qualify for an aspiration. I don’t know what your insurance situation is, but an aspiration is much cheaper. We had coverage for DH’s extractions, but they had to be at least 6 months apart in order to get coverage, so your policy might be worth checking in case he would need a second one if the post-thaw analysis doesn’t have good news (his insurance paid out over $17k for the second one, which was much longer and more thorough since the doc knew we were looking for sperm to use for IVF, and that that would be his last TESE). One more thing– those surgeries (lord, I’m writing a book!) disturb their most delicate parts, and the act of digging around and looking for sperm, can damage the parts that make sperm (and testosterone– Darling Husband started low-T therapy after the second TESE), making it less likely they’ll find something in a subsequent surgery. DH’s doctor didn’t dig too deeply in surgery #1, as she was just looking to see if there were any sperm at all. She found sperm right away. Once it was time for surgery #2, Darling Husband was in the OR for over 3 hours, and during that whole time, his doc couldn’t find any sperm. But he kept looking, and looking, and looking. The embryologist at my RE’s office spent NINE HOURS combining through the surgical specimen to find enough sperm to match to my mature eggs. So even though the first surgery wasn’t as invasive, we still think it did enough damage to make things harder to find the second time. So we know there’s no point in trying again if none of our frozen embryos becomes our child (frozen embryos are much more hardy than frozen testicular sperm). I think it’s very important that you like your MFI urologist and trust him/her. We had 2 (had to find a closer one before TESE #2 since we were planning on driving the specimens from the hospital to my RE’s office on surgery/retrieval day), and we like them both.
I’m so excited by your “surprise!” Feel free to join us on the 1+ board. There are many of us dealing with MFI issues, and at this point, I think most of us are doing either IUI or IVF (or are awaiting RE appointments to get the process started). The ladies there are amazing. I’d have lost it many times without their support. Feel free to message me about any TESE concerns if it gets to that point. Good luck!!