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Azoospermia

clomid low testosterone azoospermia

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#1 bittybaker

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Posted 27 May 2014 - 03:51 PM

Here's our story: (the quick version)

 

I am 24 years old. Overall healthy

My husband is 27. Overall healthy

  • My husband and i have been TTC  for about 2 years.
  • OBGYN sent us to female fertility specialist.
  • He recommended my husband do a SA before we went into testing for me.
  • Got results from SA and he had zero count, azoospermia.
  • Did another SA just to be sure, still zero count.
  • He was referred to a Urologist that specializes in male Infertility.
  • Urologist did full exam and found no Varicoceles, no size or shape abnormalities, everything appeared normal. Possible blockage or hormone issues.
  • Urologist ordered full blood work, including all hormone levels and genetic testing.
  • Hormone levels came back. All levels came back normal except Testosterone. He has very low T levels.
  • He has no symptoms of Low T at all.
    Decresed libido- No.
    Erectile Disfunstion- NO.
    Fatugue or loss of energy-No.
    Depressed mood - No.
    Low bone density-No.
    Increased body fat- No.
    Reduced muscle mass or bulk- No.
  • At this moment we are still waiting on the genetic testing to come back.
  • I have done some research on Klinefelter syndrome, Y chromosome microdeletion and cystic fibrosis gene mutation and I am not a doctor but none of those seem to fit either.
  • Pending positive results from this, he will immediately be started on "Clomid" to improve testosterone levels and hopefully sperm count.

    I have done research online about azoospermia, Low T, and Clomid, but i have not found anything that involves all three. I am just hoping to get some more information. Has anyone ever heard of going from zero sperm count to having a sperm count using clomid? Anyone else experience Low T with no symptoms? Help from Clomid?  I'm sure I have more questions but at the moment that's all I can think of. Any help is very appreciated!

 

 

 

 



#2 gracegirl

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Posted 27 May 2014 - 04:51 PM

We have EXACTLY the same situation as you (right down to the low T with no symptoms)...and my specialist said for us, there was nothing we could do. Now having said that, we did opt for the PESA/TESA surgery. NO sperm was found. We could have had one further surgery, but opted not too...too invasive. Again, my doctor said there was absolutely nothing we could do to create sperm.

 

The diagnosis is a scary one...our world kind of fell apart and we were absolutely devastated (my husband tore down two walls in the house the weekend we got the news). We sought counselling and it really helped to move us forward.

 

We used a donor to conceive our son. It was the best decision we ever made.

 

Feel free to pm me if you want more details.


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#3 luna123

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Posted 28 May 2014 - 09:29 AM

Has your doctor ruled out the idea of a blockage? If not, it's possible he's still producing sperm, as was my husband's case. Through testing, we found out he was born without a vas deferens, which is an indicator of being a Cystic Fibrosis carrier. Genetic testing later turned out to be negative. The PESA procedure allowed us to extract usable sperm. However, his testosterone levels were normal.

 

There are also a lot of posts about azoospermia in this thread: http://ivf.ca/forums...33-azoospermia/

and this recent post about a couple who used Clomid to boost sperm count and it worked: http://ivf.ca/forums...results-are-in/



#4 bittybaker

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Posted 28 May 2014 - 10:50 AM

Luna123- blockage has not been ruled out yet. We have only been to one visit with the Urologist and he recommended doing the hormone and genetic testing first to see what answers that gives us. All hormone levels are normal except for very low testosterone which he feels could be the reason he is not producing sperm. We should get genetic results in about two weeks.   

 

Looking in the future: Pending positive results he said he will start him on Clomid to try to boost testosterone levels and hopefully sperm count. I do not know many details about that at the moment as to how much he will take and how often and how often they will want a SA but the Urologist recommded that first before doing anything invasive.  

 

As it seems with everything in the process we are just waiting for more answers. blush.png

 

If we don't get positive results with the Clomid, he recommended a testicle biopsy to find if he produces at all.  In the case that he produces but there is a blockage he said the best option for us would be IVF. We do not have any medical coverage for "infertility" so he said if he produces but there is a blockage, performing corrective surgery would be extremely costly and there would be no guarantee for positive results.



#5 luna123

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Posted 28 May 2014 - 11:38 AM

My husband had to get testicular & rectal ultrasounds before the doctors found his issue. That came after the blood testing because it was obviously more invasive.

 

He was claim back $500 of the cost of his PESA (which cost $1500 total) through his workplace health coverage plan's insurer because they could consider it a "diagnostic" procedure (ie: diagnosing if he was in fact azoospermic) versus a fertility treatment (no coverage). I see you're in the US but it might be something to consider.  


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#6 tulip11

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Posted 24 June 2014 - 11:02 AM

hi

 

I am new to this forum and this is my first post. in 2013 we found out that my hubby has azoospermia its more than a year since we are doing different tests. his fsh is 13.2 which according to doctors is way too high but i dont think so its too high as its near to a normal value. his chromosomal test came back normal. he had two ultrasound first one was just a general one in which they saw everything is normal and said testicles are of normal sizes but second ultrasound which was last week that was detail one and checked scrotum testicles again so this time they said that right testicle is of normal size while left is slightly smaller than normal size. so till now they says its NOA. they will send us to fertility specialists now as last appointment was the last one test for diagnosis. my hubby is 32 years old. i am searching internet throughout the day for some hope , successful stories and finally found this forum. any ladies out there who got similar case and later on got their bfp. 



#7 bump_fever

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Posted 16 July 2014 - 04:46 PM

Very similar situation. May 2014 - Dx Azoospermia, DH has low T but no symptoms, FSH is normal. Karotyping normal. No blockages found. Had low sperm count + good morphology in 2009. DH was open to try PESA/MESA but our FS disagreed - if hormones dont support sperm production, then they won't be found he said.  Suggested hormones to boost testosterone and thus lead to sperm genesis. Now on HCG injections for 4 months. KMFX


Me: 31, DH: 32, TTC: 7yrs
'09 -  Multiple attempts on Clomid + IUI = all BFN's
Stress + life events = baby making on hold
Nov '13 - Dx Azoospermia - referred to RFP
May '14 - Initial consult with RFP
July '14 - HCG injections for 4 months.....
Nov 21/14 - HCG is working!! Swimmers on ice smile.png Dose doubled!
March 16/15 - IVF+ICSI, Transferred 2 embryos on day 2, BFP!!!!

#8 Precocious

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Posted 12 August 2014 - 06:28 PM

My situation is similar as well. Azoospermia with 2 sperm samples, in different labs, showing no sperm.
My bloodwork revealed normal fsh/lh but testosterone was quite low.
Testicle size smaller than average.
Currently on anastrozole, going to have tese timed with wife's ivf in sept. Not rechecking SA until day of tese.

Testosterone level and fsh level have both doubled with anastrozole. Also slight additional facial hair growth on chin, which never had before.

#9 Cristine

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Posted 22 September 2014 - 03:06 PM

Has anyone here been to see Dr Jarvi @ Mount Sinai to discuss your DH's azoospermia diagnosis?  If so, I am curious to know what your experience was like.  Does he order tests, etc?  Or is the first appt just a discussion? 

 

My DH has azoospermia and thankfully, we are able to retrieve sperm via TESA for our cycles but the quality of the sperm is quite poor.  We are interested to know if there is anyway we can retrieve sperm from other locations in the hopes of obtaining better quality sperm, or if there is a chance that reconstructive surgery would work to correct the blockage.  At this point, I don't want to leave any stone unturned.

 

Hope to hear from some of you!


More details on our infertility journey in 'About Me' page

 

Me: 40, DH: 43

TTC for many years - severe male factor - Obstructive Azoospermia

 

DEIVF in Zlin, Czech Republic - March/April 2017

Jan 25 - AF arrives, start BCP

Feb 21 - Lupron Depot shot

Mar 13 - start Estrace (2mg 3x per day)

Mar 29 - ER, 16 eggs retrieved!  DH MESA successful...3 straws frozen

Mar 30 - day 1 update:  all 16 eggs mature, 13 fertilized.  Yahoo!

Apr 3 - ET - transferred 2 grade 1 blasts - I can't believe it!  Now on to the 2ww!

Apr 11 - mustered up the nerve to POAS after a brief episode of spotting.  Instant BFP.  Oh...my...God.  In complete shock.

Apr 12 - official test day:  beta @ 9dp5dt = 238! 

Apr 13 - beta #2 @ 10dp5dt = 557

Apr 15 - beta #3 @ 12dp5dt = 1473

May 3 - viability scan @ 7 weeks - TWINS!  Baby A @ 139 bpm, Baby B @ 169 bpm

May 17 - 9 week ultrasound, both babes doing wonderful (both heartbeats 182 bpm) 

 

 

 

 

 

 

 

 

 

 


#10 luna123

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Posted 23 September 2014 - 09:50 AM

I think you'd have to talk to your doctor about corrective surgery as it depends on the cause of the blockage. In my case, my husband was born without a vas deferens so there was no surgery available to correct it. Since his hormone levels and everything else was normal, our doctor felt confident that he was producing sperm but they just couldn't get out into the ejaculate. His first step was to try the PESA procedure... he was able to retrieve good quality sperm in doing so. A needle was inserted into the epididymis and they were extracted from there. we were told that if there was no sperm retrieved with that procedure, he would try a testicular biopsy (which I believe is a TESE or TESA instead of PESA). I later read online that the sperm quality is not as good in the testicles compared to the epididymis but again, I read that online, not from the doctor himself.



#11 Cristine

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Posted 23 September 2014 - 11:04 AM

Thanks for the reply Luna.  Our urologist confirmed that we have obstructive azoo, although not for the same reason as your DH.  My DH has 2 kids conceived the old fashioned way from a previous relationship.  Something happened since then and now the sperm just can't get out.  All of his hormones are normal and when we did the testicular biopsy last year to confirm if sperm was present, it confirmed that he has normal active spermatogenisis.  The urologist explained the blockage could be anywhere in the reproductive tract. 

 

I am going to ask Dr Jarvi about the PESA and if that could possible yield better sperm quality.  One interesting thing we noticed is that for my last cycle, I had DH taking 200mg of ubiquinol daily, in addition to FertilAid.  Anyway, when the lab called me to give me my fertilization report, they asked what we had done differently for this cycle since the sperm were better in comparison to the last 2 times.  In my second cycle, they didn't even bother doing a count...this time they had 23 million and the morphology was a bit better...motility was only 13% though but that is typical for TESA samples.  Anyway, this time we had better embryos than ever before....which leads me to believe it was a direct result of having better sperm quality.  We are trying to do everything we can to maximize sperm quality which is the main reason why we want to see Dr Jarvi...perhaps he can give us some more insight into our situation and possible recommend something different we can try.  We also want to know more about the reconstructive surgery to see what he thinks...is it even worth considering in our case. 


More details on our infertility journey in 'About Me' page

 

Me: 40, DH: 43

TTC for many years - severe male factor - Obstructive Azoospermia

 

DEIVF in Zlin, Czech Republic - March/April 2017

Jan 25 - AF arrives, start BCP

Feb 21 - Lupron Depot shot

Mar 13 - start Estrace (2mg 3x per day)

Mar 29 - ER, 16 eggs retrieved!  DH MESA successful...3 straws frozen

Mar 30 - day 1 update:  all 16 eggs mature, 13 fertilized.  Yahoo!

Apr 3 - ET - transferred 2 grade 1 blasts - I can't believe it!  Now on to the 2ww!

Apr 11 - mustered up the nerve to POAS after a brief episode of spotting.  Instant BFP.  Oh...my...God.  In complete shock.

Apr 12 - official test day:  beta @ 9dp5dt = 238! 

Apr 13 - beta #2 @ 10dp5dt = 557

Apr 15 - beta #3 @ 12dp5dt = 1473

May 3 - viability scan @ 7 weeks - TWINS!  Baby A @ 139 bpm, Baby B @ 169 bpm

May 17 - 9 week ultrasound, both babes doing wonderful (both heartbeats 182 bpm) 

 

 

 

 

 

 

 

 

 

 


#12 luna123

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Posted 24 September 2014 - 04:32 PM

Good luck with the next steps! It sometimes takes a while to get to the exact cause of these things and to find the best way to proceed.



#13 hopeful79

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Posted 23 February 2015 - 04:56 PM

We have EXACTLY the same situation as you (right down to the low T with no symptoms)...and my specialist said for us, there was nothing we could do. Now having said that, we did opt for the PESA/TESA surgery. NO sperm was found. We could have had one further surgery, but opted not too...too invasive. Again, my doctor said there was absolutely nothing we could do to create sperm.

 

The diagnosis is a scary one...our world kind of fell apart and we were absolutely devastated (my husband tore down two walls in the house the weekend we got the news). We sought counselling and it really helped to move us forward.

 

We used a donor to conceive our son. It was the best decision we ever made.

 

Feel free to pm me if you want more details.

We have the same situation too.  We are just starting down the path of donor sperm.  Any help or advice would be really greatly appreciated!  It's just good to hear that others have the same experience. I'm brand new to this forum but think I need people to talk to.

 

Thanks


History:

11/2012: tested. DH = Significant MF

01/2013: IVF #1 - 4 eggs fertilized. 0 blastocyzed 

04/2013: IVF #2 - 3 eggs fertilized. 0 blastocyzed

12/2013: DH had microtese to extract sperm from testes.  No viable sperm in sample but had frozen sperm as back up and when I went in to do transfer, sperm were found in fresh sample. IVF #3 - 14 eggs, 8 fertilized, 6 made it to day 3 but 0 blastocyzed.

01/2015: Dr reco'd donor sperm. 


#14 wannabmomma

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Posted 16 May 2015 - 10:13 PM

We have EXACTLY the same situation as you (right down to the low T with no symptoms)...and my specialist said for us, there was nothing we could do. Now having said that, we did opt for the PESA/TESA surgery. NO sperm was found. We could have had one further surgery, but opted not too...too invasive. Again, my doctor said there was absolutely nothing we could do to create sperm.

 

The diagnosis is a scary one...our world kind of fell apart and we were absolutely devastated (my husband tore down two walls in the house the weekend we got the news). We sought counselling and it really helped to move us forward.

 

We used a donor to conceive our son. It was the best decision we ever made.

 

Feel free to pm me if you want more details.

 

We have the same situation as well. DH is on Clomid and will be undergoing microTese in June. The urologist has given us a 50/50 chance of finding sperm, purely based on stats. 

 

Would love to hear from anyone whose had similar experiences and have had positive results from a retrieval. 



#15 Carebear2015

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Posted 31 August 2015 - 10:56 PM

My husband had to get testicular & rectal ultrasounds before the doctors found his issue. That came after the blood testing because it was obviously more invasive.
 
He was claim back $500 of the cost of his PESA (which cost $1500 total) through his workplace health coverage plan's insurer because they could consider it a "diagnostic" procedure (ie: diagnosing if he was in fact azoospermic) versus a fertility treatment (no coverage). I see you're in the US but it might be something to consider.  



#16 Carebear2015

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Posted 31 August 2015 - 11:04 PM

Hello,I am new in this area. My husband has 0 count sperm. He will do his sperm retrieval this Wednesday. If we are lucky I start my stim on sept 12. I am on bcp right now. He has all the test negative. Normal size Low T but in normal range. The fertility doc arange same retrieval day for us. But I don't wanna waste money and suffer ing lots shots. So we change his procedure this week. However. We don't know the frozen sperm is good as fresh?for your husband ultrasound Is that covered Or you have to pay for. And are you in Canada? Where ?thx.

#17 Carebear2015

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Posted 31 August 2015 - 11:05 PM

Hello,I am new in this area. My husband has 0 count sperm. He will do his sperm retrieval this Wednesday. If we are lucky I start my stim on sept 12. I am on bcp right now. He has all the test negative. Normal size Low T but in normal range. The fertility doc arange same retrieval day for us. But I don't wanna waste money and suffer ing lots shots. So we change his procedure this week. However. We don't know the frozen sperm is good as fresh?

#18 AmandaAB

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Posted 11 November 2015 - 10:58 AM

Carebear I do not have advice but am wondering how your journey worked out last month??





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