[Naomi35]

One month ago my DH, age 27, got an azoospermia result on his first ever S/A. He took the S/A as part of the fertility workup I was going to do after we have been ttc #1 for over a year.
Neither of us had even heard of azoospermia.

So now we have an appointment in a month with the expert which we are glad about. We know all our questions will be answered.
But the type of mind I have- I am trying to figure stuff out NOW!!
This is just how I am - I have a very active mind and I want to figure dtuff out. DH is actually content to ignore it as much as possible until the appointment.

So since many of you here have dealt with azoo . . .
I thought I would list our specifics here and see if anyone can help dechipher it.

I know no one but the docs can give us actual answers. But if anyone wants to play figure out the mystery with me- or help with clues . . . .

So-
I have read some of the things that can cause azoospermia are
-varicocle, missing part of the Y chromosome, testicular failure, a blockage- caused by infection or scarring

So we can't think of any of those things for DH.
I don't know anything baout the Y chromosome thing- any indications of that?

-We know his testicles are pretty big and firm ( normal) so I think that rules out testicular failure.
-He doesn't appear to have a varicocle ( we saw a urologist for a brief exam already)
- he has low volume semen ejaculate
-normal sex drive
-as for the blockage, which we are hoping for- we can't think of any reasons Why he would have htis. He never had a hernia repair or any STD's that he know of.
- As for hormonal- he grows a beard quickly and has a deep voiceand whatever testosterone htings might be "normal"

Sorry for my use of the word normal. I am jst trying to figure it out.

Amy ideas or thought of things I may have overlooked?

Again, I may just have to accept that I don't know!
But I always try to figure stuff out.
Oh- also
-he has some kinds of digestive issues for years, may be connected?

[Kris79]

Naomi - I am just like you and tried and tried to figure things out with my DH. I think your DH's symptoms sound very promising for a blockage...especially the low volume of output. From what I understand that is one of the things they look for to indicate a blockage. One thing I've noticed that you didn't mention is the possibility of him having the absence of vas deferens. This is a congenital thing and he would have no reason to know he had it until now...I believe it is associated with having the gene for cystic fibrosis...although I could be wrong about that. I haven't researched that too far since DH's symptoms didn't indicate that as our problem. From what I have read, while it technically is a "blockage" in that the sperm can't get out...there is no way around it other than IVF.

Your appointment will be here before you know it and you will be on your way to real answers. Just so you know...some of the genetic bloodwork can take about a month to get results on. It may not be such a bad thing to go ahead and see if the urologist he's already seen will order some bloodwork to check out genetics and hormone levels just so you have those answers before you go see Dr. Schlegel. Otherwise you may have another month before you know more...even after your appt. Just a thought! Good luck!

[Naomi35]

Thanks for responding, Kris.
I forgot to put in my post that he does have his vas defernens- as confirmed by the urologist.
I guess we just have to wait and see.

It seems like a blockage to me too, I just can't figure out what may have caused that.

[Kris79]

Naomi -

I'm glad to hear that...I know from what you have said before that you are not too keen on the idea of IVF so I'm praying there is a way to avoid it for you. I really hope this is a blockage or something else that can be corrected. The waiting is the hardest part sometimes!!

Take care!

[ritag82]

Hi there. I'm glad to find someone going through the same thing.

My husband and I finally got a SA done after almost 4 years of ttc and found no sperm. Of course I was so upset. But My husband is a man of great faith and he believes we will get our miracle. From what I have read about azoo , there's a chance they can do something for us. I hope so!

We are seeing our Doctor on Monday to get out referral to a urologist. I sure am hoping to get in ASAP!!!

[DocTurek]

I am a male fertility specialist and new to this community but would like to help out however I can. As you surmised, azoospermia (no sperm count) can be obstructive or non obstructive. The ways to tell the difference include:
1. Size of testis (big is more likely to suggest obstruction)
2. FSH level (low is obstructive, high is nonobstructive)
3. Testosterone (generally normal in both).
4. History of injury, surgery, trauma, infection (generally suggests obstruction if positive)
5. Ejaculate volume (normal can be hard to tell, low volume can mean obstruction)

In this case, be sure that the urologist examines him and finds a VAS DEFERENS on each side because the most common causes of low volume azoospermia are a missing vas deferens (congenital condition found in 1/500 men and called congenital absence of the vas deferens) and ejaculatory duct obstruction. The former is generally amendable to pregnancy with technology and sperm aspiration and the latter is quite treatable surgically and entirely consistent with having kids naturally. Both conditons also have genetic associations that may have implications for the health of offspring (but generally not for the affected man) that should be pursued with counseling and testing in advance of trying to conceive.

[RDW]

DOC TUREK- Is there any way to improve morphology? My husband has 0% morphology, low motility and low count 3.9 million. He has been insulin dependent diabetes since he was 4 years old and he is not 30. He is very active and healthy. Our RE told us that IVF/ICSI is the only way

[Naomi35]

DocTurec,

Thank You so much for that helpful info!
I actually read an entire book on this since I posted ths question. But your answers helped simplify and helped me to understand a lot!

I hope it is an ejaculatory duct obstruction!
His testicles are big.
I think his ejaculate volume is low but I can't remember what the normal ammount is supposed to be.

I can't figure out why he would have a block, though. He never had any infections or surgeries that would cause scar tissue.
Still, we would be so very happy if he had a blockage that could be fixed and we conceived naturally!
Holy Moly that would be wonderful.

[sunshinegirl]

My husband was diagnosed with Obstructive Azoospermia, sounds like what your DH has as well. We have a 3 1/2 year old son who we had no trouble conceiving and my DH has an 8 yr. old son from a previous relationship - obviously he had no "sperm" issues before! Other than this, DH is perfectly healthy and passed all Testosterone, PSA, and other blood tests wiht flying colors. He is very active in sports: wrestling, football, MMA fighting and has had several surgeries involving catheters put in as well as 2 hernia surgeries. Docs say that there may be a great deal of scar tissue built up which is contributing to the sudden blockage. Could this be a possibility for your DH too? Hope this helps!
Melissa

[faithhope]

My Dh and I have been trying to conceive for at least 2 years when we finally took the step to get a SA. When we got the results we were stunned. It showed that he only had 2 sperm in the first one and then months later he had about 600,000. (extremely low) Our urologist suggested an ultrasound for a blockage and a prostate ultrasound also. The results were normal as well as all of his bloodwork. So we were advised to get a genetic test for the y chromosomes which we know nothing about really and once we got the results at least we knew the cause. He has a deletion on the long arm of the y chromosome which is completley genetic. So the good news is that they said we would have to do IVF with ICSI to get pregnant which hopefully we can. We have been so stressed and upset by the news that we haven't went forward with anything yet. But I wanted to share my story because if there is any sperm at all that they can take it only takes one. It might be a long road but just hang in there because we are all going through similar things. I hope that I might shed some light for you. If you have any ????? please just write me. I am trying to figure all of this out myself but maybe we could all help each other.
with all my love and luck,
courtney

[ljnotr]

My Dh and I are in a similar situation. We are waiting for the genetic tests to come back before the urologist will schedule the biopsy. We should have the results back in the next 2 weeks or so. I am soooo anxious as our RE has said that if we find any sperm with DH they will freeze it and I am an excellent candidate to then go ahead with IVF! So I would love to be able to help each other thru this!


Laura ( 35) fine
DH ( 36) azoospermia
TTC for 7 8 months now

[lucy4]

I am also in a very similar situation. My DH has been diagnosed with NOA, which seems to be due to a maturation arrest. Not sure the cause of that yet, but we have an appointment with Dr S to try to get some answers.

[Naomi35]

Our results came back weird. First dr. Ssaid it was likely a block- probably of the epydidimus.We were psyched and scheduled a surgery to repair it.
Then dr. S called us with the bloodwork results and said dh's chromosomes are messed up- a part of 2 of them broke off and switched, and a oart if one of them is missing.

This is different than y chromosome partial deletion.
This means that our babies- if we could conceive them- have a 1 in 4 chance( I think?) of having a missing or extra chromosome which is really not good and could cause serious issues.

We actually don't feel that we have gotten really clear answers from dr. S as to ur options. I need to call him tomorrow.
We are thinking of going with donor sperm.I think one other option would ne to do ivf and some procedure for dh- and if they could find sperm then they could check the embryo genetically before implanting.
All of it seems crazy right now and we may try to do donor sperm for our first baby as I feel really eager to get pregnant already and it has been a very long road already.

We have one family member of his that we asked and are waiting to hear form. We aren't extreemely close with him ( I have never met him but dh and he grew up together some) so atleast if he said yes it would still be the same family.
But if not, we have no idea what we would do.
Just keep on trying to figure it out.
Let's hope he is willing.

[lucy4]

Originally Posted by Naomi35

Our results came back weird. First dr. Ssaid it was likely a block- probably of the epydidimus.We were psyched and scheduled a surgery to repair it.
Then dr. S called us with the bloodwork results and said dh's chromosomes are messed up- a part of 2 of them broke off and switched, and a oart if one of them is missing.

This is different than y chromosome partial deletion.
This means that our babies- if we could conceive them- have a 1 in 4 chance( I think?) of having a missing or extra chromosome which is really not good and could cause serious issues.

We actually don't feel that we have gotten really clear answers from dr. S as to ur options. I need to call him tomorrow.
We are thinking of going with donor sperm.I think one other option would ne to do ivf and some procedure for dh- and if they could find sperm then they could check the embryo genetically before implanting.
All of it seems crazy right now and we may try to do donor sperm for our first baby as I feel really eager to get pregnant already and it has been a very long road already.

We have one family member of his that we asked and are waiting to hear form. We aren't extreemely close with him ( I have never met him but dh and he grew up together some) so atleast if he said yes it would still be the same family.
But if not, we have no idea what we would do.
Just keep on trying to figure it out.
Let's hope he is willing.

Hi Naomi. I know exactly how you feel. DH's UR had originally told him everything looked as if the azoospermia was due to a blockage as well, and there would probably be lots of sperm in the testes. Unfortunately, the biopsy proved otherwise. We still dont know for certain, but the pattern was said to be consistent with maturation arrest. We see Dr S tomorrow.

We have discussed our options, and DH has come to terms with DS if necessary.

[waitingforamiracle00]

DocTurek,

My husband has azoospermia. His doctor comfirmed that there is no blockage. He has low vloume of ejaculate. His FSH level came out higher than normal at 16.2. His LH was in normal range but at the lower end. HIs Prolactin came back normal as well but at the lower end. What can be wrong with him? and will I ever get pregnant?

Originally Posted by DocTurek

I am a male fertility specialist and new to this community but would like to help out however I can. As you surmised, azoospermia (no sperm count) can be obstructive or non obstructive. The ways to tell the difference include:
1. Size of testis (big is more likely to suggest obstruction)
2. FSH level (low is obstructive, high is nonobstructive)
3. Testosterone (generally normal in both).
4. History of injury, surgery, trauma, infection (generally suggests obstruction if positive)
5. Ejaculate volume (normal can be hard to tell, low volume can mean obstruction)

In this case, be sure that the urologist examines him and finds a VAS DEFERENS on each side because the most common causes of low volume azoospermia are a missing vas deferens (congenital condition found in 1/500 men and called congenital absence of the vas deferens) and ejaculatory duct obstruction. The former is generally amendable to pregnancy with technology and sperm aspiration and the latter is quite treatable surgically and entirely consistent with having kids naturally. Both conditons also have genetic associations that may have implications for the health of offspring (but generally not for the affected man) that should be pursued with counseling and testing in advance of trying to conceive.