Posted 17 June 2016 - 02:55 PM
Hi there. I have some experience with this. My DH has obstructive azoospermia. Not a result of a vasectomy but he has a blockage in the epididymis somewhere. We attempted to have surgey to repair the blockage but unfortunately, it didn't work.
I have used both fresh and frozen epididymal sperm for my cycles. From my understanding, epididymal (like you guys retrieved during the PESA) and testicular sperm do not thaw out very well after it's frozen. You lose alot of them after the thaw. They also do not have the same level of motility as ejaculated sperm. And you are correct, there are differences in sperm quality depending on where in the epididymis the sperm are retrieved (close to the blockage, etc). The trouble with PESA is that they go in blind. All of the sperm we retrieved had poor motility and morphology was bad too. Most of the sperm were only twitching.
However, even though we had such poor sperm parameters, I always had excellent fertilization rates (close to 100%) for each of my IVF cycles (I've done 6), except for the last one where I got 11 mature eggs but only 6 fertilized. I was extremely disappointed. But the embryologist noted that there were visible issues with many of the eggs which is most likely the biggest reason why I had bad fertilization.
I know you mentioned they said you had zero motility but were they at least twitching?
I know that some clinics insist that there isn't a difference between frozen and fresh epididymal sperm but I personally do not agree. The thawing kills alot of them. At my clinic the embryologists prefer to use fresh epididymal sperm so that is what we have done for most of my cycles except for the first one and the natural cycle (I didn't want DH to udergo the procedure to retrieve sperm for only 1 egg). Tough to say about whether or not they should have thawed out another vial. I do see their point where they figure it was sperm retrieved from the same PESA so what would be the difference.
I'm sorry you are going through this. I would ask some more specific questions about the sperm quality after thaw. Were they pliable? Were they twitching? I would also ask more details about your egg quality. Just to see if any abnormalities were noted. Sometimes they may be subtle but can indicate a problem.
How are your 4 embryos doing? I'm assuming you are still in the middle of your cycle? Sending you strength and many hugs. I'm here if you need to chat. xoxo
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