Azoospermia / Scared to death


#1

Last week, I got my semen analysis result and found zero sperm! I was scared to death. . We went to a Urologist that same date and he gave us “only” two options.

  1. A biopsy to verify if it’s obstructive or non obstructive.
  2. Take a medicine, “Clostil”, Vit C and E to promote sperm production. He asked me to do another SA test after a month and see if there are changes.

We had to go with option 2 since we don’t have that much cash. My question is, are there some tests to know if my case is obstructive or non obstructive? Can I do some tests like Physical Examination, Hormonal Evaluation, Genetic Testing and so on? I wanted to know how to find out what caused my issue without having to go to a biopsy please because it’s too costly.

Also, in the semen analysis report, they said that if your pH is lower than 7.2, that would mean that it is non obstructive already. Is this correct?


#2

Sorry to hear you are going through this diagnosis. I don’t know about the pH level but I do think hormone levels can give you some idea. My DH had low testosterone and very high FSH which were both indicators, along with a zero sperm count, that he had testicular failure. He did have the mTESE procedure to see if they could find sperm but there wasn’t anything.

I would think that if a man is still producing sperm and they just can’t get out, the hormone levels would be normal or at least closer to normal. I’m sure this isn’t always the case, but I’d think it would be worth having the tests done just to get a better idea of what your chances might be if you do have the biopsy.

Best wishes to you on this journey.


#3

Thanks. I’m heading to a second opinion now. Probably check for some varicocele and maybe a hormone check up. By the way, I see a BFP on your signature. Were you NOA and then conceived naturally through clomid?


#4

After the mTESE showed no sperm, we moved on to using a donor. So we used IUI and donor sperm. Neither of us was crazy about the idea before knowing we’d exhausted our options to have a child who shared both of our genetics though. It has worked out well though and now it’s not something we dwell on much at all, although it is something we’ll share with our children.

Good luck with the second opinion! I hope it’s something that works out for you to find sperm and conceive that way.


#5

[QUOTE=Kris79]After the mTESE showed no sperm, we moved on to using a donor. So we used IUI and donor sperm. Neither of us was crazy about the idea before knowing we’d exhausted our options to have a child who shared both of our genetics though. It has worked out well though and now it’s not something we dwell on much at all, although it is something we’ll share with our children.

Good luck with the second opinion! I hope it’s something that works out for you to find sperm and conceive that way.[/QUOTE]
When you decided for donor, did you came across anything which suggests that IVF is associated with any risk? Specially for Wifey


#6

I don’t think so. The only risk of an IVF is the money that will be used to make it possible.

I’m on clomid right now and I hope this will work out for me. I’m also a heavy smoker like 15020 sticks per day. Are there any cases proven already that smoking caused Azoospermia on a single male?


#7

We didn’t do IVF, just IUI. As for risks, none that I’m aware of. Donors are all screened and then their specimens are quarantined for 6 months and re-tested before they can be released for use…so there’s no risk of catching something from them. One thing to be aware of is CMV status. If you are looking at going this route, it’s best to have a CMV- donor if your wife is CMV-…I’m not sure what the exact implications are but I know if she contracts CMV while pregnant it can be dangerous for the unborn baby so it’s best just to avoid it. If your wife is CMV+ then it doesn’t matter because she’s already been exposed to the virus.


#8

[QUOTE=scaredguyhelp]Last week, I got my semen analysis result and found zero sperm! I was scared to death. . We went to a Urologist that same date and he gave us “only” two options.

  1. A biopsy to verify if it’s obstructive or non obstructive.
  2. Take a medicine, “Clostil”, Vit C and E to promote sperm production. He asked me to do another SA test after a month and see if there are changes.

We had to go with option 2 since we don’t have that much cash. My question is, are there some tests to know if my case is obstructive or non obstructive? Can I do some tests like Physical Examination, Hormonal Evaluation, Genetic Testing and so on? I wanted to know how to find out what caused my issue without having to go to a biopsy please because it’s too costly.

Also, in the semen analysis report, they said that if your pH is lower than 7.2, that would mean that it is non obstructive already. Is this correct?[/QUOTE]

I’m sorry you are going through this. It is very painful news to hear. Hopefully option 2 will work for you.
We are NOA here and we already knew it was because of the undescended testicle.


#9

Only one testacle? Has there been any story that the testosterone therapy worked and the couple was able to conceive naturally?


#10

My DH has azoo. his is non obstructive and is CBAVD. It is associated with cystic fibrosis. He does not have CF but his azoo is somehow related. therefore I had to be tested to see if I was a carrier for CF. I am not. If i was there would have been a high chance of having a child with CF.

We did IVF waaaay back in 2003. There performed a PESA and got sperm the first try. I was blessed to become pregnant our first IVF. Daughter born in 2003.
We did IVF in 2006 which resulted in a m/c very early.
We did IVF later in 2006. BFP…daughter born 2007.

Azoo in not a death sentence. Follow the protocols. We did get a 2nd opinion. Check with a facility that has done many many TESA/PESA procedures.

We have recently done 3 IVF cycles over the past year. All of which have failed but I am not a spring chicken anymore so we are dealing with my age as a factor now.
DH has said that the PESA was SO different than 10 years ago. They have become experts at it. NO pain.

IVF is exspensive. We have spent so much money. I guess you have to do what you can afford and research your options. Seeing a urologist is the first step. You need to determine the cause of your azoo.
Sperm donor is a much more cost effective alternative. I am glad we invested the money to see if IVF/ICSI would work for us. I realize not everybody can stretch it financially. I wish you the best of luck.


#11

Sounds like you need a second opinion. There are a lot of things to do before determining NOA (non-obstructive) or OA (obstructive). First, like several posters have mentioned already you need to have a blood test and do genetic testing. Sounds like you already had a blood test. I don’t know about the ph but if your FSH is elevated that is a typical sign of testicular failure and NOA. But my husband has NOA and he has low to normal FSH levels, so that alone is not determinative. You should also have an ultrasound to find out if there are any blockages or varicoceles. And genetic testing to find out if you have any Y micro deletions on the Y chromosome. I have heard that heavy smoking can cause low sperm counts, but when you are dealing with zero sperm count that is typically hormonal or genetic. Or obstructive. So I would suggest to get some additional testing done. See a urologist that specizlies in male infertility. And possibly a reproductive endocrinologist too.

Sorry you are going through this.


#12

Thank you Shana. I haven’t had blood test yet. I am set to have an ultra sound this coming Thursday. Fingers crossed*

I am a heavy smoker and I just quit last week, smoking 15-20 sticks per day. Are there any instances that smoking causes azoo?


#13

Honestly, I don’t know the answer to that for sure but having done a ton of research on the topic, based on what I’ve read, I really doubt heavy smoking would cause azoospermia. I think it could cause very very low sperm counts and possibly issues with motility and morphology, but I don’t think it would cause azoospermia. There is a world of difference between low counts - even severely low counts and no count. However, I am not a doctor and can’t say for sure. But, if you are beating yourself up thinking that you caused this by smoking, you should give yourself a break because it is likely not related. My husband never smoked ever in his whole life and he has azoo so that is something for you to consider.

But, it is good that you quit and it can only help you so that is so wonderful and you should be really proud of yourself for that.

[quote=scaredguyhelp]Thank you Shana. I haven’t had blood test yet. I am set to have an ultra sound this coming Thursday. Fingers crossed*

I am a heavy smoker and I just quit last week, smoking 15-20 sticks per day. Are there any instances that smoking causes azoo?[/quote]


#14

Thanks Shana. I am heading for a scrotal ultrasound this Thursday. Anyways I think I was not Azoospermic maybe years ago as my GF and I just had a conversation and we both agreed that my semen was sticky way back (we use withdrawal). But now, it’s almost liquid like water. It virtually drips after sex(when penis is pulled out).

Also, she would always caught me masturbating because woulds see the used tissue paper in the garbage, it’s somewhat yellowish.

Now we backtracked on what might have caused this. Can you guys please make an honest opinion what your bet would be? Major changes in the past 2-3years.

  1. I ride a motorcyle, travelling time is around 2H per day (testicular injury?)
  2. I played tennis with “boxers” only. This means that my testicles would sway around every time I ran around the court. (This is around 5 days per week)
  3. Smoking? Maybe we could rule this out already.

I’m thinking #2 might have caused this and I’ll probably ask the next Urologist. What do you guys think?


#15

Sorry about that. Can I at least edit what I posted?


#16

Thanks Shana. That’s a great help. I was also wondering if it is possible that I have normal sperm count say 2 years ago the went azoospermic just this month.

My GF and I both agreed that my semen is sticky before but now it’s waterish. Also, a tissue paper used to wipe went yellowish before but this year, it’s plain white.

We back tracked a bit on what had changed the past years and I was hoping if you guys can have an opinion on what might have caused my condition.

  1. I play tennis with boxers only, 5 times per week. Perhaps my testicles went into trauma because there’s no support? Wearing boxers only.

  2. I ride a motorcyle for work and spent driving 2H per day, 5H per week.

  3. I just noticed today that I “might” have a Varicocele by just self inspecting.

  4. Heavy smoking? I guess we could rule that out.

Any advice would be very much appreciated. I’m heading for a second opinion this Thursday.


#17

I just had a scrotal ultrasound last Thursday. Indeed I had Varicocele. We were about to visit our doctor but he has an operation that day. This means I need to wait for next thursday again(restday) so I could check with him if I needed surgery.

Varicocele only causes low sperm counts but not azoo from what I read but there are cases the cured it too. I just hope that the doctor will give a go signal and have this covered by my insurance.


#18

Second opinion was a disaster. Our urologist went straight ahead to biopsy. I was try very hard to avoid that. Also he said my varicocele is only small for it to be the cause of azoospermia.


#19

[quote=scaredguyhelp]Thank you Shana. I haven’t had blood test yet. I am set to have an ultra sound this coming Thursday. Fingers crossed*

I am a heavy smoker and I just quit last week, smoking 15-20 sticks per day. Are there any instances that smoking causes azoo?[/quote]

Smoking can trigger early menopause in women and low sperm counts in men. It’s just not friendly to the gonads of either gender. I have a friend who found she was infertile (in menopause) at 38, which is not just very early in general but early for her family too, and apparently it’s likely because she’d been smoking heavily since the age of 12.

But I don’t know if it causes azoospermia (no sperm) as opposed to oligospermia (low sperm). The answer to that question for you should come in 3-6 months, since you’ve quit and it takes at least 3 months for dietary/health changes to register in your sperm. That’s because it takes about 3 months for each new “crop” of sperm to develop and reach maturity. So if you bounce back quickly after quitting smoking it could be in as little as 3 months, whereas if you bounce back less quickly you may need to wait another 3 months to see a change.

Since it’s entirely possible that your overall health improvements could improve your fertility, you might want to go whole hog and dedicate the next 3-6 months to improving your diet and such. (Make sure you take vitamin C, vitamin E and zinc–those are the “sperm vitamins”).

I’m glad to hear your doctor prescribed a testicular ultrasound. In addition to getting a better idea of how things are “wired” in there, the ultrasound can diagnose you or give you the all-clear when it comes to testicular cancer. My DH was diagnosed with azoospermia and it turned out it was due to testicular cancer, which was spotted on the ultrasound. That’s rare but it can happen. He’s totally fine now, but there’s pretty much no medical test that’s cheaper or less invasive than an ultrasound, and it’s the gold standard when it comes to checking the testicles for tumors.


#20

Thank you Trixicat. Looking at you signature, I am sorry to have read it. Good luck on it.

I guess right now, I’m just waiting for my second SA. I also don’t want to go to the IVF route since the costs are over the top.