CBAVD – MESA / ICSI / IVF. BFP #1 time!!!
Me and my wife started our infertility journey about 3 years ago.
Part 1. The misdiagnosis.
I was discovered to be azoospermic and devastated. My (former) urologist did a series of additional tests – cystic fibrosis genetic screen (confirmed CF carrier), trans rectal ultrasound, hormone levels, pituitary MRI. I was discovered to have very low testosterone levels and subsequently had an mri where they noticed some “abnormalties” around the pituity gland. From this point forward there was a lot essentially “barking up the wrong tree”…
I was referred to an endrocinologist who instantly started treating me as a patient with Hypogonadic Hypergonadism – a malfunction of the testes aka non-obstructive aspermia (NOA). I asked about a biopsy to see if my testes were producing sperm but told this was pointless. I was put onto 9 months of HCG IM injections which was to be followed by 6 months of FSH injections. I was repeatedly told that this was my only hope of fathering my own children. Numerous things didn’t add up:
a. I went through pubity and am a pretty large guy.
b. I have always had a good sex drive
c. I have larger than average sizes testicles
I decided to seek out some proven experts in this field. I found a doctor who had written various papers in the field of hypergonadism in children, sent her all my information and organized a consultation. Within a few minutes of examining me and looking over the folder of test results (a bible at this point), she instantly knew something didn’t make sense. After an examination or the testicles, she immediately identified a lack of palpable vas deferens (the tubes that carry sperm from testes) and diagnosed me with CABVD aka Obstructive Azoospermia.
My urologist + endrocinologists had neglected to notice the lack of palpable vas, furthermore failed to acknowledge the significance of the CF carrier mutation results. It is widely reported that a large % of male CF carriers have CABVD (as do CF patients). This new DR advised me to come off the HCG injections immediately as they were probably doing more harm than good by raising Estrodiol levels and impairing sperm production. She referred me to one of the leading urologists in the country.
Upon examining me and looking at my various test results, he told me there was a 99% chance my testes were creating sperm and it was simply the fact they had no way of getting out due to the CABVD. He wanted to move ahead with IVF treatment asap and simultaneous egg retrieval with either Tesa or Mesa sperm retrieval(depending on findings upon opening me up). After the various conflicting opinions, advice and treatment I was nervous about going ahead with the IVF without knowing for sure that they could retrieve sperm but I trusted this doctor – he had an impeccable track record in this field. The failsafe was that in the event they didn’t retrieve anything, my wife could have her eggs frozen for future options – e.g. sperm doner IVF.
Part 2. MESA / ICSI / IVF
Thank god my wife had great hormone levels, egg reserve and we didn’t have to deal with any major issues on her side too. She responded very well to stimulation and had 19 mature follicules retrieved. My doctor was able to retrieve a sample of 50 million sperm from my epidydimis (MESA) with a motility of up to 40%. The procedure took about an hour. After 18 months of anxiety, it was the happiest moment of my life when I woke up and they told me they had struck gold.
They fertilized 11 eggs on the same day as MESA and on day 3 they had 2 good looking embryos to transfer (1 x AB,1 x B). The two week wait was agonizingly slow after so much action. On the day of the results, we took the day off and drove to the beach preparing ourselves for the worst. While in the car driving, my wife’s physician called and announced that we were pregnant and her levels were looking great. With tears streaming down our face in a complete state of disbelief, could this really be true!!! How could we be so blessed to be pregnant on the first IVF attempt!! We still can’t believe it. In our minds we had resigned ourselves to the fact that we would do whatever it took to have a family together whether that meant exploring unconventional means or multiple attempts. In addition to the BFP, we also had the great news that we had 3 blastocycts make it to day 5/6 and were frozen for future attempts.
My wife soldiered the ghastly PG injections until week 12. Of course we were worried at every step but we are now the proud parents of a beautiful, healthy one yr old baby boy.
Our take aways from this experience are the following:
- always question your doctors, interview them about previous patients that have worked with that have similar profile to you. Educate yourself, read up on research papers, experts in the field who are on the cutting edge of your particular problems.
- ABSOLUTELY always seek out second and even third opinions from other doctors.
- Stay positive and mentally strong and try to laugh a lot in the adversity of this cosmic curve ball. Hope for the best outcome but also be accepting of the alternatives however painful you think they might be. We watched many Will Farrell videos throughout the whole ordeal especially his Harvard Graduation speech.
- Don’t bottle it all up and torment yourself. Goes without saying that infertility is a deeply deeply personal thing and even more so for men. It’s not something you can easily discuss with your male friends or even family.I spent years always knowing deep down that fertility was going to be an issue and I bottled it up, living with this dark cloud for much longer than I needed to. Discuss all your hopes, fears & alternatives with you partner.
- Have faith, it can happy for you regardless of what odds / statistics are against you.
Of course everyone’s cases are so very different but I found great comfort in reading many of the other stories online while we were going through it all if for nothing else but to be reassured that we weren’t alone in our struggle.
I wish you all the very best of luck in your journeys.