# zero sperm count - what are the options on NHS?



## couple

Hi, I hope someone out there will be able to shed some light on what we can expect to happen. we have no children and would like some. My partner has zero sperm count but as of yet we don't know why - our GP has refered us to a urologist who apparently can find out - alas it has been three months and we are still waiting for a letter. we have however got an appointment soon at a fertility clinic on NHS (surprisingly fast?) and we don't really know what will happen there. we were a bit surprised that our GP kind of dismissed the urologist idea and said not to 'expect much' from that department (what is that supposed to mean?) but we really hope there is a way that we can have a child and both be its biological parents. i have read various things on the internet which explain that this can be achieved, and what ways and processes there are but we are not really sure if this is just somewhere in USA, or also here in Britain, and most importantly, can this happen on NHS too? is biopsy to establish if there is blockage, and surgery to retrieve sperm which can then be used for IVF for me? can someone help? thank you!!


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## wibble-wobble

Hi hun

There are things that can be done for guys with zero sperm. A urologist is the best specialist to try to see. My husband was referred to Dr Lewis Jones at the Liverpool Women's Hospital, he specialises in fertility has around 30 years experience I think he said. The first tests he carried out we're a physical examination and blood tests (hormone profile,karotyping,y micro deletions, cf carrier status) and an ultrasound to check for sinister lumps (blockages of pipes would be too small to pick up on an ultrasound as the tubes in the testes themselves are tiny)another sa. After the results of these tests a tese (testicular biopsy was arranged) The biopsy is to find sperm. They can usually tell from test results if there is a blockage.... all results would be normal.

If they find sperm through either tesa,tese,pesa or mtese (all different kind of biopsies they do depending on test results) they would use the sperm in icsi (sperm injected directly into the egg)

All nhs pct's are different so what they fund treatment wise, varies all around the country. An nhs guideline is that you should see a specialist within 18 weeks of referral from your Gp but treatment could be a wait of up to 18 months after that.


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## couple

thank you for your reply, wibble wobble  so all these you talk about were done through urologist, is that right? so i guess we will still hold our hopes up for a letter from them and hope for some of these to happen, which you listed. i just wasnt sure why the GP kinda said not to expect much from there, she made it sound to me straight away as if our only options were donor or adoptions? i didnt think this was right or fair without anyone doing any examinations first? i guess we will find out... fingers crossed x


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## Betty-Boo

Hello and welcome to Fertility Friends   

I've included some forum boards that may help answer some of you questions   

*Fertility Investigations ~ *CLICK HERE

*Complementary, Holistic and Spiritual Approaches ~ *CLICK HERE 

*Male Factors ~ *CLICK HERE

Have a look round the site and if you get a little stuck with the navigation side of things - please shout!

You can also "meet" and chat with people in your local area through the *Location boards*. This is especially useful to find people who may be using the same clinic and or in the same PCT area. CLICK HERE

We also have a chat room - which is a fabulous place to 'meet' and chat with others. Our newbie chat is every Wednesday. A great chance to meet other new members and find out a little more about how the site works.

*Newbie chat ~ *CLICK HERE

All the best - our paths may cross again in other areas of the site.
Good luck,

  

Tis xx


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## wibble-wobble

Gp's are generally useless when it comes down to fertility related problems. Did you say you already have an appointment with a fertility specialist?

We thought our Gp had referred us to the wrong person when we received our first letter as it was gynae out-patients at a women's hospital. A bit of googling later, I found out that he was a specialist in male factor infertility,who just happened to work out of the hospital as the fertility clinic we're now at operates at that hospital   . You could try the same to see if the same thing has happened to you. 

Definitely push for more tests for your hubby , I know I wouldn't have been happy to go with a donor until I knew for certain that there was no possibility of my hubby being the biological father. You need to get to the end of the journey so there are no 'what ifs'. It could be that there is a high chance your husband produces sperm and that they just can't find there way out.... absence of the Vaas-defferens can be caused by being a CF carrier this is in effect being born with a vasectomy and with a case like this (if to say this was the problem) the chances of getting sperm through ssr (surgical sperm retrieval would be really high) There are a lot of things that need to ruled out as the cause of zero sperm.... And if you look in the right threads on this forum you'll see (in peoples signatures) that a lot of people with zero go on to have their own biological babies


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## couple

HI! thankyou for you reply!  yes we are invited to a clinic in the gynaecology out patients at liverpool womens hosp. i tried lookin thru the forums and posts but i find it sooo confusing, everyone seems to talk in letters that mean something and i have no idea what it all means!? yes everyone seems to know what all these abbreviations mean  so i have no idea what to read or what i am reading .. yes this is what i am reading elsewhere also, different ways of checking if sperm can be retreived surgically but what i dont know when i read other peoples comments who keep having loads of different procedures and surgeries - are they going private and paying and thats wht they are getting all this help and appointments? or does it also happen like this on NHS? i guess its cos of how dismissive of urology our GP was that made me think on nhs with azoospermia no one is gonna look into cause or look for sperm, but just tell us to have a donor... i hope i am wrong?


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## wibble-wobble

Hi again 

Does it say what doctor you seeing? 
Are you local to the Liverpool area to? I'm on the wirral. The pct have funded everything for us so far, all initial tests the biopsy and we get 2 cycles of Ivf. There is criteria that you need to meet be under a certain age,have a bmi of 29 or less and have no children.

If we wanted a second opinion on another biopsy I think we would have to pay.

There's a thread for Liverpool women's hospital

http://www.fertilityfriends.co.uk/forum/index.php?topic=282502.0

I post there a lot and quite a few others going through treatment there do to. Your welcome to come over and chat with us on there. I think everyone is the same with the abbreiviations when they first join, even after a year of posting I still see a couple of letters and have to think for a minute what they mean


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## couple

yes it says Mr Aziz/Dr Lewis-Jones clinic. we are a bit further away, in wales, but liverpool is apparently where we have to go? what is PCT?  do you know if this clinic will look into my partners azoospermia, its causes, and the bopsies etc? or does someone else somewhere else have to do that?


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## wibble-wobble

PCT is primary care trust, the ones that make all the decisions on what to fund. The Liverpool Women's hospital has a web link that directs you a page to say all access criteria for wales (a lot of welsh patients get referred to liverpool,think it's the nearest clinic to offer IVF) I'll try and dig it out later so you can see exactly what you need to be for funding.

We had exactly the same referral letter. The first 4 appointments were all about hubby, I was just asked a bit about my history and asked to get my Gp to run cycle day 2 or 3 bloods so I could take results back with me next time I went in.... which got repeated by Dr LJ after he'd done all of hubby's tests and biopsy. Dr LJ doesn't have anything to with the Ivf, I've just found out as now that all are tests are done he's passed us over to the Ivf team,we see them for the first time on the 17th.

You'll be in good hands if your treated by Dr LJ he really is a nice guy,takes the time to make sure you understand everything he has said before you leave. I only seen Mr Aziz in passing so I can't really comment on how he is

How long is there until your appointment? I remember feeling really nervous about going for the first time and like you I was thinking what can a gynae do for my man   They should say write on the letter that Dr LJ is a urologist/fertility specialist it would help 

Where abouts in Wales are you? I'm originally from Anglesey and moved to Birkenhead about 6 years ago


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## irishpete

Hi Couple,

Sorry to hear your news, I complete understand as I also have zero sperm.

My GP was utterly useless and insensitive.  From day one she was talking about the next steps, donor sperm and adoption.  I wasn't ready for that.

More tests are required to determine whether it is obstructive or non-obstructive azoospermia.  My urologist, Mr Jonathan Ramsay could tell immediately from my FSH/LH blood results that it was non-obstructive for me.  I was gutted.

He arranged for me to have karotype/chromosone blood tests, and these proved that I have a non-inherited, genetic condition called Klinefelters, and as a consequence, I am infertile.

We chose to go to Mr Ramsay as he is a specialist urologist in male infertility, and that gave me some reassurance following the utterly disgusting way which I was treated by my GP.  We also wanted to speed the process along, given that we had been ttc for 3 yrs.  Fortunately, my private medical insurance covered the cost of the investigations (total cost approx £1k).  Mr Ramsay is based in the London area, and he was really good.  I wouldn't hesitate to recommend him.

Well that was a year ago and we are continuing are fertility investigations (well my DW is) in preparation for donor sperm treatment, hopefully.

Good luck.  I'm happy to answer any questions...


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