IVF following Sperm Retrieval


#1

My Husband and I have been trying for a year unsuccessfully to conceive. I have a child from a previous relationship who is turning 11 next week. When we first started trying, I missed my period right away and thought we hit the jackpot early on… only 3 failed home tests proved us wrong. When I called my doctors office, they told me that I had to miss 3 periods and still have a negative at home test before they’d see me. I was NOT a happy camper. 3 months passed and we were still in the same situation… no period and no signs of pregnancy. Blood tests revealed that I wasn’t ovulating. My OB/GYN started me on Clomid and still no ovulation. After the 3rd round, I was referred to a specialist. They tested both my husband and myself and found that I have PCOS and my husband has azoospermia. For the last month and a half, I’ve been back on birth control, a prenatal vitamin (the most ironic combination of medications if you ask me) and metformin for an insulin resistance they discovered when they did my blood work. My husband has been sent to a reproductive urologist. After more tests and a physical exam by him, they determined that a sperm retrieval (epididymal aspiration) may be possible.

So that brings me to current day and my question to all of you… I’ve tried calling his doctor’s office and my doctor’s office and no one is getting back to me. We have no idea what happens next! How long before we know if the retrieval was successful? How long before my doctor’s office can begin the next step in IVF? WHAT is the next step in IVF? I’m so frustrated that I have all these phone calls out to all these different offices and no one has gotten back to me for 2 days. Has anyone else had to go through this procedure that could give me an idea of what’s in store in the foreseeable future?


#2

I think you need to call and set up a consultation appointment with an RE. An OBGYN won’t help you at this point and you need an RE to take you on from here on out. That would be your starting point and they can help you out from there.


#3

Yes, you will need an RE and a urologist familiar with infertility. Luckily the clinic we went to had both, which made things simpler.
Next steps will likely be more testing on you and DH and then he would have a procedure and you’d start meds for your cycle if that’s how they decide to proceed.
With that method of sperm extraction, IVF with ICSI is the only option.
Good Luck!


#4

We’ve been seeing a specialist at Chicago IVF for me since the end of August and that’s who referred my husband to the Reproductive Urologist. I called his physician’s office once and left a message and called my physician’s office twice trying to get a hold of someone and no one seems to be able to tell me what comes next.


#5

I have PCOS and DH has MF also. He had FNA/ sperm mapping before he had the TESE done, he didn’t have it done at this place but this website does a good job of explaining what I’m talking about Sperm Mapping, Testicular Mapping, FNA Mapping for Azoospermia, I would highly recommend having this done before any actual retrieval procedure. So if I were you guys I would ask the urologist if they do this procedure or find out who does in your area. How long it takes to get results would really depend on the doctor and lab who are doing it, I would ask them their turn around time. I would also recommend having the mapping done before you start the IVF because then you know if you will be able to get sperm from DH to be able to use or not. From there your clinic will be able to tell you when they can cycle you, they are only able to do so many at one time. Once you are actually going through the IVF cycle it goes pretty quickly. You can message me if you have any more questions. I hope you get some responses soon.


#6

When my hubby had sperm retreived, it was the day before my retreival. The next day my eggs were retreived and they were fertalized. We did not have very good luck with that cycle, but I am sure it has worked for many others.

I know they can also retreive sperm ahead of time and freeze it. Then it could be used whenever you go through your IVF cycle. Ours was used fresh, was not frozen.

If you have general questions about IVF then I would be glad to help. Just let me know. Also, I have a lot of IVF info on m blog if you would like to check it out.

If you RE is not calling you back, I would be concerned about your choice of RE’s. My clinic always returns calls the day of. Even if they have to make calls after 5 pm. If you are not happy with your RE, then you may want to look for a new one, who can give you the answers you want. Good luck to you!!!


#7

We had sperm retrieved from the epididymis in the month before my IVF cycle. We opted for the PESA (percutaneous epididymal sperm aspiration) which is done in the office setting. Our doctor did the aspiration and checked with the lab during the procedure to see if they were able to get motile sperm. That way they can keep trying until they achieve success. Sometimes the PESA will not work and there will be a need for MESA (microscopic extraction) which requires anesthesia and an open incision to directly visualize the epi using a microscope to harvest the sperm that way. It’s more expensive and obviously more invasive (but more successful). If both of those fail they can get sperm from the testicle as well.

We deciced to do the aspiration in the month before my IVF cycle and freeze. I did not want to take the chance at a fresh aspiration at the time of my egg retrieval. If they didn’t find sperm we would have been unable to fertilize my eggs fresh. That would have been too much of a risk for me. Most say frozen sperm is just as good as fresh (well, I guess there are different opinions on that one) but I think frozen is just as good.

In the month we did our sperm extraction I also did my IVF work up. Bloodwork, physical exam, saline ultrasound and such. Those tests will take some time to get results. In the month following we did our IVF cycle which started with a one month course of BCP and then the start of IVF hormone injections. So, workup in January, BCP in February and IVF injections/cycle in March.

I hope this is helpful. I would be concerned about the lack of response from your doctors at this point. Good luck on your journey!


#8

My husband had reversal a few years ago. He has issues with motility so his urologist recommended that he undergo mTESE or microTESE. It’s a simpler procedure than a regular aspiration. The nurse instructed me that as soon as I get my calendar for my February IVF to call her so she can schedule it. She said it should be done 2 days prior to my retrieval.
If they are not returning your call, might as well find another urologist.


#9

We did FINALLY get some calls back - from both my doctor’s office and my husbands. Everything is set for Feb 2nd - they’ll try to retrieve as much of a sample as possible during the procedure and then proceed with cryo-preservation. I’m still waiting to schedule my next appointment, but they did say that there’s no guarantee they’ll be able to retrieve a viable sample when this is done in 3 weeks so for now it’s just waiting to see what happens with his procedure. It’s just a bit nerve racking but I’m trying to remain as positive as possible.


#10

Good luck with the sperm aspiration! They will always tell you there are no guarantees. That is just enough of a statement to make your mind wander! lol. We have had it done successfully (twice) and I think for the most part they are usually successful! Sounds like you are on your way…