Tuesday, February 2, 2010

Mr. Jem's business

This post is all about Mr. Jem and his man-business.

Two years ago when we started TTC Mr. Jem had his first SA. The doctor's first question when the results came in where, "Has Mr. Jem had any chemotherapy?" The answer was "No, why?" His response: "Because there are virtually no sperm in the sample."

Yes, dear readers, the results were that bad. 100 thousand swimmers. Too little to check morphology. Bad, especially as 25 million are the minimum amount to be considered normal.

Mr. Jem was in a sucky job and tho we had "pulled the goalie" he wasn't really in a good place to even talk about having a baby until Summer 2009. He retested. 600K.

The Diagnisis: Male Factor Infertility. The treatment: IVF with ICSI.

We had been doing acupuncture as soon as we decided to do IVF. The acupuncture clinic didn't really take his low count very seriously. They had him on special vitamins, Chinese herbs and only did acupuncture right before the SA. They (and our RE, Dr. W) said: "It only takes one sperm." Well, actually, it takes more than that!

The week before ER, his SA came back with zero sperm.

***Sounds of tires screeching to a halt***

Because of this, he had a testicular biopsy the day of retrieval to get sperm for the IVF with ICSI. After cutting into both sacs they were able to extract enough to fertilize my eggs AND freeze some for next time, if necessary. The silver lining from all this is that Mr. Jem found a urologist he really trusts.

Since the IVF, the urologist, who I call Dr. Johnson, did blood work on Mr. Jem. Mr. Jem had low testosterone. His FSH was normal. The way Dr. J. described it was, "The brain is sending the signal to the factory, but the factory isn't making any sperm."

In December Mr. Jem's Free Testosterone was 35, well below normal. Dr. Johnson put him on Test.im. After 4 weeks, Mr. Jem's level rose to 75, within normal. Dr. Johnson switched him over to Clom.id for two reasons: 1) to produce more better sperm so we can see if we can get PG naturally (we are MFI, after all, and if we can avoid another IVF cycle, that would be WONDERFUL) and 2) there's a generic equivalent to Clom.id (unlike with Test.im) so it costs $35 instead of $200 per month.

There are also other medical benefits of a normal testosterone level: it protects bone density, protects against heart disease, can help him lose weight and gain muscle mass, as well as raise his libido (always good!). Mr. Jem's sex drive has always been lower than mine, which has been the source of a lot of conflict over the 11 years that we have been together.

So, with the addition of Clom.id and more testosterone, I hope Mr. Jem's energy, libido and sperm count climb.

I just wish that Dr. W had told us to see the Urologist BEFORE we started IVF. He didn't. He said, "Don't bother." I disagree and urge all of you who are MFI to make sure you check out all the options. Oh, and freeze sperm when you get the chance, rather than relying on getting a good sample the week before retrieval. If I could spare anyone the heartache and worry of that, I will have done my job here.

I'd love to hear anyone else's (or DH's) experience trying to increase sperm count. What did you/he take? How did it work?



Adele said...

Yikes, I bet it was a screeching halt:( It's so crazy that Dr. W didn't insist he see a urologist. It goes to show how narrow their thinking sometimes is, how much you have to be your own advocate. Which is not easy because, let's face it, we're not the ones with medical degrees. I don't have any advice on the MFI but I heartily echo you on freezing the sperm. Just in case of a lower count, or nerves, or an act of...whatever! We did it and though we didn't use it that time around, it's added insurance.

addingtothepack said...

Whoa - I can't imagine not going to a urologist for MFI!

TFO also has/had low testosterone. He was put on Arimidex (a breast cancer drug) for 3 months. It quadrupled his total motile sperm (improved his total count, morphology and motility). Unfortunately, he had to stop taking it after 3 months because of the effect on his liver; but we got pregnant within 6 weeks of him going off the drugs. His urologist said he could go back on Arimidex for a few months in the future or try Clomid.

Anonymous said...

As you know my DH is on Clo.mid and has been for about 10 days. So, we don't really have any idea if it's worked. I hope for the best in your DH's next SA.

Michelle said...

My DH has Azoospermia or Testicular Failure, which is no sperm. He also had below normal testosterone and normal FSH levels. After Clom.id for 1 month, his T levels rose almost 100 points. At 3 months, his level was lower, but still in a normal range.. but zero sperm still.
He had no side effects from the Clom.id, he's always had a high libido.
The Uro recommended Arimidex but said it probably wouldn't help in his case. We figured if our insurance covers it.. he would give it a go. Insurance does not cover it. It's $300/a month out of pocket.
We are destined for IVF w\ ICSI as well, with DH having the sperm extraction surgery. (also not covered by insurance)
Anytime you need to talk I'm here, my email's in my blogger profile.

Priscilla said...

I couldn't agree more!! We're MFI here too and we exhausted all our options with a urologist prior to starting in on IVF-ICSI. My DH was diagnosed with a bi-lateral varicocele and all his SAs were low low low in all three categories...he had vericocele repair surgery and a year later there was still no improvement in his SA so at that point the doc told us that there wasnt anything else he could do since all of DHs hormones were normal. Even though it didnt help us avoid IVF-ICSI we are glad we at least did all we could with a urologist since there are cases where is DOES help a couple get to be IUI cadidates or even conceive spontaneously.

At my DHs last SA there was some improvment...not a ton, but some. He had been taking all kinds of vitamins that are supposed to help with male fertility(multi, fish oil, zinc, L-arginine complex, vits C & D and folic acid.)

Best of Luck to you and Mr. Jem. I hope you find a happy ending to all the frustration!!

Brandy said...

DH's sperm count was around 750,000 when we got him checked. Testosterone was on the low side of normal (I think 200). He used clomid for three months to try to increase the count. His testosterone shot through the rood (over 1,000), but sadly, his count stayed the same. The RE told us that the success rate for clomid increasing sperm counts isn't great, but that sometimes it works and it's crazy not to try it before moving on to more expensive things.


Anonymous said...

That is so weird that the acupuncture clinic didn't take it seriously! My last acupuncturist (she has a natural fertility clinic) was huge about treating the husbands even if it wasn't MF when people were doing IVF. And to see results, you generally have to do treatments for 3-6 months.

I just can't believe the RE didn't advise him to see a urologist sooner too. With all the bloodwork and tests they run on us, you'd think they'd at least encourage some sort of similar work-up on guys that show some sort of problem.

Tiffany said...

We're dealing with severe MFI also. His count started pretty good, around 8 million, but motility was very low so the urologist put him on Clomid to increase count and motility. All his hormones were normal before Clomid, but FSH was at the very lowest end of normal. On Clomid, his testosterone went way too high, and his count dropped. We stopped the Clomid but his count kept dropping, all the way to zero. Now if we do IVF, we will have to do the testicular biopsy as well. Really wish we had frozen something, but no one every suggested it. The urologist just kept telling us we would be fine, that the count would bounce back, that we could always fall back on IVF. Well not anymore.

Melissa G said...


We were also told not to bother seeing a urologist. DH's testosterone is below normal, but his FSH was fine.

When we saw a new RE last month he's the one who suggested that we go see a urologist. If not for fertility for his overall health because low testosterone can lead to bone density issues!!!

DAMN IT!!!!!!!!!

Oh not that there is a shortage of Acu clinics in the bay area but I fricken LOVE my acupuncturist, and she does work with MFI. DH hasn't seen her for that but because Captain Dipshit (our first RE) told us NOT TO BOTHER!!!!


Thank you for posting this. I really look forward to what else people suggest.

Fertility Chick said...

Azoospermia over here too! My husband was never put on clomid, but he did try arimidex for a number of months but there was no significant change. He did have varicocele surgery (both sides) but that too didn't change things and his azoo is considered a result of testicular failure. I'm here too if you ever wish to chat!

Poppet said...
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Trinity said...

No gleaming insight here, but I do feel a little frustrated that our RE didn't even bother discussing means to improve my husband's count/motility/etc. I actually just forwarded your post to the hubs so that he can take a peek at it. He's been followed by a urologist for his varicocele, but the varicocelectomy was cloaked as a "pain" issue somewhat out of fear that it wouldn't be covered by insurance if it was attributed to infertility treatment... Major frustration.