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Micro TESE and freezing - 1st failed IVF


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#1 xrt1921

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Posted 11 August 2011 - 05:52 PM

Hello,

My wife recently completed an ivf cycle at a fertility clinic downtown toronto. Unfortunately it was unsuccessful :(

Our problems with fertility stems from myself. I was diagnosed with obstructive azoospermia requiring a microtese procedure. After the procedure was completed the sperm was transported from the hospital to the IVF clinic where it was frozen.

When it came time for fertilization, the sperm did not survive the thawing and we were only able to fertilize 3 eggs which failed to get my wife pregnant. 2 embyros reached to 8 cell and 7 cells--those were implanted on day 3. The 3rd was a 5-cell embryo which we decided to wait to see if it will survive until day 5 then we would freeze--unfortunately it didn't survive.

My wife had 33 eggs retrieved of which 17 were eligible for fertilization using ICSI however I was told that after the thawing, only a few sperm were moving but the rest didn't make it. They injected all the eggs with the hope that some will make it but as I said before, only 3 fertilized.

Is this normal for sperm retrieved via mirco tese not to survive thawing? I wish this was explained to me prior to pursuing IVF...we were left devastated that with so many healthy eggs, none made it. Is freezing an issue for sperm retrieved via micro tese?

Any information is greatly appreciated. My wife does not wish to proceed with any further IVF treatments and I am trying to figure out what went wrong.

#2 Lisa1969

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Posted 12 August 2011 - 07:45 AM

Hello,

My wife recently completed an ivf cycle at a fertility clinic downtown toronto. Unfortunately it was unsuccessful :(

Our problems with fertility stems from myself. I was diagnosed with obstructive azoospermia requiring a microtese procedure. After the procedure was completed the sperm was transported from the hospital to the IVF clinic where it was frozen.

When it came time for fertilization, the sperm did not survive the thawing and we were only able to fertilize 3 eggs which failed to get my wife pregnant. 2 embyros reached to 8 cell and 7 cells--those were implanted on day 3. The 3rd was a 5-cell embryo which we decided to wait to see if it will survive until day 5 then we would freeze--unfortunately it didn't survive.

My wife had 33 eggs retrieved of which 17 were eligible for fertilization using ICSI however I was told that after the thawing, only a few sperm were moving but the rest didn't make it. They injected all the eggs with the hope that some will make it but as I said before, only 3 fertilized.

Is this normal for sperm retrieved via mirco tese not to survive thawing? I wish this was explained to me prior to pursuing IVF...we were left devastated that with so many healthy eggs, none made it. Is freezing an issue for sperm retrieved via micro tese?

Any information is greatly appreciated. My wife does not wish to proceed with any further IVF treatments and I am trying to figure out what went wrong.


My DH has a similar issue. I haven't been able to get to the Egg retrieval stage yet but when I met with the embroyologist he mentioned that My husband may need to have the TESE performed again the day of the retrieval depending on how the sperm thaw out. Were you given this option? I would think if not many sperm thawed and you had such a large number of eggs that another fresh TESE would increase your odds.

I am already worried that his sperm will not fertilize my eggs..they had mentioned a donor sperm for me...but the only reason we are doing IVF is so we can have a biological child together.

Sorry to hear the process didn't work. I would think if you were to try again in the future to go with a fresh sample done the same day as the retrieval..now that you kow that you have some sperm.

Good luck and sorry the process didn't work for you both.
Me (42) DH (41)
12year old son from prior marriage

TTC 11/09

March 2011 testing done at New Life
April 2011 Semen analysis and PCT found no sperm
May 2011 DH had scrotal and transrectal ultrasound, found blockage
June 3 2011 TESA performed found sperm :)
June 29 2011 Endometrial Biopsy and Sonohystrogram scheduled

1st IVF
June 30 2011 Start Suprefact
July 9 2011 Started Gonal F 300 CD2 Follicle Count 2 on right and 2 on left
July 16 2011 Cycle cancelled not responding to meds

2nd IVF
AF over 2 weeks late
August 22 2011 CD3 Follicle Count of 6 on right and 4 on left
August 22 2011 Started 300iu of HMG
August 27 2011 started 50mg of clomid, stopped injections
August 31 2011 Cycle cancelled

3rd IVF
AF just 6 days late this time!!
September 26 2011 CD4 follicle count 4 on right and 4 on left
September 26 2011 started 100mg of clomid (on for 5 days before starting stims)
September 30 2011 gonal f 300iu
October 3 2011 ovidrel at 10pm
October 5 2011 ER 2 eggs retrieved, only 1 mature did not fertilize :(

IVF with DE
April 18, 2012 cd3, ultrasound, bloodwork and started BCP
April 18, 2012 DH did semen analysis at Create and they found sperm :)
June 7, 2012 Last day of BCP
June 14 CD3 US , BW, Cyst is gone :) Start Estrace 4mg 3x daily
July 1, 2012 egg retrieval for donor 15 shared eggs, only 5 fertilized
July 4, 2012 ET 3 good to transfer, 2 others watching - transferred 2, froze 1
July 14,2012 HPT negative, still held out hope it was early but too afraid to try another HPT
July 18, 2012 Beta BFN

Next step FET
July 24-CD23
Estrace 4mg 3 times daily
Aug 4, 2012 lining check 10B, :)
Aug 6, 2012 PIO shots daily, doxycycline for 3 days, medrol for 4 days
Aug 10, 2012 transfer last embie 3day 7 cell
Aug 24, 2012 Beta BFN :(

#3 xrt1921

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Posted 12 August 2011 - 08:57 AM

Unfortunately we weren't given an option to have the tese performed the same day. My urologist was at another hospital and was in no way affiliated with the clinic. No I am left wondering if we should have found a clinic that could perform the procedure the same day as the egg retrieval.

Is there any clinic in Toronto that can do this?

#4 Lisa1969

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Posted 12 August 2011 - 09:05 AM

Unfortunately we weren't given an option to have the tese performed the same day. My urologist was at another hospital and was in no way affiliated with the clinic. No I am left wondering if we should have found a clinic that could perform the procedure the same day as the egg retrieval.

Is there any clinic in Toronto that can do this?


I am currently with New Life Fertility. All of the main procedures are done in Mississauga which isn't too far from Toronto. My husband had his TESE done there and we have paid for another one with the IVF under the assumption that it may have to be done the same day as the egg retrieval.

ON the plus side your sperm was able to fertilize some of the eggs. So might not be a bad idea to get a second opinion
Me (42) DH (41)
12year old son from prior marriage

TTC 11/09

March 2011 testing done at New Life
April 2011 Semen analysis and PCT found no sperm
May 2011 DH had scrotal and transrectal ultrasound, found blockage
June 3 2011 TESA performed found sperm :)
June 29 2011 Endometrial Biopsy and Sonohystrogram scheduled

1st IVF
June 30 2011 Start Suprefact
July 9 2011 Started Gonal F 300 CD2 Follicle Count 2 on right and 2 on left
July 16 2011 Cycle cancelled not responding to meds

2nd IVF
AF over 2 weeks late
August 22 2011 CD3 Follicle Count of 6 on right and 4 on left
August 22 2011 Started 300iu of HMG
August 27 2011 started 50mg of clomid, stopped injections
August 31 2011 Cycle cancelled

3rd IVF
AF just 6 days late this time!!
September 26 2011 CD4 follicle count 4 on right and 4 on left
September 26 2011 started 100mg of clomid (on for 5 days before starting stims)
September 30 2011 gonal f 300iu
October 3 2011 ovidrel at 10pm
October 5 2011 ER 2 eggs retrieved, only 1 mature did not fertilize :(

IVF with DE
April 18, 2012 cd3, ultrasound, bloodwork and started BCP
April 18, 2012 DH did semen analysis at Create and they found sperm :)
June 7, 2012 Last day of BCP
June 14 CD3 US , BW, Cyst is gone :) Start Estrace 4mg 3x daily
July 1, 2012 egg retrieval for donor 15 shared eggs, only 5 fertilized
July 4, 2012 ET 3 good to transfer, 2 others watching - transferred 2, froze 1
July 14,2012 HPT negative, still held out hope it was early but too afraid to try another HPT
July 18, 2012 Beta BFN

Next step FET
July 24-CD23
Estrace 4mg 3 times daily
Aug 4, 2012 lining check 10B, :)
Aug 6, 2012 PIO shots daily, doxycycline for 3 days, medrol for 4 days
Aug 10, 2012 transfer last embie 3day 7 cell
Aug 24, 2012 Beta BFN :(

#5 Karolinasmommy

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Posted 12 August 2011 - 09:44 AM

We completed our procedure at ISIS (Mississauga) on the same day.
The urologist said he preferred getting the sperm fresh on the same day of the egg retrieval, so that is why we never had the option of freezing sperm before.

D

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#6 xrt1921

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Posted 12 August 2011 - 12:32 PM

Thanks for all the replies. My wife has been traumatized by the ivf experience. She hyperstimulated and ended up having to drain 1.5 litres of fluid. The fluid ended up in her lungs and she had difficulty breathing. With the progesterone shots the needle left her leg paralyzed and they finally told us to use the suppositories.

All of this we could have accepted if the cycle worked but to find out the freezing issue afterwards was a serious blow.

She does not want to try ivf again. I just needed to get some answers in case she does change her mind.

#7 leigh14

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Posted 13 August 2011 - 08:46 AM

Hi,

I'm so sorry to hear that the IVF experience was so hard. It is challenging for sure. My DH had the TESE procedure done when we had our first IVF. It was timed for the same day as my egg retrieval and the urologist came to the clinic. At that time, one extra vial was taken too and it was frozen. Unfortunately, that cycle was a BFN. For our next cycle, we switched RE's and he seemed to be leaning towards us doing a fresh TESE instead of using the frozen vial. He set up an appointment with us with a different urologist--Dr. Jarvi to have a consult. Dr. Jarvi thought that given what he saw on the lab report about the frozen sperm, that we would be fine using it, and that pregnancy rates are comparable with frozen/fresh sperm. That is what we did although we were warned by our clinic that frozen sperm doesn't always thaw properly and that there was a chance that my DH would have to have another TESE on the day of my egg retrieval (the clinic had arranged to have a urologist on standby if we needed it for a fresh TESE). Fortunately, the frozen sample thawed okay and we were able to use it. I did get pregnant from that cycle but unfortunately miscarried. It is unlikely it was because of the frozen sperm though! We have age-related factors and I have since had further testing done, revealing some immunological issues. We are now with another new RE and he is of the opinion it is better to do a fresh TESE (we have to anyway, as we have no more frozen sperm).

I am sorry that your wife overstimulated and doesn't want to do IVF again. I hope that she reconsiders. Now that it is known that she overstimulates, her protocol would likely be changed considerably to try to prevent this.

Good luck with everything!

Leigh
Me: 40
Dx: DH: Vasectomy; need IVF/ICSI ME: D.O.R. and many immunological issues. (Initially presented as "normal" but issues were only discovered after IVF attempt #2 and #3 after testing at new clinic)
IVF attempt #1 Nov.2009, Age 37: Long "Lupron" protocol
Dec.2009: Cycle cancelled due to oversuppression
IVF attempt #2, Age 38: April 2010: 3 eggs retrieved, 2 mature, 2 fertilized, ET of 2 embryos BFN
IVF atempt #3 at new clinic: November 2010, Age 38: 5 eggs retrieved, 4 mature, 4 fertilized, ET of 2 blastocysts BFP
Strong beta numbers but babies not measuring on track but one heartbeat is present. Followup u/s reveals no HB's :( Had D&C--so sad.
Moved to new clinic closer to home + more of a focus on testing for potential immunological factors:
Further testing reveals three mutations related to inherited thrombophilia (2 MTHFR mutations and PA1-1 mutation), positive ANA, elevated NK cells and cytokines and low levels of leukocyte antibodies (LADS), Recommended Immunological treatment: Humira, LIT, IVig and blood thinners if PG
IVF Protocol: Low stim for me/ TESE needed for DH; took Humira in late August and early September; taking DHEA plus Co-Enzyme Q10, vitamins for DH just for good measure! September--two trips to Mexico for LIT treatment, treatments 3 weeks apart
Initial re-testing through Alan Beer Centre after some of the immune treatments reveals only cytokines were lowered, NKs still high and LAD numbers still low. Another LIT in Mexico is recommended. We decide to begin cycle on doctor's recommendation of just doing IVIG.
IVF#4, Age 39 : November 2011: Worst AFC EVER--a whopping 4! Three follicles responded, two eggs were retrieved. Three day transfer of two Grade 1 8 cell embryos: "Fahita" & "Burrito" Stick, stick, stick little ones!
BFP! Beta of 569
Viability u/s at 6 w 2d shows TWO babies measuring on track with heartbeats of 121. Looks like babies might be sharing the same amniotic sac.
Second u/s at 7w 2 d shows ONE baby with hb of 150, measuring 7 w 3 days. No sign of twin. Vanishing twin syndrome?
Third u/s at 8 w 2d shows ONE baby with hb of 170, measuring 8 w 3 days. Looks like a little jellybean!
12 week u/s at 12 w 2 days and baby is measuring 12 w 5 days with a heart beat of 150. Baby mooned us and waved at us with one hand....looked like a "royal" wave to me!
13 week doctor's appointment, HB=155 on doppler
14 week u/s to check cervix, HB=148
16 week u/s to check cervix, HB=138, baby had hiccups!
20 week u/s--everything looks good! HB=130, looks like we're having a GIRL!
IPS results very good!
39 weeks: Our baby girl arrived!!! She is healthy and beautiful! We are so happy! :)

Lilypie Maternity tickers

#8 xrt1921

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Posted 13 August 2011 - 09:46 AM

Thanks for your reply. My urologist was also dr.jarvi and have no complaints with him. My surgery was investigative since he did not know if I had a blockage or not. Turns out that my epididymis is small and is not storing any sperm and nothing can get past. Once he realized he couldn't repair anything he did the micro tese and my wife brought the sample over to the Create Fertility clinic for freezing.

Now that I know a little more it seems that it would have been ideal to have a urologist at create to perform the procedure. My surgery had to be scheduled during the day surgery clinic at mt.sinai hospital as I don't think they do procedures of this sort at Create.

Knowing what I know now it seems going to a clinic that does the micro tese the same day would be ideal.

#9 Karolinasmommy

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Posted 13 August 2011 - 10:05 AM

Sorry to cut in, quick question, how much does a micro-TESE cost? Is it the one that you are put under for?
Wait...I think I a thinking about MESA?

I know there are TESE and PESA that can be done with you under local anesthetic. But MESA requires you to be put under.

I've been thinking of having my DH go and do the MESA, but if frozen sperm doesn't work out that great, I can understand why our urologist wanted same day fresh sperm.

D

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#10 xrt1921

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Posted 13 August 2011 - 10:31 AM

The micro TESE cost $1500. Going into my surgery Dr. Jarvi didn't know what he was going to find so he gave me information on all the procedures. It wasn't until afterwards that he told me that he performed the micro TESE.

I was put under general anasthetic since there was the hope that he would be able to repair any blockage which would make it a more involved procedure. Since he couldn't he performed the microtese which is much shorter.

#11 leigh14

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Posted 13 August 2011 - 03:24 PM

Hi Shawn,

Just wanted to mention that on my last cycle we were at Hannam Fertility and they made the arrangements to see Dr. Jarvi (we also found that he was excellent). We are not doing our next cycle at Hannam due to some of the immunological factors and treatments I need, but if we had, the game plan was to do a fresh TESE and Dr. Jarvi (or another urologist from the clinic) would do the TESE on the same day as the procedure. If you are looking for a Toronto clinic that would help to arrange this on the same day, I'd look into Hannam. It is a very good clinic overall.

Good luck.

Leigh
Me: 40
Dx: DH: Vasectomy; need IVF/ICSI ME: D.O.R. and many immunological issues. (Initially presented as "normal" but issues were only discovered after IVF attempt #2 and #3 after testing at new clinic)
IVF attempt #1 Nov.2009, Age 37: Long "Lupron" protocol
Dec.2009: Cycle cancelled due to oversuppression
IVF attempt #2, Age 38: April 2010: 3 eggs retrieved, 2 mature, 2 fertilized, ET of 2 embryos BFN
IVF atempt #3 at new clinic: November 2010, Age 38: 5 eggs retrieved, 4 mature, 4 fertilized, ET of 2 blastocysts BFP
Strong beta numbers but babies not measuring on track but one heartbeat is present. Followup u/s reveals no HB's :( Had D&C--so sad.
Moved to new clinic closer to home + more of a focus on testing for potential immunological factors:
Further testing reveals three mutations related to inherited thrombophilia (2 MTHFR mutations and PA1-1 mutation), positive ANA, elevated NK cells and cytokines and low levels of leukocyte antibodies (LADS), Recommended Immunological treatment: Humira, LIT, IVig and blood thinners if PG
IVF Protocol: Low stim for me/ TESE needed for DH; took Humira in late August and early September; taking DHEA plus Co-Enzyme Q10, vitamins for DH just for good measure! September--two trips to Mexico for LIT treatment, treatments 3 weeks apart
Initial re-testing through Alan Beer Centre after some of the immune treatments reveals only cytokines were lowered, NKs still high and LAD numbers still low. Another LIT in Mexico is recommended. We decide to begin cycle on doctor's recommendation of just doing IVIG.
IVF#4, Age 39 : November 2011: Worst AFC EVER--a whopping 4! Three follicles responded, two eggs were retrieved. Three day transfer of two Grade 1 8 cell embryos: "Fahita" & "Burrito" Stick, stick, stick little ones!
BFP! Beta of 569
Viability u/s at 6 w 2d shows TWO babies measuring on track with heartbeats of 121. Looks like babies might be sharing the same amniotic sac.
Second u/s at 7w 2 d shows ONE baby with hb of 150, measuring 7 w 3 days. No sign of twin. Vanishing twin syndrome?
Third u/s at 8 w 2d shows ONE baby with hb of 170, measuring 8 w 3 days. Looks like a little jellybean!
12 week u/s at 12 w 2 days and baby is measuring 12 w 5 days with a heart beat of 150. Baby mooned us and waved at us with one hand....looked like a "royal" wave to me!
13 week doctor's appointment, HB=155 on doppler
14 week u/s to check cervix, HB=148
16 week u/s to check cervix, HB=138, baby had hiccups!
20 week u/s--everything looks good! HB=130, looks like we're having a GIRL!
IPS results very good!
39 weeks: Our baby girl arrived!!! She is healthy and beautiful! We are so happy! :)

Lilypie Maternity tickers

#12 xrt1921

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Posted 13 August 2011 - 03:49 PM

Thanks for the tip! If there is a next time I would certainly look into this.

#13 edickson

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Posted 20 December 2016 - 04:55 PM

Hi there, were you seeing Dr. Fisher by any chance in Missisauga? Is that were the microtese took place or did you have to go to the hospital, how much did it cost? Thanks!



#14 xrt1921

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Posted 21 December 2016 - 08:41 AM

Hi there, were you seeing Dr. Fisher by any chance in Missisauga? Is that were the microtese took place or did you have to go to the hospital, how much did it cost? Thanks!

Hello -- no we saw Dr. Jarvi at Mt. Sinai.  I think the cost was $1500 if I remember correctly