Doing mTESE without doing IVF at the same time... Frozen vs fresh sperm for IVF?


#1

Hey all,

I am starting a new thread on this topic because it came up in my other thread in the Male Infertility forum (not this the Male [B]Factor [/B]Infertility forum). I am not sure if everyone follows both forums, so thought I would ask here, too.

My husband is scheduled for mTESE (after two 0 sperm SAs and bloodwork diagnosed NOA - high FSH, normal all else, including high testosterone) next month. Our doctor told us that the chances with frozen and fresh sperm were the same (I swear he said they are finding frozen is better), and he always freezes sperm from mTESE. This works great for us, since we won’t start IVF until we know if we have DH sperm, as we haven’t decided yet that we’ll go to DS if they don’t find sperm with the mTESE.

Anyhow, SanDiegan let me know in the other thread that fresh sperm is better, and actually said that a good place won’t do frozen. We are going to a top Chicago doctor that specializes in male infertility and mTESE is 80-90% of all he does. But we haven’t met with the fertility center yet that he works with (best success rates in Chicago) and were planning to have our appointment after the mTESE.

Take a look at this: Efficiency of Using Frozen-Thawed Testicular Sperm for Multiple Intracytoplasmic Sperm Injections

Now I am freaking out… I have read a lot of folks on forums saying that fresh is better, and it sounds like Dr Schlegel only does mTESE to use fresh sperm for concurrent IVF based on an article I read. Although doing mTESE and IVF separate feels right for us, I don’t want to lower our chances of success if they do find sperm!

Anybody else done an mTESE without doing IVF at the same time?

From reading online there is a big difference of opinion about fresh vs frozen… would love to hear what everyone’s doctors have said and personal experiences.


#2

We are planning on scheduling mtese in September, timed with IVF because both DH’s urologist and the IVF doctor advised that, considering we are dealing with severe MFI (DH also has azoo), it is better to use fresh than frozen. They explained to us that, with men with normal sperm counts, it is not a big deal to freeze the sperm because there is so much. But in our situation, we will be lucky to find any sperm, and if we are dealing with like 10 sperm, or a small number like that, then it is riskier to freeze them because sperm sometimes get damaged during the thawing process.

I’m not happy about going through IVF especially considering there is no gaurantee that we will find anything during the mtese, but we decided that if we don’t find anything from DH, or if the sperm they find is no good, then we will go ahead and freeze my eggs so the IVF won’t have been for nothing. I’m 35 so I’m getting nervous about my own fertility and I think having my eggs frozen will make me feel better about taking some more time to decide where to go if we don’t get any sperm from DH.

I’m sorry if this information makes you nervous. I don’t want you to panic, but I would hate for your DH to go through the mtese, have them find sperm only for that sperm not to thaw well and be useless. For that reason, you may want to consider just doing the IVF concurrently so that way if they do find anything it can be used to fertilize your eggs. And if they don’t find anything then you can just freeze your eggs if you want.

Obviously, everyone is different so it may be that your DH’s doctors feel confident that his sperm would thaw well and that is why they recommend doing it independent of IVF. This is just what our doctors told us so I’m sharing it with you. Good luck with everything.


#3

We had a better fertilization and better quality embryos with frozen TESE sperm than we did with the fresh stuff. I did find a study that suggests that it is better if the lab thaws the frozen stuff a day in advance in order for it to mature and so that they are better able to pick out the best looking ones (as you know testicular sperm aren’t mature when they are harvested). Anyway, I was pleasantly surprised by our results and as long as your docs have worked with frozen TESE sperm before, I would trust them


#4

Thanks Shana and MusicGal!

It’s funny reading through these things you feel like you know someone even if you haven’t talked to them… you two are such people. :slight_smile:

I appreciate both of your advice. I called the fertility center yesterday to see if I could move up my appointment to before the surgery (though I doubt I can at this point!), just to make sure all is well from their perspective, not just the urologists. But he does work with them very regularly, so I am confident this plan is solid. Plus, and this may be TMI outside of fertility, but my dad is dying from lung cancer (we were told 4 weeks ago tomorrow that he had 2-3 weeks max, but he’s hanging in here!) so from a personal perspective, this plan works out much better. I wouldn’t want to do IVF right now anyhow with the time and toll it takes, plus I would like to be more relaxed to have the best chance when we go through it.

Shana: I am 32 but will be 33 by the time we do IVF; I can relate on feeling the pressure with my own fertility based on age, even though it’s my husband’s azoo that is our official problem. I feel like I want to do this all as soon as possible in case we go through it more than once… or in case we need to change to another option. I didn’t even think about the egg freezing option if the mTESE didn’t work out. That makes tons of sense and sounds like such a good idea! I would be way more open to timing the IVF with that option on the table. GOOD LUCK! It looks like your DH had an mTESE before - did you do IVF cycle that time too? It’s SO amazing they have found sperm in his SA, I have total faith you will be successful this time!

MusicGal: That’s awesome to hear. I know none of this is black and white, but it’s always such a relief to hear of someone who has had success on your chosen path. :slight_smile: When is your due date? CONGRATS!!!


#5

Stayingcalm, I just saw your response below. I’m so very sorry to hear about your Dad. I can’t imagine going through that on top of everything MFI related. That’s a lot to handle at once. My heart goes out to you.

Yes, my DH did have the mtese before. In March of last year he had varicocelectomy and they did a mtese at the same time. We only found immature sperm then. Since then he has been on fsh injections and the doctor though that perhaps the combination of repairing the varicocele, along with the meds, may result in some mature sperm production after some time. So now that we’ve given it some time we’re gonna try again. But that will be it for us. If they don’t find anything at the next mtese we’re moving on. What did you guys decide? Your thoughts below make a lot of sense, so I totally understand if you decided not to do IVF at the same time. Oh, and to answer your question, no I didn’t do IVF during my DH’s first mtese, and looking back I’m glad I didn’t. Now, I’m older and feel like even if they don’t find anything, at least we can freeze my eggs. But I think given your age, you have time still and if you’d rather not do the IVF at the same time that makes a lot of sense too.

[quote=stayingcalm]Thanks Shana and MusicGal!

It’s funny reading through these things you feel like you know someone even if you haven’t talked to them… you two are such people. :slight_smile:

I appreciate both of your advice. I called the fertility center yesterday to see if I could move up my appointment to before the surgery (though I doubt I can at this point!), just to make sure all is well from their perspective, not just the urologists. But he does work with them very regularly, so I am confident this plan is solid. Plus, and this may be TMI outside of fertility, but my dad is dying from lung cancer (we were told 4 weeks ago tomorrow that he had 2-3 weeks max, but he’s hanging in here!) so from a personal perspective, this plan works out much better. I wouldn’t want to do IVF right now anyhow with the time and toll it takes, plus I would like to be more relaxed to have the best chance when we go through it.

Shana: I am 32 but will be 33 by the time we do IVF; I can relate on feeling the pressure with my own fertility based on age, even though it’s my husband’s azoo that is our official problem. I feel like I want to do this all as soon as possible in case we go through it more than once… or in case we need to change to another option. I didn’t even think about the egg freezing option if the mTESE didn’t work out. That makes tons of sense and sounds like such a good idea! I would be way more open to timing the IVF with that option on the table. GOOD LUCK! It looks like your DH had an mTESE before - did you do IVF cycle that time too? It’s SO amazing they have found sperm in his SA, I have total faith you will be successful this time!

MusicGal: That’s awesome to hear. I know none of this is black and white, but it’s always such a relief to hear of someone who has had success on your chosen path. :slight_smile: When is your due date? CONGRATS!!![/quote]


#6

Stayingcalm, I just saw your response below. I’m so very sorry to hear about your Dad. I can’t imagine going through that on top of everything MFI related. That’s a lot to handle at once. My heart goes out to you.

Yes, my DH did have the mtese before. In March of last year he had varicocelectomy and they did a mtese at the same time. We only found immature sperm then. Since then he has been on fsh injections and the doctor though that perhaps the combination of repairing the varicocele, along with the meds, may result in some mature sperm production after some time. So now that we’ve given it some time we’re gonna try again. But that will be it for us. If they don’t find anything at the next mtese we’re moving on. What did you guys decide? Your thoughts below make a lot of sense, so I totally understand if you decided not to do IVF at the same time. Oh, and to answer your question, no I didn’t do IVF during my DH’s first mtese, and looking back I’m glad I didn’t. Now, I’m older and feel like even if they don’t find anything, at least we can freeze my eggs. But I think given your age, you have time still and if you’d rather not do the IVF at the same time that makes a lot of sense too.

[quote=stayingcalm]Thanks Shana and MusicGal!

It’s funny reading through these things you feel like you know someone even if you haven’t talked to them… you two are such people. :slight_smile:

I appreciate both of your advice. I called the fertility center yesterday to see if I could move up my appointment to before the surgery (though I doubt I can at this point!), just to make sure all is well from their perspective, not just the urologists. But he does work with them very regularly, so I am confident this plan is solid. Plus, and this may be TMI outside of fertility, but my dad is dying from lung cancer (we were told 4 weeks ago tomorrow that he had 2-3 weeks max, but he’s hanging in here!) so from a personal perspective, this plan works out much better. I wouldn’t want to do IVF right now anyhow with the time and toll it takes, plus I would like to be more relaxed to have the best chance when we go through it.

Shana: I am 32 but will be 33 by the time we do IVF; I can relate on feeling the pressure with my own fertility based on age, even though it’s my husband’s azoo that is our official problem. I feel like I want to do this all as soon as possible in case we go through it more than once… or in case we need to change to another option. I didn’t even think about the egg freezing option if the mTESE didn’t work out. That makes tons of sense and sounds like such a good idea! I would be way more open to timing the IVF with that option on the table. GOOD LUCK! It looks like your DH had an mTESE before - did you do IVF cycle that time too? It’s SO amazing they have found sperm in his SA, I have total faith you will be successful this time!

MusicGal: That’s awesome to hear. I know none of this is black and white, but it’s always such a relief to hear of someone who has had success on your chosen path. :slight_smile: When is your due date? CONGRATS!!![/quote]


#7

Hello! I know this thread was started some time ago, but wanted to let know you know that we had success with frozen sperm. Details are in my signature. I’m also curious what RE/clinic you are going to - I’m from the Chicago area. We went through FCI, but I’d like to try for baby 2 and plan to consult different REs. Feel free to pm me!! Best of luck! :cross:


#8

Staying calm, just checking in to see how you are doing. Thinking of you and your Dad and your DH’s surgery. Not sure if you went ahead with the mtese given everuthing you were going through but just thought I’d check in. Hope you are doing well.


#9

Hello Shana,
If I were you I would do Micro Tese and IVF all at the same time, with donor backup (if that’s an option for you).
Read my signature and you’ll see how many mistakes we’ve made and now we’re back to square one, doing the same thing we tried 3 years ago.
Freezing eggs is not the greatest thing. I don’t think they are the greatest quality once they thaw them.
MSG me if you like we can chat.


#10

Hi all,

Sorry it’s been so long. My dad passed away this summer. DH’s original mTESE surgery was scheduled a month or so later, but the doctor canceled it the day before because he was stuck out of the country. The surgery was rescheduled and the earliest they could get us in was September - DH had the mTESE yesterday. We just heard the news that although there were many large tubules taken, “surprisingly” the technician found no sperm at all. The doctor thinks that DH has maturation arrest, but they sent some samples to the pathology lab so we will get confirmation on this.

Now I am trying to learn more about maturation arrest and immature sperm, and whether there is any chance at all for us. The doctor said there was not.

Anyone have any insight to share, or resources to point me to? It’s a really dark day for us.


#11

Hi all,

Sorry it’s been so long. My dad passed away this summer. DH’s original mTESE surgery was scheduled a month or so later, but the doctor canceled it the day before because he was stuck out of the country. The surgery was rescheduled and the earliest they could get us in was September - DH had the mTESE yesterday. We just heard the news that although there were many large tubules taken, “surprisingly” the technician found no sperm at all. The doctor thinks that DH has maturation arrest, but they sent some samples to the pathology lab so we will get confirmation on this.

Now I am trying to learn more about maturation arrest and immature sperm, and whether there is any chance at all for us. The doctor said there was not.

Anyone have any insight to share, or resources to point me to? It’s a really dark day for us.

Shana - Why did they start your DH on Clomid after the first failed mTESE? My DH has high testosterone, so Clomid was never discussed, but he also has high FSH (19). DH’s doctor is a proponent of Clomid, so him not recommending it for DH I didn’t really research it too much but thought they give it when the testosterone is low. Today he also mentioned he has seen men have sperm in future SA after maturation arrest, but without anything consistent about those men he could point to, and very much the exception not the rule. Fingers crossed for you, too, and thanks for thinking of us.