# Non Obstructive Azoospermia in 2020



## Hopein2020 (Oct 5, 2020)

Hi Everyone,

This is my first ever thread here. Was hoping to get some advice/support from anyone who has been in a similar situation before. I had been TTC for about 8 months until we decided to go for some tests. DH semen analysis results came back with zero sperm on 2 separate occasions, FSH of 23, L3 of 11 and borderline low testosterone. We had one phone consultation with a urologist which wasn't very useful as he could not examine DH. Currently we're just waiting for something from a fertility specialist to whom our GP has referred us to. Due to Covid, I think this might take some time? Wondering if we should go private. Have heard a lot about Dr Ramsay. Has anyone with similar results been to visit him? Roughly how much would we have to save aside if we went down the private route of investigations, SSR and ICSI?


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## MrsRL (Dec 11, 2013)

Hi Hopein2020, I rarely post on here now but I saw your post and wanted to reply and say I cannot recommend Mr Ramsay enough. After our first IVF cycle didn't go well, we decided to do a lot of research and change things before having another cycle. We improved our diet, took suitable vitamins, looked at what my husband could do such as keeping the area cool (you can buy boxer shorts online) and also visited Mr Ramsay. My husband had low/poor everything due to undescended testicles as a child. Mr Ramsay also diagnosed a variocele that no one else had noticed, so my husband had an operation for that and was put on tamoxifen tablets to improve his levels of testosterone etc. If there is something that can be done, he will do it. He is a lovely man that really does care about his patients, it also helps to have someone looking after the male as we felt most consultants are only interested in the female, even when the issue is male infertility. It is not cheap to go private and I cannot remember the exact costs, but I would suggest having an initial appointment and see what he suggests. He will likely recommend several tests to start with so he can get an overall picture and come up with a plan. We still needed ICSI for our second cycle and we were very lucky to get our son out of it. I really do believe that without Mr Ramsay as well as the changes we made, this would not have been possible. Good luck and wishing you all the best x

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## Hopein2020 (Oct 5, 2020)

Hi MrsRL, thanks a lot for responding! I can see that azoospermia related threads have been pretty quiet for a while so I was a bit skeptical about a response but really appreciate your advice. I'm going to book an appointment with him and just hope he can help us too. My DH hasn't been physically examined yet but I wonder if he also has a varicocele. Did your husband ever experience any uncomfort or pain before having it was discovered? Did he also have high FSH?

P.s. A huge congratulations on your boy


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## Chriskirsty (May 3, 2013)

Hello hopein2020 
I just wanted to say sorry you find yourself here with male factor infertility,, We too suffer from this Y chromosome micro deletion and I can only mirror what Mrsrnl has said (my old cycle buddy ) mr Ramsay is a wonderful  Man he is one of the best specialists in male factor infertility,, after finding out dh had zero sperm in his analysis we were told we would have ICSI and dh would have a ssr to find sperm this failed,, I started my medication for egg collection and it was decide dh would have a micro tear to find sperm the day before egg collection this failed,, our nhs clinic told us we would never have biological children,, to me I just couldn’t accept it,, I found this site and heard of dr Ramsay I booked an appointment with him in Harley street,, He examined dh and said because of the type of deletion he had it thought it was possible to help dh produce sperm he was placed on tamoxifen fast forward 6 months later we had sperm,,we went back to our nhs clinic had two further failed rounds of ICSI and a failed fet..,for round 5 we moved to a clinic in London and finally after 9 years got a bfp,, mr Ramsay is a miracle worker,, fast forward 3 years and we are currently 8 weeks pregnant with baby number 2... he has made the impossible happen and I will be forever grateful to him,.  Our initial consultation was £250 but that was in 2014 and we still qualified for nhs too 

I hope he can help you like he has helped so many in the quest for a baby on here 

Mrs Rnl wow hello my old cycle buddy I hope you and little one are ok,, can you believe they are 3,, it feels so surreal talking about mr Ramsay he helped us both achieve the dream 


Kirsty xxx


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## K jade (Aug 11, 2013)

Hello
Can I advise that if u want to see Mr Ramsey do make an appointment soon
I did hear a rumor hes going to retire quite soon.

Christkirsty massive congrats!!


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## MrsRL (Dec 11, 2013)

Hi again Hopein2020, sadly this forum in general seems a lot quieter than when I used to post on here during my IVF cycles. I recently watched a programme about male infertility so it brought me back here. I'm so glad that they're talking more about it, as it's really not spoken about enough.

I hope you manage to get an appointment with Mr R and that he can do something. My husband didn't really experience any pain so wouldn't have been aware of the variocele. I think it was quite substantial though. I've checked our records, his FSH was 14.4, LH 4.9 and testosterone 28.5, this was in 2014 I believe so before we saw Mr R.

I've also looked and our initial appointment with Mr R was £200 and we were also told to allow a further £700 for any tests. For us the cost was definitely worth it and even if the cycle hadn't been successful, I think I would have still be glad we did everything we could.

Have you got a fertility clinic yet? Or not? I would definitely do research before you choose if not, we had a very different experience between the 2 clinics we use and I felt this also impacted on my frame of mind for the cycles as well. 

If you have any questions, please ask and I'm sure myself or Kirsty will help. Thank you for the congratulations, my son has recently turned 3 so in a way time has passed so quickly but in another this all feels like yesterday. 

Nice to see you on here Kirsty and huge congratulations on your pregnancy. Wishing you all the best. I hope all is well with you.

K Jade - wow I did wonder if he would be due to retire soon. It will be such a loss to male fertility when he does, I don't know of anyone like him.

xx

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## Hopein2020 (Oct 5, 2020)

chrisKirsty- wow congratulations! This gives me a lot more hope and I am very happy for you. So glad you never gave up! You and your OH are very strong and am sure are great parents too 😊

K jade- thank you for letting me know. I have just heard back from his PA and seems that he's still working. Really hope he doesn't retire any time soon.

MrsRL- My DH has much lower testosterone and higher FSH but really hoping medicine can improve the hormones. I've been told to keep £1000 aside for any additional tests. We don't have a clinic through the NHS yet and the process is much slower especially with Covid-19.

Does anyone know whether there is a criteria a male has to meet for treatment through the NHS? 

Also my knowledge on the fertility treatments is very limited as I'm new to this. Can somebody explain what they mean by cycles? Can 1 ICSI treatment consist of more than 1 embryo transfer?


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## MrsRL (Dec 11, 2013)

If there is anything that can be done then Mr Ramsay will definitely do it. He looks at everyone individually and doesn't send you for any unnecessary tests either as he realises the cost is high. The prices may have increased as we went in 2016. I can imagine that Covid-19 makes the process even slower, it definitely makes everything much harder so I can't imagine what it's like when you just want to get started with it all.

I think the main criteria they look for is women meeting it all, rather than men, even in male factor. Have you been referred by anyone yet? I think once you've both had all the tests required the hospital then refers you on to your chosen clinic.

Some areas offer only 1 IVF cycle, while others offer 3. In my area I could only have 1 cycle under the nhs. By a cycle they mean one full fresh cycle. I'm not sure if a frozen cycle is also covered under the NHS, as I've never had anything to freeze for either of my cycles. I think it would only be one fresh transfer included and possibly frozen but someone else would have to confirm that. Both times we had 2 embryos transferred, the first time we only got to day 3 but the second time we got to day 5. I hope you get some more information soon x


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## MrsRL (Dec 11, 2013)

This might help you- https://www.nhs.uk/conditions/ivf/availability/

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## Hopein2020 (Oct 5, 2020)

Thank you so much for the detailed response. I can't believe there are people out there who are so kind to offer their honest advice and support to those who are struggling. I really appreciate it! 

Our GP has referred us to a fertility clinic but no idea which clinic and when we'll hear from them. I just can't wait to see Dr Ramsay now.


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