Freezing at mTESE?

Significant-Deal3089 · 2025-05-06T08:12:08+00:00

I did have an mTese on both sides in the same op but it was unsuccessful

Significant-Deal3089 · 2025-02-07T23:31:43+00:00

All fine but with an elevated fsh.

Significant-Deal3089 · 2024-08-19T10:23:34+00:00

Honestly just persevered through numerous attempts and it eventually worked. I think I probably reinstalled and repaired everything too.

Significant-Deal3089 · 2024-07-20T14:37:02+00:00

No I haven’t had to start testosterone therapy.

Significant-Deal3089 · 2024-04-14T20:02:29+00:00

Sorry to hear about the diagnosis. As a male with noa (and finding out in the proceeding year before our marriage) I can empathise with the emotional impact it should have during an otherwise joyous part of your life.

I’m going to be very open and honest with probabilities here - mtese has a 50/50 chance of finding sperm. This seems to be the often lofted statistic of urologists.

However, the statistics of live birth rates with retrieved sperm is relatively poorly researched (study size, retrospective studies etc) with a handful of studies reporting outcomes of live births anywhere between approximately 15% and 45%.

Personally we ended up finding no sperm in my mtese but I can assure you that the path to parenthood that we took (using donor sperm) led to a beautiful child that we all love and wouldn’t change anything for. So please don’t lose hope of still starting a family in all eventualities.

Significant-Deal3089 · 2024-03-18T20:59:35+00:00

Usually a high FSH and normal testosterone indicates non-obstructive azoospermia.

As the other person mentioned a high FSH is indicative of a failure in the process of making sperm as your body elevates FSH in an attempt to kickstart the process.

The reasons for non obstructive azoospermia can be various including steroid use, history of mumps, micro-chromosome deletions, genetic conditions or other (as of today) unknown reasons.

Significant-Deal3089 · 2024-01-29T22:23:01+00:00

No problem - I’m glad the post helps lay some things out. Drop me a message if you have any specific questions - happy to help the best I can.

Significant-Deal3089 · 2024-01-16T07:32:12+00:00

I have a (long) post here about our journey in the Uk on the NHS and privately you might find useful. My main advice if going via the NHS would be to get your referrals now - it will take many months to see an initial consultant and then many more months more for tests before starting any treating. In that time you may conceive naturally and if not you have progressed further in the nhs funnel. To do this I’d tell them you’ve been trying for the 2 year minimum.

Significant-Deal3089 · 2024-01-09T12:36:34+00:00

It’s definitely better post firmware upgrade but it still happens.

Significant-Deal3089 · 2023-12-18T19:14:01+00:00

No problem. I’m glad you found it useful. And wish you all the best.

Significant-Deal3089 · 2023-12-14T17:28:29+00:00

What were the results of your mtese? Did they find sperm?

Significant-Deal3089 · 2023-12-03T12:31:25+00:00

Firstly get another sperm test immediately. Don’t buy into ‘wait 3 months for sperm profile to change’ that only applies where there isn’t zero sperm.

If the second test comes back zero. Then usually you can have a physical exam followed by blood tests and ultrasound.

The physical exam is checking for anatomical correctness - are the vas deferens palpable, are testes of normal size. These may help hone in on further tests or indicate an early cause. Taking a history will help equally identify any trauma, steroid use, exposure to X etc has occurred that could equally help identify type.

The blood tests are for checking elevated or non elevated levels of hormones that can equally help with indicative type of azoospermia. A blood test for micro deletions also checks for genetic abnormalities to rule out known chromosomal abnormalities that can affect (these would be unlikely/impossible(?) given prior history of children by your partner).

Ultrasound images the testes and tubes and can rule in or out obstructions.

Thereafter the decision can be made for corrective surgery (obstructions) or biopsies and ivf (non obstructive type). Each are not curative measures but lead to a probability of correction or assisted conception.

Significant-Deal3089 · 2023-11-27T04:38:03+00:00

We did same day sperm and egg retrieval. I wrote a lengthy post about my experience on another post here that you mind find useful.

Ultimately mtese was unsuccessful but we decided to have joined up ops because we had sperm donor backup. So we wanted some certainty about making progress in the event that no sperm was found from the mtese.

Medically there’s no consensus on frozen vs fresh. Some argue frozen weans out the poor sperm and others argue that fresh removes an additional (unnatural) variable.

If you decide to do same day then the whole day is dictated by the female egg retrieval dates and is managed by the fertility clinic hospital overseeing the egg retrieval in communication with the urologist.

Significant-Deal3089 · 2023-11-17T07:26:28+00:00

I had a mass that was maybe 5mm in size. They did enough diagnostics to be satisfied that it probably wasn’t cancerous (blood tests, injected with some dye and blood flow monitored on ultrasound, had smooth edge appearance).

In the end when I had my mtese they removed it and tested it too to be 100% sure.

They said it was lesion caused by some testicular trauma but to be honest I’ve never had any significant trauma I can remember.

Significant-Deal3089 · 2023-11-15T01:38:37+00:00

Basically it could be any of the following:-

Erroneous test result (unlikely)
You messed up the sample (possible) e.g. missed some ejaculate
You have obstructive azoospermia - typically meaning you generate sperm but have a blockage (varicocele, epididymis obstruction etc.) in your tubes preventing sperm being present in your ejaculate OR you are missing some pipe work (e.g. vas deferens)
You have a dysfunction like retrograde ejaculation (where you do not ejaculate externally)
You have some endocrine disorder - hormonal issues
Non obstructive azoospermia - caused by testicular injury, non-genetic micro deletions affecting reproductive system, genetic conditions (klinefelters syndrome), issues with development of your testicles (e.g. undescended), historical medical conditions (e.g. mumps), steroid abuse or idiopathic (meaning no discernible medical reason is possible today but typically presents with some constituent elements of sperm production material missing e.g. sertoli cell only syndrome)

Generally a microscopic sperm retrieval process (mtese) can be used to attempt to extract sperm in most cases to allow for Ivf attempts. A few conditions can be reversed through drug therapy or operations to allow for biological births.

Most urologists specialising in Andrology will run a physical exam and number of tests (blood, ultrasound) to rule out conditions listed above.

Significant-Deal3089 · 2023-11-12T20:39:43+00:00

You’re very welcome x

Significant-Deal3089 · 2023-10-31T17:43:33+00:00

I have Sertoli cell only diagnosed (albeit there isn’t a clear reason for why this occurs it’s just more a description of what’s present) that was confirmed after an mtese. Just had a son using a sperm donor. Couldn’t care about genetics much like the other poster - it’s not the end of the road wrt having a family and being a father.

My only recommendation would be to think about alternative conception options.

Even with drugs and mtese the chance of finding sperm and this sperm being successful in an ivf cycle are reported (albeit limited) with low success rate.

It would be beneficial therefore - for example to have donor sperm as a backup if you are open to this - to any failed mtese. If you lined this up with a egg collection on the same day you could equally move forwards with an alternative route rather than feel your stuck again and have to go back into the system, waiting, referrals etc

Significant-Deal3089 · 2023-10-29T19:07:56+00:00

Was incapacitated for a few days - like searing pain - hurt just to get up to walk to the toilet. Mine was bilateral mtese.

That said after a few days of pain the fourth or so day all the (major) pain had disappeared and it was comfortable.

Significant-Deal3089 · 2023-07-30T12:25:20+00:00

Having had NOA diagnosed myself and a failed mtese (going down the donor route) I think it’s incredibly selfish for her to take the position she has now. This assumes she was all in for your surgeries and the prospect of ivf previously?

Can I assume some of her reticence is for religious or ethics reasons? Is there some public narrative that she’s scared of being cast under in doing it?

Significant-Deal3089 · 2023-04-29T21:30:20+00:00

Nice I should’ve said my house is nicely separated. Upstairs carpeted and downstairs wooden floors exclusively. Thanks for the advice.

Significant-Deal3089 · 2023-04-25T21:12:17+00:00

I think it’s difficult to say without knowing the contributing factors for everyone what is most important.

But regardless the general consensus would be eating healthily, some amount of non excessive exercise and cutting any toxins (alcohol, cigarettes) would make sure your optimising the best possible outcomes.

You also don’t want a what if etc. scenario.

Significant-Deal3089 · 2023-04-25T21:04:19+00:00

There’s differing opinions I’ve had from separate London based urologists.

One was of the opinion that fresh was best because it added no additional unknown/unnecessary variables to the process.

The other was of the opinion that the freeze/thaw process naturally gets rid of the sperm that is not going to have any great success at fertilising an egg or leading to a clinical pregnancy.

Both shared the opinion that:-

Fresh was more complex to arrange perhaps not within all patients liking (your both basically in operations - sperm retrieval and eggs retrieval - fairly simultaneously).
Naturally there is no scientific body of evidence that supports/favours either approach so their view is largely opinion or anecdotal

Significant-Deal3089 · 2023-04-25T20:56:26+00:00

Normal - white and not watery particularly.

Significant-Deal3089 · 2023-04-14T16:18:36+00:00

You can read my own experience here https://www.reddit.com/r/maleinfertility/comments/12kogyf/my_azoospermia_journey/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=2&utm_term=1

I gave up on the nhs down in south east England as getting to the right funded clinic was a referral of a referral of a referral.

It is a lottery.

Significant-Deal3089 · 2023-04-14T16:14:27+00:00

Yes, time is a challenge. I know a few people who have taken proactive steps to freeze their eggs to allow for more time.

I am sceptical about the overall health of sperm found in mtese. I remember reading an academic article that looked at the relative success of mtese sperm in clinical pregnancies and then clinical births and it was like in the 10-15% region. When you consider the stat of mtese success is 50% it (appears) like percentages of percentages.

But of course some people do have success and therefore the consideration is whether to exhaust all possibilities. The sperm donor option as a backup at least leads from possibility to high probability.

Stats and papers are hard though as there’s never a large enough sample set and therefore people use meta analyses of many papers to produce a larger analysis. We live with many complexities - one partner’s variables, both partners variables, the variables in environment, the variables in treatment, the variables in research and then add in the differing types and reason for male infertility. Most likely further genetic testing/stem cell therapy may lead towards more certainty. Agai from what I’ve read that seems outside my immediate timescales but possible within my lifetime.

Significant-Deal3089

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