We found out last Friday that my husband has no sperm. Seeing a urologist May 6th. What should we expect from first visit? Also, he has low testosterone and is on depo testosterone that he gets every other week. I wonder if that’s what is causing the problem? He has a 17 year old from a previous relationship.
I am going through this same thing, so can share what our first visit was like with a urologist after a first SA showed no sperm…
My husband was referred to a urologist by my gyne, but we did some research and decided to go to a different one that specializes in male infertility. When we went in, we had another doctor (doing a fellowship maybe?) come in and we gave our background and shared the tests we had done so far, and he explained how they look at azoospermia, what the options are, etc. Then he did a physical exam of my husband. Then the main doctor came in and kind of repeated - explaining what would happen next, and did an exam. He explained obstructive and non-obstructive azoospermia… I had done a lot of research so I had a lot of questions, as well. He explained next up my husband needs to have blood work done and get another SA.
Depending on these next things, they may be able to identify if any medication could help raise sperm count, if there is an obstruction that they may be able to operate to clear up (after which we might be able to try naturally, or do IUI), or if they may need to do a mTESE where they would attempt to retrieve sperm surgically (and we would have to do IVF with ICSI). Our doctor doesn’t do biopsy before an mTESE as it’s not conclusive, but I have read of others who have had that done. Our doctor would freeze any sperm found, so I don’t have to plan out an IVF cycle timing-wise with it (I have read of others where the doctor times an IVF cycle with TESE so they can use live sperm).
From what I have read, if your husband is on a testosterone supplement that could absolutely be contributing. From what I understand, if a guy takes testosterone your body stops producing it… I think they would stop that and maybe give him Clomid or something that would help his body create more instead of supplementing it. But this is completely based on what I have read, not from any personal experience or real knowledge!
My advice would be to research urologists in your area and find one that focuses on male infertility and make sure they have experience with azoospermia (if possible). Expect a conversation including what tests YOU have done already, how long you have been trying, etc, and a physical exam, and then a second SA and blood tests scheduled before another follow up appointment.
Good luck! Keep us posted!
My husband had an SA that had no sperm either. We were referred to an urologist who recommended a TESE exam. My husband has high FSH levels and after TESE they could find no sperm. Dr says it is probablyndue to testicular atrophy. He has recommended that my husband gets a Dexa bone scan every two yrs and that donor sperm or adoption are our only options
Did your husband have a biopsy? Or actual mTese? If he just had a biopsy (where they take two or three samples from the testicle), then he may still have sperm that is retrievable through an mTese (3-5 hour surgical procedure in which a surgeon goes through the testicle looking for sperm). We had a biopsy, were told that there was no sperm, got a second opinion and have found sperm twice through mTese. MTese is done in conjunction with IVF so that if you find anything it is used immediately to fertilize your eggs. If you read through these and other forums you will find a lot of info on your options, as well as good male fertility specialists. You may still wind up using donor sperm or adoption, but you may want to get a second opinion before you make that decision.
[QUOTE=iheartmemories]We found out last Friday that my husband has no sperm. Seeing a urologist May 6th. What should we expect from first visit? Also, he has low testosterone and is on depo testosterone that he gets every other week. I wonder if that’s what is causing the problem? He has a 17 year old from a previous relationship.[/QUOTE]
That will be temporary Azoo for your husband. Sperm production stopped because of the artificial testo. Usually, the Urologist will have you stop taking those and give you hcg shots or something similar like clomid. Things are looking bright in your case.