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Fertility after a decade

i realize you maybe international not USA based as I have rarely seen Edoxoban used for a fib in USA. so the generic names for

eliquis = Apixaban
Xarelto = rivaroxaban

 
something is definitely off. ALT is high, but what was AST? if coming from liver you would expece slight increase in AST too. Do you drink alcohol and if so any heavy consumption.

Ferritin can be elevated in inflammatory state. is your crohns active right now?

What is the range on the prolactin?

fatty deposits dont happen within a few months so unlikely. probably you are right edoxoban is the culprit and may need to change. eliquis, and xarelto are some other options. Did the cardioversion work? if so you only have to be on them for a month or so no?

just my two cents
Thanks for replying mate.

I've got more bloodwork 2 weeks from now to retest this.

I don't drink or smoke. Never have.

AST was normal at 45.

Range on prolactin is 86-324.

The cardioversion worked in that I haven't had an afib episode since but typically I was getting them 2-3 times per year, so time will tell. Waiting for an ablation.

Not sure on the duration of edoxoban. My cardiologist suggested I stay on it as it reduces your risk factor as I have 2 risk factors now. But I have emailed him to find out.

Also got my DNA fragmention back today. Average frag was 38%, with 29% healthy and 13% high.

Below 30 average is normal, so I'm slightly elevated. Hoping that the loose underwear and icing etc will help that.
 
Another update:

Met with Dr Jonathan Ramsay today, who is the leading male fertility expert in the UK. It was incredibly insightful and you can immediately tell he knows what he is talking about. He wasn't judgemental at all, quite the opposite. He was actually supportive of what I had done to date.

He has referred me to a specialist endocrinologist for the hormone side of things, as he feels I may have always had a gonadotropin issue. Part of this was he said despite the HMG use, he would have expected to have seen my FSH come up by now. He also said it is more than feasible to be on TRT if carefully managed in combination with menopur / rFSH and achieve good fertility markers. So this was also reassuring.

I have also been referred to a gastro to have a fibroscan of my liver, due to the high ALT. That will confirm whether there is a NAFLD or anything else going on. It could of course be the HMG / HCG if there is some excipient in there that shouldn't be present. I can't see it being the Clomid but I have dropped that now due to the ALT anyway.

We also have our first consultation with the IVF clinic tomorrow.

Dr Ramsay said that my numbers and DNA frag are actually OK. More than fine for PISCI with a good, experienced embryologist. So this gives me some hope. He did also state the sooner I have the surgery on the varicocele the better, as that will indeed improve the DNA frag.

I suspect I will have that surgery either the end of this month or early May. I might get lucky and get it done sooner depending on when my urologist has availability.

I am curious to see what the endo says, who I have booked in to see next Tuesday evening.

Pending what the IVF clinic say tomorrow, I may opt to get some sperm frozen this month and again after the surgery.
 
Minor point to add, did another at home test today and unfortunately my total count is still dropping; it came in at 4.06m per ml.

I've no idea why it is dropping, its devastating as I had been praying it was still going up.
 
Minor point to add, did another at home test today and unfortunately my total count is still dropping; it came in at 4.06m per ml.

I've no idea why it is dropping, its devastating as I had been praying it was still going up.

Sorry to hear that but keep looking ahead. Sounds like you have a decent plan and good medical support. Don't let yourself get down about it.
 
Sorry to hear that but keep looking ahead. Sounds like you have a decent plan and good medical support. Don't let yourself get down about it.
Here's the kicker. I got an update on the result today as they had gone and manually verified it. Apparently the system misread the video data taken and it was actually 15m per ml..

Honestly the emotional roller coaster is immense. I'm likely to get some frozen within the next few days just in case
 
Here's the kicker. I got an update on the result today as they had gone and manually verified it. Apparently the system misread the video data taken and it was actually 15m per ml..

Honestly the emotional roller coaster is immense. I'm likely to get some frozen within the next few days just in case
oh my gosh!! Yeah talk about a serious mental roller coaster!
 
So I had my fibroscan today, liver is fine. Cap score was 191. Had 14 vials of blood taken to check for a variety of things but the consultant thinks my ALT is likely the edoxoban and he thinks my liver should adapt.

Was a nice guy, very interesting.

Have endo app on Tuesday but the new urologist I saw basically said you'll need to be on trt whilst using gonadotropins. So that's reassuring.

It's now the end of my wife's cycle so within the next 7 days we will know whether this cycle was successful or not. I am hopeful. But let's see.
 
So I had my fibroscan today, liver is fine. Cap score was 191. Had 14 vials of blood taken to check for a variety of things but the consultant thinks my ALT is likely the edoxoban and he thinks my liver should adapt.

Was a nice guy, very interesting.

Have endo app on Tuesday but the new urologist I saw basically said you'll need to be on trt whilst using gonadotropins. So that's reassuring.

It's now the end of my wife's cycle so within the next 7 days we will know whether this cycle was successful or not. I am hopeful. But let's see.

Good update overall and sounds like you have a good medical team.
 
Thought id give an update.

Unfortunately we didn't achieve pregnancy last month. I was hopeful, but alas... no joy. So we try again this month.

I have my laparoscopic varicolectemy this Monday coming, which I am not looking forward to. My urologist said I should be fine to have sex within a couple of days, so we shouldn't miss my wife's fertile window. Her fertile period is around the 27th, op is on 22nd. I am having both sides done.

I also saw an endo last week who said he thinks I have hypogonadotropic hypogonadism. We are unsure if that was always the case but given I have never once in my life had a pregnancy scare with 2 long term partners from the age of 14 and having never used a condom.... it is quite possible.

I am unsure at this stage whether I will actually take the prescription he gave me for HCG and HMG, as it is private and we have to pay for it... and heres the kicker... it was £3.1k for 3 months worth lol. I am waiting for another quote from an online pharmacy he recommended, but the cost was insane.

I had 2 sperm samples tested and frozen over the last week; one with less than a 24 hour abstinence in an effort to reduce DNA fragmentation, and the other with a 5 day abstinence so we could do a HBA test and semen culture as well.

They were both actually pretty good:

1.5ml total (need to get this up)
29m per ml (from 0.7m)
52% progressive motility
11% morphology (from 3%)
HBA 66%

So if anything happens, we at least have 4 vials of this frozen which would do us 4 full cycles of IVF.

I am currently rotating 5 brands of HMG, but mostly using the Ferring Menopur that I have as follows:

2000iu hcg 3x per week
112.5iu HMG 3x per week (usually 75iu of which is Ferring)

I went back onto TRT last Wednesday after the endo cleared me to do so, and my god I feel better. I finally have libido and actually feel good again. Thank god lol!

Now I just need to try and get this layer of fat off that I developed on my abdomen over the last 12 weeks or so. I just couldn't seem to stop it, i assume because I had F all testosterone. For reference, for 10 years I have had no trouble staying lean pretty much all year. This is the fattest my abdomen has been in a very, very long time. The rest of my body fat didn't seem to change at all.
 
Really feel for you after reading this whole thread.

My concern is in pursuing pregnancy, your mental health is taking a beating, you’ve been without any test, which we know is deleterious for your health

at least you’ve started TRT now.

I fully appreciate for those struggling to have a kid it must be all consuming but you’ve got to look after yourself mate as well otherwise you’ll be no good to anybody

Keep your chin up and here’s hoping you and the wife crack the code very soon
 
Thought id give an update.

Unfortunately we didn't achieve pregnancy last month. I was hopeful, but alas... no joy. So we try again this month.

I have my laparoscopic varicolectemy this Monday coming, which I am not looking forward to. My urologist said I should be fine to have sex within a couple of days, so we shouldn't miss my wife's fertile window. Her fertile period is around the 27th, op is on 22nd. I am having both sides done.

I also saw an endo last week who said he thinks I have hypogonadotropic hypogonadism. We are unsure if that was always the case but given I have never once in my life had a pregnancy scare with 2 long term partners from the age of 14 and having never used a condom.... it is quite possible.

I am unsure at this stage whether I will actually take the prescription he gave me for HCG and HMG, as it is private and we have to pay for it... and heres the kicker... it was £3.1k for 3 months worth lol. I am waiting for another quote from an online pharmacy he recommended, but the cost was insane.

I had 2 sperm samples tested and frozen over the last week; one with less than a 24 hour abstinence in an effort to reduce DNA fragmentation, and the other with a 5 day abstinence so we could do a HBA test and semen culture as well.

They were both actually pretty good:

1.5ml total (need to get this up)
29m per ml (from 0.7m)
52% progressive motility
11% morphology (from 3%)
HBA 66%

So if anything happens, we at least have 4 vials of this frozen which would do us 4 full cycles of IVF.

I am currently rotating 5 brands of HMG, but mostly using the Ferring Menopur that I have as follows:

2000iu hcg 3x per week
112.5iu HMG 3x per week (usually 75iu of which is Ferring)

I went back onto TRT last Wednesday after the endo cleared me to do so, and my god I feel better. I finally have libido and actually feel good again. Thank god lol!

Now I just need to try and get this layer of fat off that I developed on my abdomen over the last 12 weeks or so. I just couldn't seem to stop it, i assume because I had F all testosterone. For reference, for 10 years I have had no trouble staying lean pretty much all year. This is the fattest my abdomen has been in a very, very long time. The rest of my body fat didn't seem to change at all.
Have you had estrogen levels checked? That could be what piled on the belly fat.
 
We tried to have sex last night and sadly I just couldn't get an erection. It's gotten really bad.

We discussed it last night a bit and this morning, and agreed this is pointless if I can't perform, so I will probably go back onto TRT today. It's actually affecting me quite badly mentally; not being able to get an erection is really the worlds worst feeling.
@bensif ...hope 2024 gets better for you. One never experienced it myself. No erection even with foreplay,watchng porn etc. Damn, I feel for you. Was your sex partner understanding? I hope so.
Tried bimix or trimix? Gets your penis hard like steel. You'll fuck like a champ.


MS
 
Have you had estrogen levels checked? That could be what piled on the belly fat.
Yes, it's been rock bottom since January (15-40pmol/L).

I thought the same as you, but I think its perhaps more a combination of hormone balance (T to E), hcg, and probably being less motivated thus generally burning less.

Ironically my thyroid is the highests its ever been at about 80% over reference range (free t3).

@bensif ...hope 2024 gets better for you. One never experienced it myself. No erection even with foreplay,watchng porn etc. Damn, I feel for you. Was your sex partner understanding? I hope so.
Tried bimix or trimix? Gets your penis hard like steel. You'll fuck like a champ.


MS
Thanks mate. My wife has been supportive thankfully. I think she understands how demoralising ED is for a man.

I hadn't tried bimix or Trimix but since being back on trt after 4-5 days everything Is working perfectly again.
 
Another small update. I had a bi-lateral laproscopic varicolectemy on Monday to deal with the poorly embolised left side varicocele and newly acquired right side varicocele.

Wasn't too bad, but still pretty sore. I opted to have this done due to my dna frag and morphology. So by the time we our next cycle of ivf in approximately 4 weeks I will be 5 weeks post op.

My wife is ovulating at the moment so fingers crossed we get lucky.

I managed to do cardio the last 2 days but I really can't train or put pressure on my abdomen. Even twisting is hard. Just hoping the scarring is minimal as I had 3 small 5mm incisions; bottom of left lower ab, under naval and centre of right lower ab.

The glue on the left side came off today and it doesn't look great but it's only been a week I guess. Only a bodybuilder would worry about this lol.

Honestly can't wait to get this small layer of fat back off as I hate having soft looking abs.
 
Just reading the description of your procedure makes me feel ‘uncomfortable’
 
So i am now 2.5 weeks post surgery. Incisions have healed up more or less, but last few days developed a very painful left testicle which I am quite worried about. GP prescribed me some antibiotics and my urologist (surgeon) said lets see if that settles things, if not to go in and see him ASAP.

I decided to do at an home sperm test because I was quite concerned and it came back quite bad in comparison to 4 weeks ago. For reference, 4 weeks ago was 29m per ml by lab test, today 2.9m per ml by home test. I am not entirely sure it would reduce that much unless I have a blockage or something.

I have been back on TRT for about 4 weeks now, so unless that has some how drastically reduced my count, but ive been on an increased dose of hCG and HMG. I am however still using grey market meds as apposed to the prescription he wrote me as it was so damn expensive.

We are due to do IVF in approximately 3 weeks so I really need to turn these numbers around by then (although I have my 4 frozen vials from last month).

This journey has been such a roller coaster.

If anyone has any insight, id appreciate it.
 
So i am now 2.5 weeks post surgery. Incisions have healed up more or less, but last few days developed a very painful left testicle which I am quite worried about. GP prescribed me some antibiotics and my urologist (surgeon) said lets see if that settles things, if not to go in and see him ASAP.

I decided to do at an home sperm test because I was quite concerned and it came back quite bad in comparison to 4 weeks ago. For reference, 4 weeks ago was 29m per ml by lab test, today 2.9m per ml by home test. I am not entirely sure it would reduce that much unless I have a blockage or something.

I have been back on TRT for about 4 weeks now, so unless that has some how drastically reduced my count, but ive been on an increased dose of hCG and HMG. I am however still using grey market meds as apposed to the prescription he wrote me as it was so damn expensive.

We are due to do IVF in approximately 3 weeks so I really need to turn these numbers around by then (although I have my 4 frozen vials from last month).

This journey has been such a roller coaster.

If anyone has any insight, id appreciate it.

Thanks for an update! Sounds like there is a lot going on. Some of this gets well outside of my knowledge so I'd love to give you advice but afraid I'm not much help at this juncture. Rooting for you man and can't wait to hear about a successful IVF.
 

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