Back & Ready to Take Names & Kick Ass -- IVF with micro-TESE

[CurlySu717]

Hi friends

It's been awhile!  We are circling back after taking 6 months off from our run of 5 failed IUIs with donor sperm.

How we went from IUI with donor sperm to IVF with micro-TESE is a long story best told over a drink, but suffice it to say my brain works in weird ways.

At any rate, when we started the IUIs, I thought I knew what I was doing, and I thought my physician knew what she was doing, and I was wrong on both counts.  So -- please school me!

I need my labs repeated but I'm almost 33 with no known issues on my end.  DH is almost 33 with non-obstructive azoospermia due to undescended testicles not corrected until the age of 13.  I know that in all likelihood, we'll wind up using donor sperm, but if we're doing IVF anyway, we may as well give the micro-TESE a shot and see if we get lucky.  In terms of stats, per based on a basic PubMed search, it looks like we have about a 30% chance of this working with DH's sperm.  

What should I expect an IVF protocol look like?

What questions do I need to ask of the physicians I am interviewing?

Has anybody out there had any success with TESE or micro-TESE?

I don't know what I don't know, so open to all input from my armchair REs over here!    Thanks, y'all!

[lemonliz]

Welcome back :)

Most common protocol by far is the antagonist. Especially for no known issues.

My friend k1111k is a TESE success story. She's not around here much anymore but I'm sure you can find all the details in her post history! There's one other TESE success story, I think maybe those3words, but don't quote me on that.

[punkybrewster]

********Grad Warning************

CurlySu717, we have almost the exact same situation. MH has NOA due to undescended testicles, and there are no known issues with me. This might be long, but I will recap exactly what we did. In the end, just know that we were successful, using MH's sperm, against all odds. I have my FX for you as well!

We ended up going through 2 full IVF procedures. My doctor wanted MH to have his micro TESE ahead of my IVF, in case there was no sperm found, there would be no reason for me to go through with IVF. So in Dec 2015, he had the surgery. There were a few sperm found, so I did IVF that March. Unfortunately, sperm does not freeze well, and especially testicular sperm is not the best quality. So, although I had 20 eggs retrieved, there were only 3 sperm found, and only 2 of those were moving. 2 of my eggs were fertilized, but unfortunately they arrested before we were able to do the transfer.

Fast forward to September 2016, we decided to try again with another micro TESE for MH, which would be simultaneous with my IVF. So the micro TESE was 2 days before my scheduled egg retrieval. This was definitely stressful, as we had to have everything coordinated between my RE and MH's urologist. And you don't really know when the egg retrieval will be until 2-3 days beforehand. From that cycle, I had 9 eggs retrieved, and they found 9 sperm, all moving. Unfortunately only 3 of those eggs were fertilized. They transferred 2 at 3 days, they both stuck, and I am now 27 weeks pregnant with twins. The other embryo arrested, so we don't have anything else frozen, aside from my eggs, at this point. We had donor sperm as a backup in that cycle, but we did not have to use it.

My biggest piece of advice would be to not do the micro TESE ahead of IVF, as frozen sperm just doesn't thaw well. Since you are willing to use donor sperm anyways, I would have that on hand as a back up, so in case they don't find any or not enough of YH's sperm, they are able to fertilize all of your eggs. My RE would give preference to any embryos of MH's for transfer, regardless of quality, if we had any using donor sperm as well. Another piece of advice would be to try to use a urologist and RE that work together, it made things so much easier logistically on us. Both of our doctors were in constant communication throughout my cycle, and we really didn't have to do much to coordinate things, besides show up when we were told!

We also had originally planned on doing PGD testing, but after there were so few sperm found the first time, we scrapped that plan, as it was not worth risking the embryos not surviving the freezing and thawing. So that is something else to consider.

Each of my IVF protocols was about 10-12 days, from day 1 of stims to egg retrieval, using Gonal-F, Menopur, and Cetrotide. It really wasn't bad for me at all. By the last day or two, my ovaries hurt a little bit, but really just like period cramps, nothing worse. The whole procedure was honestly a lot easier than I thought it would be.

So sorry for the super long response, but it was so hard to find any information on IVF with micro TESE when we were going through it. I always found it so comforting to hear other success stories. Feel free to ask me any questions you might have, I don't know everything, but I did a lot of research during our cycles.

[ProfessorChaos]

No advice, but welcome. I hope your stay is short and sweet.

[laurensc927]

Welcome back & good luck!

[CurlySu717]

***TW***
punkybrewster, I was hoping to hear from you!! I was searching the posts I've missed over the last few months and saw your success -- I'm so happy for you, and it gives me SO much hope!!
***end TW***

We had found a very rare reproductive urologist in our city, and he works in a fertility practice with his father and brother. I don't think the father is that active in the practice anymore, but his brother does female-factor infertility, IVF stims, and ER. We haven't met with them yet but in all likelihood we would be having simultaneous procedures in rooms next door to each other. I was worried about freezing and thawing so thanks for that heads-up -- I'll be sure to ask and push to have everything done the same day if possible.

The IUIs were so hard for me in terms of turning me into a raging hormonal b---h every month, month after month -- so I'm hoping IVF will be easier in that regard -- even if it has a similar effect, at least it's over after ER. At this point, I don't know if we'd do more than one cycle.

[punkybrewster]

****grad warning*****

Our RE and urologist actually recommended having the TESE the day before ER. Apparently that gives the lab enough time to search through the sample and find usable sperm. Nothing needs to be frozen in that time frame. I'm suso and every office has a different idea about that though.

Are you planning or have you thought about having donor sperm as a backup in case they don't find any sperm or they don't have enough?

[CurlySu717]

punkybrewster, oh yes, that's definitely the plan! I'm focusing on the end goal of getting pregnant -- if the mTESE works for us, it'll be a lovely surprise.

I wish I could explain why it's taken me the better part of three years to psych myself up emotionally for IVF. ...I wonder if it has more to do with being back on my Wellbutrin than anything else.

[doves654]

Welcome back!

[gabride2010]

I have no advice, but welcome back and good luck!

[Deleted]

Welcome back and good luck!!

[laurat]

My husband has Non mosaic KFS. We did several sperm analysis and they came back with zero sperm. We will need to proceed with microtese and ivf. Is it best to do microtese and egg retrieval and ICSI on the same day? What about 24 hours apart? We don't know what to do as the hospital affiliated with our urologist said they cannot coordinate same day microtese as Egg retrival and ICSI. What hospitals in Massachusetts, CT, or NY do it the same day or even 24 hours apart? Should we definitely shoot for a hospital that does not have to freeze the sperm if some is found? Please help!
Thank you, Laura