Fertility— MicroTese Unsuccessful Biopsy Info Included

[AceTen21]

Long-time member that has always enjoyed this community.

My wife and I have been trying to conceive for over a year. I was tested for fertility in May and have had zero sperm count in 4 tests over this summer.

Began seeing a well-regarded urologist in May 2021. Hormone values all came in normal except FH was 16. Test 800 on clomid natty; prior natural test in the 500-600 range. Genetics testing came back without issue. Age 39, pretty active and otherwise healthy, BMI 25.

Prescribed Clomid 25mg everyday for 6 months leading into MicroTese surgery last month. The MicroTese was unsuccessful, no sperm found in testes : (

My background. Sustanon and Test user 2008-2010. 3 cycles of tren in 2009-2010.
HGH in 2010.
Always pct. In 2014 used arimidex for about a year to cure gyno. Helped but ultimately did surgery for that.

My wife and I have moved on from hopes of having a biological child. Our most likely path will be donor sperm from shared-dna relative. Life has been good to us so far, and we’re grateful for what we have. I was pretty worried the azoospermia was initially cancer.

In parallel path, I am planning on trying HMG, HCG, Clomid just to have closure on this issue. Any recommendations would be helpful.

My biopsy info below.

Thank you,
AceTen

Your Value A. Testis, left mid pole, biopsy: Testicular tissue with markedly reduced spermatogenesis. Maturation arrest in 25% of tubules. Hyalinization in the remaining 75% of tubules. Leydig cells present. B. Testis, right mid pole, biopsy: Testicular tissue with markedly reduced spermatogenesis. Maturation arrest in 95% of tubules Hyalinization in in the remaining 5% of tubules. Leydig cells present. Note: Immunohistochemical studies performed on part B show no staining for OCT4, CD117 or PLAP.

Clinical Information

Your Value Pre-op Diagnosis: Testicular failure [E29.1] Post-op Diagnosis: Testicular failure [E29.1]

 

[bodybuilder8806]

Sorry to hear about that experience, if you haven't tried HMG though I'd absolutely try that first before giving up. After 15 years on TRT, trying HCG with HMG worked for fertility and may have more of an impact than what you had on the clomid.

 

[Delt123]

What’s the reason they went for a biopsy instead of the HCG/HMG route first?

 

[AceTen21]

Thanks bodybuilder8806 and Delt123.

My doc thought clomid solely would give best results. I was hesitant to go off on my own experimenting/ adding HCG/HMG while under scheduled-surgery care.

HMG seems pretty hard to come by. I am reaching out to 3-5 azoospermia experts nationwide, to get a second opinion on everything, and review biopsy info more granular, and possibly get scripted for the HMG.

I am not too optimistic. Not sure if there’s ever been an unsuccessful micro-tese, then positive outcome.

I’m tempted to add in hgh to my long-shot efforts, to help repair any damaged cells.

 

[bodybuilder8806]

Thanks bodybuilder8806 and Delt123.

My doc thought clomid solely would give best results. I was hesitant to go off on my own experimenting/ adding HCG/HMG while under scheduled-surgery care.

HMG seems pretty hard to come by. I am reaching out to 3-5 azoospermia experts nationwide, to get a second opinion on everything, and review biopsy info more granular, and possibly get scripted for the HMG.

I am not too optimistic. Not sure if there’s ever been an unsuccessful micro-tese, then positive outcome.

I’m tempted to add in hgh to my long-shot efforts, to help repair any damaged cells.

Yeah I'd say that's the first step is seeking multiple opinions. I'm not a doctor, but I'd be surprised if you didn't find other doctors that argued from a medical standpoint that HMG/HCG has a more direct effect on raising fertility.

I'm just looking at other possibilities, but clomid relies on your bodies own ability to produce the FSH and LH needed to stimulate spermiogenesis whereas HMG / HCG would bypass this and essentially be providing the best kickstart possible independent of relying on clomid to get your hpta axis fired up which may not be sufficient if you have an underlying problem with the HPTA producing the necessary FSH / LH needed in sufficient amounts to make you fertile.

 

[AceTen21]

Yeah I'd say that's the first step is seeking multiple opinions. I'm not a doctor, but I'd be surprised if you didn't find other doctors that argued from a medical standpoint that HMG/HCG has a more direct effect on raising fertility.

I'm just looking at other possibilities, but clomid relies on your bodies own ability to produce the FSH and LH needed to stimulate spermiogenesis whereas HMG / HCG would bypass this and essentially be providing the best kickstart possible independent of relying on clomid to get your hpta axis fired up which may not be sufficient if you have an underlying problem with the HPTA producing the necessary FSH / LH needed in sufficient amounts to make you fertile.

Thank you. 100% agree.

 

[AceTen21]

Follow-up. My doctor is willing to prescribe hcg, clomid, and fsh. I may need to procure HMG on my own if I cannot get that prescribed.

Given biopsy info— I’m considering adding hgh to repair cells and boost fertility.

I’d say my biggest learning on this would have been to test semen analysis pre-gear; or in my 20s. That way if there was an issue time would have been more on my side.

 

[bad rad]

You don't need hMG and FSH if you include hCG.

Successful spermatogenesis and pregnancy rates with hMG and rFSH are similar.

Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism

 

[bodybuilder8806]

You don't need hMG and FSH if you include hCG.

Successful spermatogenesis and pregnancy rates with hMG and rFSH are similar.

Efficacy of follitropin-alpha versus human menopausal gonadotropin for male patients with congenital hypogonadotropic hypogonadism

Yes HMG is essentially just HCG/FSH so if he is prescribing FSH no need for the HMG as well.

 

[foxman101]

@AceTen21

Hey man, first off, check out @flex22 thread on fertility, he’s got a ton of good info, along with some trials / error stuff. It’s a good read tho it won’t true my answer your question.

Personally,
I just got done with a run of
1000iu HCG 3x a week
50mg clomid ED
20mg. Nolvadex
1/4 tab adex EOD.

I had more HCG and even HMG on the way but luckily the wife got pregnant.. I guess it was a Christmas blessing.

I would give it one more try, you never know…
If you don’t try with HMG etc, you’ll always question it in the back of your mind.. so why not. If it doesn’t work your not in a worse spot than you are now.

Good luck man, I hope the best for you

 

[szority]

I'm not trying to be a shill for otc products here. I notoriously think most are shit. However, I do know a guy who did some pretty dramatic doses of HCG for several times throughout a year period and his LH and FSF barely responded. I'm talking 10,000iu in a single week just to see if their was a response. Ultimately they got pregnant and all he used was Tribestan and proviron at 50mg a day, nothing else. It cant hurt

 

[bad rad]

Tribestan is researched backed for fertility improvements.

Comparison on the Effects and Safety of Tualang Honey and Tribestan in Sperm Parameters, Erectile Function, and Hormonal Profiles among Oligospermic Males

<i>Introduction.</i> This study aims to evaluate the effectiveness of Tualang honey on sperm parameters, erectile function, and hormonal and safety profiles. <i>Methodology.</i> A randomized control trial was done using Tualang honey (20 grams) and Tribestan (750 mg) over a period of 12 weeks...

www.hindawi.com

 

[Flex500]

Here is a thread that may (or may not) help. Lots of good info from many members. Our situations are a bit different as we have a child already and I knew what my previous count was. Nevertheless, maybe some nuggets of info that may help…

https://www.professionalmuscle.com/forums/index.php?threads/trt-fertility-protocol-and-few-questions.169678/

 

[bad rad]

Long-time member that has always enjoyed this community.

My wife and I have been trying to conceive for over a year. I was tested for fertility in May and have had zero sperm count in 4 tests over this summer.

Began seeing a well-regarded urologist in May 2021. Hormone values all came in normal except FH was 16. Test 800 on clomid natty; prior natural test in the 500-600 range. Genetics testing came back without issue. Age 39, pretty active and otherwise healthy, BMI 25.

Prescribed Clomid 25mg everyday for 6 months leading into MicroTese surgery last month. The MicroTese was unsuccessful, no sperm found in testes : (

My background. Sustanon and Test user 2008-2010. 3 cycles of tren in 2009-2010.
HGH in 2010.
Always pct. In 2014 used arimidex for about a year to cure gyno. Helped but ultimately did surgery for that.

My wife and I have moved on from hopes of having a biological child. Our most likely path will be donor sperm from shared-dna relative. Life has been good to us so far, and we’re grateful for what we have. I was pretty worried the azoospermia was initially cancer.

In parallel path, I am planning on trying HMG, HCG, Clomid just to have closure on this issue. Any recommendations would be helpful.

My biopsy info below.

Thank you,
AceTen

Your Value A. Testis, left mid pole, biopsy: Testicular tissue with markedly reduced spermatogenesis. Maturation arrest in 25% of tubules. Hyalinization in the remaining 75% of tubules. Leydig cells present. B. Testis, right mid pole, biopsy: Testicular tissue with markedly reduced spermatogenesis. Maturation arrest in 95% of tubules Hyalinization in in the remaining 5% of tubules. Leydig cells present. Note: Immunohistochemical studies performed on part B show no staining for OCT4, CD117 or PLAP.

Clinical Information

Your Value Pre-op Diagnosis: Testicular failure [E29.1] Post-op Diagnosis: Testicular failure [E29.1]

This might be useful for you.

Sperm were obtained at the second micro-TESE from six men who had received hormonal therapy (21%), whereas no sperm were retrieved from untreated men (P < 0.05).

Human chorionic gonadotrophin treatment prior to microdissection testicular sperm extraction in non-obstructive azoospermia

AbstractBACKGROUND. Despite the improved success rate of sperm retrieval by microdissection testicular sperm extraction (micro-TESE), methods to stimulate sperm

academic.oup.com