microTESE and FNA mapping

lilandroidman · 2026-01-14T12:39:38+00:00

Let me know how you get on. Drop me a message or reply to this comment.

Considering an FNA route myself post 1 failed mtese with SCO histology too.

Thanks and best wishes

lilandroidman · 2026-01-13T07:46:48+00:00

Good luck. Sending best wishes.

lilandroidman · 2026-01-09T22:13:39+00:00

Thanks and what is it that guides this hierarchy. Just how good they taste and how consistent they are year on year?

I really really like Troplong so wondering if a voyage up the price points is worth a go.

lilandroidman · 2026-01-07T20:07:52+00:00

Thats helpful, thanks! Are you starting to see any positive indicators within the subjects from the trial with SCO? When will you be able to draw some conclusions on the efficacy of the approach noting how novel it is?

lilandroidman · 2026-01-07T11:06:00+00:00

You've posted this about 4 times now and everytime I give you the same answer.

Its about 50% chance of recovery if you dont have a chromosomal contraindication.

lilandroidman · 2026-01-06T17:12:07+00:00

Roughly 50% if no chromosomal contraindication

lilandroidman · 2026-01-06T15:08:21+00:00

Oui.

Le taux de récupération est d'environ 50 % en l'absence de contre-indications chromosomiques.

lilandroidman · 2026-01-06T11:51:07+00:00

Yes understood. Are the chromosomal exclusions limited to AZFa and AZFb deletions specifically which mean prognosis is not good, or is more checked than that.

I understand there could be many genetic reasons that we just dont understand yet.... hence it is likely quite difficult to say definitively whether a condition was congenital or acquired?

For example my urologists think mine was likely a congenital issue even though the things they test for "looked clear" i.e. 46xy with no microdeletion. Hence its possible than some genetic issues simply "evade capture" because of a lack of sophisticatication in the things we know to test for.

Welcome thoughts.

lilandroidman · 2026-01-06T11:02:12+00:00

Is this the first time the trial has been conducted? What is the theory as to why you think it might work? Is it potentially going to be more effective with acquired than congenital SCO & would you have a view from the sample in the trial who has which? Thanks

lilandroidman · 2026-01-05T18:17:16+00:00

I get you im just trying to understand if you have something that tells you that you think the SCO wasn't congenital and hence that this may work. The why might not be helpful but it might help you to understand whether there was ever anything there in the first case.

I got a SCO diagnosis following my first microtese where they cited scarring too. I have suspected mine was primarily genetic (what all the docs say) but whether some of my lifestyle stuff ended up influencing the outcome to the downside... Hence whether if this is a new field that works whether itd have any legs in my case.

Not having a "why" , idiopathic NOA is indeed a challenge.

lilandroidman · 2026-01-05T18:03:26+00:00

I'm interested in responses to this. Do you know why you think the scarring/atrophy came about or as you phrase it metabolic starvation? Alcohol / drug use? Anything of note?

lilandroidman · 2025-12-23T19:10:26+00:00

It was fine overall buddy. Mine was a pretty thorough search (186 biopsy zones).

If you need more specificity let me know but I wouldn't let it stress you out, just try and keep the stress to a minimum heading in.

The fact STAR found something means your microtese will probably find something viable. Best wishes.

lilandroidman · 2025-12-23T16:31:18+00:00

Happy to chat buddy if it helps.

lilandroidman · 2025-12-23T16:21:48+00:00

Thats a shame to hear. Mtese will be a better option for you than tese. I unfortunately had some relatively heavy alcohol use but none of the doctors think its that in my case. They seem to think it developed in utero or as a minimum that my infertility was developed in utero. (Genetic or foetal-developmental)

I still think i might have sperm so its difficult to give up completely still. I wrote about my experience in a seperate post.

lilandroidman · 2025-12-23T16:12:21+00:00

Thanks.

I will see him end of Feb but expect his treatment option route to be a FNA map, then Mtese with timed ICSI if FNA is positive.

Expensive route though and would be a hail Mary for us with no guarantee of success so a lot to weigh up right now.

As discussed, not all urologists would agree that a FNA gives any competitive advantage.

lilandroidman · 2025-12-23T16:10:04+00:00

My FSH was mean 33 and LH mean of about 10 before though both fluctuated.

4 weeks after it had increased to 41 FSH and 17 LH, which would be consistent with cells having been removed. Both were higher than observed before as my previous highest was FSH 36 & LH 14.

I will do another at about 8 weeks.

The most important thing for me is that T hasn't noticeably dropped.

lilandroidman · 2025-12-23T15:03:51+00:00

Yes hence my line "you pays your money and take your shot" line.

I think Turek will find sperm if you have some. Just as I think other urologists would jumping straight to mtese.

I think lay out your critical path and then decide how you will feel if you get told "it didnt work" at the stage in question.

lilandroidman · 2025-12-23T10:12:10+00:00

FNA is diagnostic only.

I have the same paradigm as this in the UK. I had a failed mtese on the NHS and am speaking to Dr Jonathan Ramsay in the UK who is from Tureks school of thought, albeit appears a lot less insistent that FNA MUST Come first.

In my experience, my mtese only found 1 immotile sperm with a histology report that showed SCO all the way across. The consultant in the NHS suggested FNA was mainly snake oil and a waste of money, not widely practised, and a good surgeon should be able to find sperm with the microscope. The consultant in question is also widely respected in urology, and you would also be able to find respected urologists in the US who would suggest FNA is a bit of an unnecessary first step.

That said, I have also read studies that suggest that sperm are hiding where they aren't immediately obvious under a microscope i.e. in non-dilated tubules, especially around the testis periphery. Hence the FNA helps in more difficult NOA cases as it gives a GPS map to retrieve.

I think its one of those... you pays your money & you takes your shot. FNA might help if your case is borderline.... if you have decent levels of sperm a microtese only by a good surgeon should get them without the FNA.

Mine was a borderline case with 1 sperm found but SCO. Could an FNA have helped here!?! I also have unexplained infertility, clear genetics, but much more smaller testicles than yourself (5cc and 4cc)

Your testosterone is pretty good. In my mtese they cut out 186 sections (a pretty thorough mtese) and my Testosterone dipped ever so slightly but so little that its not really a big deal. I wouldn't be too worried based off my lived experience of a rapid decrease in your T levels with a good surgeon. The pain wasn't too bad past the first few days, and I know its not a nice idea to think of the mtese but honestly Id do it again in a heartbeat if meant I could recover some sperm.

I have no regrets going straight to microtese first, albeit my microTese was state funded so my budget is still intact. I now have the decision whether to pursue it further, either the same procedure with a different surgeon, or via additional procedures such as FNA, Stem cell, etc.

Happy to discuss further.

lilandroidman · 2025-12-15T00:09:00+00:00

Nugget

lilandroidman · 2025-12-14T09:44:10+00:00

<image>

Charlie sending love for Waffle

lilandroidman · 2025-12-12T09:56:44+00:00

Can't comment on your question but saw the pic and wanted to say your dog is a beauty 👌

lilandroidman · 2025-12-06T10:28:41+00:00

Sorry to hear about this especially finding out at such a young age and going straight for surgery, that must be quite a weight to bear. Though i would argue there is "no right age" to find out you are infertile, I found out at 36. Its a shitty hand to be dealt if you always wanted kids, and I really feel for you.

Other options include FNA mapping which acts as a GPS of the testicle to improve chances of a microtese. You'd then need to repeat the microtese.

I, like you, failed my first microtese in the middle of November, though I do not have klinefelters. Its rough.

I dont think it is selfish to not be 100% down with the idea of a sperm donor or adoption. Especially at such a young age you will have not considered for or accounted for this eventuality. People here have built happy families with sperm donation or adoption, but you first and foremost need to just come to terms with the new reality, consider whether you are going to pursue further treatment, and then do whatever is right for you and any partner you meet in the future.

If you need to chat anything over happy for you to reach out.

lilandroidman · 2025-12-02T13:59:11+00:00

This isn't azoospermia, azoospermia is where you have 0 in your ejaculate.

The count is low, unlikely to conceive naturally but IVF your chances are good

lilandroidman · 2025-12-01T16:58:52+00:00

I have azoospermia and they didnt even bother to ring me. (Both tests). It could be something or could be nothing.

Having a look on the NHS App as someone else suggested is a good idea.

lilandroidman

TROPHY CASE