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Small testicle size and azoospermia


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#1 MapleBecky

MapleBecky
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Posted 04 January 2012 - 02:23 PM

We found out that we are dealing with azoospermia. I have noticed that his testicular size is smaller than average, especially on his right side. I'm assuming this is probably a non-obstructive azoospermia diagnosis in the making.

What causes this kind of thing to happen? There is likely not a fix to this, right? Would even TESE be an option? I'm feeling worried.

I haven't said a word to him about any of this yet, I think I will let the doctor say it when he gets examined, I don't want him to think that I have been analyzing him while being intimate.

Becky (35)  Unexpectedly widowed in Feb 2013.  The night after my ER.  I was married to an incredible man named Chris.

Son, age 6
TTC #2 (his first) since our wedding in July 2011.

Dec 1, 2011- Found out he has azoospermia (no sperm in SA.)  Totally heartbroken and shocked.
Jan 2012- First consult at fertility clinic.
March 2012- My tests show high LH but everything else was normal. His LH/FSH were high, testosterone was really low. (4.2)
May 17, 2012- Official Dx of testicular failure and non-obstructive azoo. Given the option of mTESE, TESA or using a donor.
June 7, 2012- Urologist is seeing us again per our request. We need him to answer some questions about the procedures and testosterone.  He would not consider Clomid or any hormones for DH.
June 27, 2012- Saw RE and decided to proceed with dIUI. Told we needed one cycle on the BCP because of my high LH.
June 28, 2012- Started BCP for 21 days. Did pre-IUI micro and blood testing on July 3rd. Told they should be in on time for IUI in early August.
July 21, 2012- CD1. Called clinic and found out my cycle was canceled. They messed up and my file wasn't ready. They forgot to draw vit D and some other results are missing.
August 9, 2012- Nurse left message saying they cannot do this cycle either. Now it will take 2-3 MONTHS for DH's blood tests before we can use donor sperm.
August 10, 2012- RE called. DH has a reactive Hepatitis C blood test and they are trying to figure out if he's got an active infection or was exposed in the past.
August 23, 2012- He's Hep C NEGATIVE! Phew!
October 2012- Latest SA results still shows azoo, but we're glad the testosterone looks normal now. dIUI after 21 days on the pill. Clomid for cd3-7, LH is too high (17 and 14.6) and progestone getting too high. Had 3, 13.5mm folliciles and my lining is 8.6. CD13- Lining was good, triple layer at about 9. Now I just have one 17.5mm follicle on my left side.
October 17, 2012- dIUI  canceled. Clomid didn't work, estrogen too low, LH was normal again and progesterone was off too. Now we need an appointment to talk to our RE again to start over.
Dec 2012- Saw RE and we have to do IVF/ICSI, even with a donor. So, we decided to throw in a TESA with donor backup. Bloodwork this cycle, BCP and mock in Jan and hopefully a Feb IVF/ICSI/TESA!
 
IVF #1
Mock done, teaching visit done.  Started Suprefact on Jan 30.  AF arrived on schedule.
Baseline done, starting Gonal-F and Luveris Feb 11.
Stim day 4-  1 follicle at 11mm, 40 more under 10.  My lining is already a triple lining and at 8.6
Stim day 6-  8-9 follices between 11-13mm at least 20 more under 10mm.  This doctor saw my lining at 6.3?   Encouraged to walk because my circulation to my uterus wasn't what they wanted to be this time.  No idea what that means.
Stim day 8-   14 follicles.  All measuring between 11 and 15 with more under 10.   Lining is over 10.  Circulation is good again.   They are letting me skip my day 9 appointment. 
Stim day 10-  TRIGGER tonight!   I have 14 between 15-21mm, a few more at 14 that may catch up.  Lining is over 10.   DH's TESA is tomorrow.
Feb 21-  No sperm found with TESA.   ER tomorrow with donor sperm.
Feb 22-  ER was successful!  Collected 18 eggs.   7 from my right and 8 on my left.  We can skip ICSI because the donor's sperm is great.  Crossing fingers for a good fert report tomorrow.
June 2013- Updating. My husband, Chris, passed away unexpectedly of Sudden Arrhythmia Death Syndrome just hours after my ER on Feb 23.  Had 14 fertilize.  9, 5-day frozen blasts are at the clinic waiting for me to make some decisions. 

 

FET #1

June 2014-  5-day blast.   BFN just in time for what would have been our 3rd anniversary.  

 

FET#2

August 2014.  FET #2 on Aug 25 with another 5-day blast.  BFP!   Had scare with a bleed at 4w5d, but beta is still doubling.  Due May 13, 2015.  Ultrasound on Oct 5.

Oct 5-  8w4d-  Blighted Ovum.  Stopping estrogen and progesterone.  Waiting to miscarry.  Looking forward to moving on with life.

Oct 17- D&C.   Feeling peace about being at the end of the infertility battle.  Looking forward to the next chapter in my life.


#2 Dr. Tamer Said

Dr. Tamer Said
  • Scientific Advisor
  • 134 posts
  • Gender:Male
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  • My Clinic:ReproMed

Posted 05 January 2012 - 07:57 AM

There are many causes that may lead to small testicular size: abnormalities during development, hormonal imbalance, previous trauma, maldescended testicles, surgeries, etc.

Your husband needs proper evaluation ASAP including medical history, physical exam, hormones and most importantly testicular ultrasound. These will be addressed since you have an appointment with a urologist.

TESE may be attempted, however the feasibility should be assessed based on the above.

Regards.
Tamer M. Said, MD, PhD, HCLD(ABB)
Director, Andrology Laboratory & Reproductive Tissue Bank
The Toronto Institute for Reproductive Medicine - ReproMed
56 Aberfoyle Crescent, Suite 300
Toronto, ON M8X 2W4
Email: tsaid@repromed.ca

#3 MapleBecky

MapleBecky
  • Global 100+
  • 549 posts
  • Gender:Female
  • Location:New Brunswick
  • Dx:Male Factor
  • My Clinic:Conceptia

Posted 05 January 2012 - 05:09 PM

Thank you. We're booked to get into a fertility clinic on the 25th and are still waiting on a uro appointment his family doctor set up. I'm hoping the fertility clinic can get started on some of the testing in the meantime.

He remembers having an inguinal hernia and repair at 8. I wonder if that could have something to do with.

Becky (35)  Unexpectedly widowed in Feb 2013.  The night after my ER.  I was married to an incredible man named Chris.

Son, age 6
TTC #2 (his first) since our wedding in July 2011.

Dec 1, 2011- Found out he has azoospermia (no sperm in SA.)  Totally heartbroken and shocked.
Jan 2012- First consult at fertility clinic.
March 2012- My tests show high LH but everything else was normal. His LH/FSH were high, testosterone was really low. (4.2)
May 17, 2012- Official Dx of testicular failure and non-obstructive azoo. Given the option of mTESE, TESA or using a donor.
June 7, 2012- Urologist is seeing us again per our request. We need him to answer some questions about the procedures and testosterone.  He would not consider Clomid or any hormones for DH.
June 27, 2012- Saw RE and decided to proceed with dIUI. Told we needed one cycle on the BCP because of my high LH.
June 28, 2012- Started BCP for 21 days. Did pre-IUI micro and blood testing on July 3rd. Told they should be in on time for IUI in early August.
July 21, 2012- CD1. Called clinic and found out my cycle was canceled. They messed up and my file wasn't ready. They forgot to draw vit D and some other results are missing.
August 9, 2012- Nurse left message saying they cannot do this cycle either. Now it will take 2-3 MONTHS for DH's blood tests before we can use donor sperm.
August 10, 2012- RE called. DH has a reactive Hepatitis C blood test and they are trying to figure out if he's got an active infection or was exposed in the past.
August 23, 2012- He's Hep C NEGATIVE! Phew!
October 2012- Latest SA results still shows azoo, but we're glad the testosterone looks normal now. dIUI after 21 days on the pill. Clomid for cd3-7, LH is too high (17 and 14.6) and progestone getting too high. Had 3, 13.5mm folliciles and my lining is 8.6. CD13- Lining was good, triple layer at about 9. Now I just have one 17.5mm follicle on my left side.
October 17, 2012- dIUI  canceled. Clomid didn't work, estrogen too low, LH was normal again and progesterone was off too. Now we need an appointment to talk to our RE again to start over.
Dec 2012- Saw RE and we have to do IVF/ICSI, even with a donor. So, we decided to throw in a TESA with donor backup. Bloodwork this cycle, BCP and mock in Jan and hopefully a Feb IVF/ICSI/TESA!
 
IVF #1
Mock done, teaching visit done.  Started Suprefact on Jan 30.  AF arrived on schedule.
Baseline done, starting Gonal-F and Luveris Feb 11.
Stim day 4-  1 follicle at 11mm, 40 more under 10.  My lining is already a triple lining and at 8.6
Stim day 6-  8-9 follices between 11-13mm at least 20 more under 10mm.  This doctor saw my lining at 6.3?   Encouraged to walk because my circulation to my uterus wasn't what they wanted to be this time.  No idea what that means.
Stim day 8-   14 follicles.  All measuring between 11 and 15 with more under 10.   Lining is over 10.  Circulation is good again.   They are letting me skip my day 9 appointment. 
Stim day 10-  TRIGGER tonight!   I have 14 between 15-21mm, a few more at 14 that may catch up.  Lining is over 10.   DH's TESA is tomorrow.
Feb 21-  No sperm found with TESA.   ER tomorrow with donor sperm.
Feb 22-  ER was successful!  Collected 18 eggs.   7 from my right and 8 on my left.  We can skip ICSI because the donor's sperm is great.  Crossing fingers for a good fert report tomorrow.
June 2013- Updating. My husband, Chris, passed away unexpectedly of Sudden Arrhythmia Death Syndrome just hours after my ER on Feb 23.  Had 14 fertilize.  9, 5-day frozen blasts are at the clinic waiting for me to make some decisions. 

 

FET #1

June 2014-  5-day blast.   BFN just in time for what would have been our 3rd anniversary.  

 

FET#2

August 2014.  FET #2 on Aug 25 with another 5-day blast.  BFP!   Had scare with a bleed at 4w5d, but beta is still doubling.  Due May 13, 2015.  Ultrasound on Oct 5.

Oct 5-  8w4d-  Blighted Ovum.  Stopping estrogen and progesterone.  Waiting to miscarry.  Looking forward to moving on with life.

Oct 17- D&C.   Feeling peace about being at the end of the infertility battle.  Looking forward to the next chapter in my life.