My doc called today and answered most of the questions we had. First, he confirmed the surgery date for June 18th, and explained what needed to be done in preparation. I have to have medical clearance from my primary because they will be tubing me. I was a little surprised that they decided to tube me, because from other stories I have read, most people just get twilight sedation or local anesthetic. I’m guessing that because they are repairing both sides as well as taking biopsies, that this might be a little bit longer of a surgery, and that it would warrant being under general anesthesia.
Next he explained that after speaking with Jess’ IVF doc, that he would keep the biopsies and do all the pathology instead. I’m unsure why IVFNJ would not want to do it. I have read on other sites, as well as medical journals, that they have frozen TESE sperm with not the greatest results, but some good results, no less. Oh well, I guess we will just have to go with the flow.
Recovery time for me will be about 2 weeks before I can return to work. Most people are released for work after 1 week, but with my job, I need to be 100% before I can return. In regards to the varicocele repair, the doc said you normally have between 3 and 6 months before you can see any results. He’s putting the mark at 4 months before we do any more testing. This would put us at starting another IVF round sometime in November or early December (if all goes well).
Jess got a call from the IVFNJ doc today. He was confused about the message he recieved from my doc. My doc was trying to coordinate my varicocele repair with IVFNJ. He wasn’t trying to get Jess on an IVF cycle, but did want to send some biopsies to IVFNJ for sperm extraction/freezing (if they find any). Her doc explained to Jess that they don’t really freeze sperm from TESE. It has a terrible pregnancy rate, and they would not count on it as backup. This is a small step backward, because we thought if they had found some sperm, that we could freeze it for the next round of IVF. Regardless, I will probably have to go through another surgery for extraction. This just moves us closer to donor backup.
Today was my appointment for the reproductive urologist visit. Jess took off of work early so she could make the trip with me. When she got home, we rounded up the results from my previous semenalysis, hopped in the car and started making the trip to Marlton. From my previous visit to the Marlton office, I knew we would have a decent wait to be seen. It seems like this office over books, and is in slow motion. Not to mention that my doctor is only there on certain days. Once we finally got in to see the Doc, we gave him the results from the previous semenalysis done by IVFNJ. He was a bit surprised because all earlier tests done showed me with a diagnosis of azoospermia. From what reproductive endocrinologist at IVFNJ explained, it seems that regular labs (Centra State, which is where all my previous semenalysis’ were done), will mark the results as no sperm even if there are a small quantity. I’m assuming this is because an abnormal result would be less than 20 million per ml., and how do go about reporting maybe 10 per ml. There is no scale to measure that little quantity. Also, the lab at IVFNJ looks through the entire sample, not just a small quantity of it. Anyway, the point is they did find something!
The Doc explained that the only true way to determine my lack of sperm would be through further testing (DNA, major biopsies). After answering our 1000 questions, the Doc agreed to be on board with the cycle of IVF. He explained that he would be performing a percutaneous sperm aspiration procedure(this is a variation of a TESE procedure called PESA), using local anesthetics, and sperm extraction through needles. He uses ultrasonic guidance, which helps to locate areas that would have a better chance of having sperm. This is opposed to going in blind and just taking multiple samples here and there. This brings us to our last question posed for the Doc. Which was “What are the chances of finding viable sperm?” His response was a very conservative 50/50. He did however say that having any kind of sperm in the last semenalysis was a great sign! We are hoping and praying for the best!