[Crunchie]

Hi everyone my first post here is not a happy one.

My lad was diagnosed with testicular cancer back in January and had the affected testicle removed at the end of that month. We were told this shouldn't affect his sperm production and he'd be fine with the remaining testicle.

Unfortunately the surgery didn't come quick enough to stope the spread of the cancer and 5 months later he was told it had returned in a lymph node in his chest.

He was recommended to have a short course of chemotherapy and as the cancer was caught early this is expected to cure it. However as I'm sure most of you are aware chemo can affect fertility so he was recommended to store sperm.

He went to give a sample last week which turned out zilch. Another one this week has given the same result. We know he was not always this way as he has gotten two seperate ex girlfriends pregnant.

As far as we were aware testicular cancer doesn't really affect the other testicle so we're very confused as to what has gone on. He has been reading material from the web which details the possibility of a blockage? However there is now no time to investigate this before his chemo starts which from what I understand is likely to make the situation worse. His course will be a short one (over three months) and he is still relatively young (30). we are not thinking of having a family any time soon but as you can imagine we're both devastated that the option may not be there.

Before he had his surgery I asked his doctor about having sperm stored but was told he'd only get that if he was having further treatment and they didnt expect the surgery to affect him that way.

I guess what I really want to know is is there any hope? And if the worse comes to the worse what are our options?

thank you

[yolieight]

My husband who had 3 children from a previous marriage and one child with me was having some pain in his testicles and went to visit a urologist and was told after tests that it was possible that he had a rare form of cancer and they recommended immediate removal to determine for certain what the growth was and if it was cancerous.

Fortunately it was not cancer however they saw these growths on both of his vas and removed the growths from both and therefore gave him a vasectomy he was 46 and had 4 children so his doctor did not think this was a problem but I was only 24. When we decided that we wanted another child the surgery was so drastic that it was impossible for him to have a "vasectomy reversal" and our only option was IVF with ICSI. He had a mese/tesa procedure where they cut into his scrotal sac and actually removed pouches on his testicles. During this they viewed the pouches under a microscopic to verify if there was sperm. Thankfully there was and we were able to continue with our IVF. It took 3 attempts for us but I am now 20 weeks pregnant with our 2nd child.

My point- maybe it is possible for a surgeon to perform this type of procedure to retrieve sperm and then it can be frozen. My husbands was frozen and unfrozen and frozen again and it still worked.

Good luck

[Crunchie]

thank you for the reply yolieight! I'm 24 too and kiddies are not something I'd have just now as I've only just bought a new flat and I'm therefore skint. Also my job is not very secure and I don't feel I'm ready just now.

I was wonering if this procedure you describe is readily available? We're in Scotland and have never heard of it before. I'm not sure if it's a bit different over here but Steven has more or less been told "that's that! Sorry".

It's a bit galling as when he first started having pains in his testicle before the surgery I told him to ask about the possibility of sperm banking. His doctor told him it wouldn't be neccessary unless he was having chemo so nothing was done. I can't help but wonder if we had pressed for this before would we have a little tube of tadpoles safely hibernating for us.

Then again we haven't really been to a fertility clinic to discuss things. As far as we were aware our options were IVF with donner sperm or adoption neither of which appeal to the other half at all.

[yolieight]

It is a procedure that is readily available in the states but I don't know about Scotland. This is the website for our doctor who is a pioneer in male infertility. He was actually the first doctor to ever perform a vasectomy reversal. This may give you some information to inquire with doctors on.

"MICROSURGICAL (TESE) TESTICULAR SPERM EXTRACTION FOR AZOOSPERMIC MEN: Abstract of Presentation for Meeting of the American Society for Reproductive Medicine (ASRM) in September 1999"

I love how doctors act like they know everything. We also asked about sperm banking and were told it wasn't necessary. Storage of sperm in a private bank would have been about $150/year and we paid about $5,000 for the above procedure and had to do IVF 3 times to get pregnant. In total it cost us about $35,000.

Also you will love this - I got a bill today for the storage of the remaining sperm that we have from the above procedure. I'm pregnant now but I'm not comfortable discarding the unused sperm at this time before our son is born. However, as long as he is healthy and everything goes as planned we will not have anymore children. Another hard decision pay the money for storage or risk the chance of something going wrong and wanting to try again.

[Crunchie]

We were offered the sperm storage free on the NHS thankfully.

The number of stupid mistakes that were made with Steven's illness was scary. I actually decided to write out everything that happened. The worse thing was after the op to remove the testicle a doctor looked at his chest Xray and told Steven that the cancer had spread to many different areas.

Steven phoned me up in a right state so I started the drive to the hospital barely able to see because of all the tears. Before I reached him he phoned me back and had been told that the doctor who was actually qualified to look at Xrays had checked it and it was fine.

Here's a few wee samples out of his "timeline of events"...

2008
11th- 13th September
Admitted on the 11th due to pain in right testicle. Told it could be due to cyst, tumour, cancer, infection, twist.

Discharged with antibiotics and painkillers and told the pain was due to an infection.

10th-12th October
Ultrasound Scan on the 10th, scan seemed to trigger same pain as I suffered before.

Re-admitted to Queen Margaret due to pain and the fact no one was sure what the scan results were showing.
Discharged and again told again that it was just an infection.
Given pain killers (Will need to check on antibiotics but I don’t think I was given any)

Jan 09

19th
Phoned about ultrasound scan appointment as I had received no word as to when I would be taken in for the scan.
Told my appointment is for the 21st of January (two days away)

20th
Letter arrives about the ultrasound scan appointment for the following day. The letter is dated the 19th of January, what if I had not phoned and the letter did not arrive on time? First class post no longer guarantees a letter will arrive the next day.

21st
Ultrasound scan
Was told that someone would phone me regarding the results the same day. No one had phoned by 5pm and so I rang myself only to be told “everyone from that dept has gone home”.

27th
I had the operation and was given a chest X-ray at night.
On the 28th I was advised that my chest X-ray was indicating that I had cancer and it had spread to several places. 50 minutes later I was told that the radiographer had checked my X-ray and deemed it fine. Why was I being advised about my X-ray results by someone who was unqualified to do so? The first conclusion understandably caused a lot of upset for both me and my partner.

Around 12.30pm I was discharged and given my discharge letter. I was not advised what to do re the wound and dressing (i.e. did I have to keep it dry, when could I take the dressing off etc). I had assumed that this info would be contained within the discharge letter but it was not. I was also discharged without pain killers and as a result spent 4 days at my partners house unable to do very much due to post-op pain. My GP prescibes strong pain killers straight away and was shocked that I had not been given any.

Added to that the amount of time we spent on the phone trying to reach various people was awful. No one in the NHS seems to have heard of answering machines apparently.

Neither of us have any faith left in the doctors that are looking after Steven. I think he's going to have the chemo then after a while seek help in finding out why he is suddenly not producing any sperm as it seems there may be a lot of different reasons why.

[jrsygrl22]

My husband had TC in 2002 at 25. The RPLND surgery to remove it from his lymph nodes caused what they call "retrograde ejaculation", the semen is going into the bladder from what i understand. We have seen the best specialists at Memorial Sloan Kettering and his condition is not fixable but there are things to try that work well on some people. In some cases they can go in and take it out of the bladder and use it for insemination. Also Sudafed, as odd as it sounds, can be used to help the problem. When that didnt work the Dr did some tests to see if a surgery would fix it. Was no good for us but luckily he froze a few vials before the surgery that we plan to start using in a few weeks to start IVF. Researching the best doctors before making any decisions is the best advice i can give!

[SFBaygirl]

I am so sorry that your DH is having such a rough time with the cancer and I hope the chemo is effective.

I was also going to mention the possibility of surgical removal of sperm through the mTESE already mentioned.

For those of us with DHs with azoospermia (0 sperm count) this is often our only hope of having biological children, bio from both parents anyway. I am honestly not sure how well sperm retrieved this way fare after being frozen/thawed as these aren't often normal sperm that are being found. With your DH having had a normal count at some point as evidenced by the prior pregnancies this may not apply.

I sincerely hope for the best for both of you. Would traveling to the states to Cornell Univ. in NYC be a possibility? It is quite pricy but probably just about the best place in the world for male infertility.

If you check out the azoospermia thread in the male factor infertility section you will see several people there whose DHs have had testicular cancer as well.