# No sperm??



## Richl84 (May 11, 2017)

Hello everyone, I have been reading this forum and feel compelled to register. My wife and I have been trying for a year and have had no luck so we decided to go doctors.

My first semen sample came back as zero sperm and we were both devastated like many people on here. I had to give a second sample and that was not much better, but they say after spinning it they found 7 sperm 4 of them alive and motile but all abnormal, I feel slightly better as there seems to be a production of it were previously the showed nothing but obviously somethings not right so we have been referred to a fertility clinic. I'm just wondering what they will do next and if there is any treatment for it?? Thank you all for looking and hope to talk soon, all the best Richard..


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## bundles (Jul 16, 2011)

Hi Richard & welcome 

I have no direct experience of your problem but there is a urologist called Mr Ramsey who has worked wonders. I've even seen him called the Sperm Genius !!! There is a thread all about him here:

http://www.fertilityfriends.co.uk/forum/index.php?topic=333159.msg6162649#msg6162649

I can't say it's 100% but I'm sure there is a lot that can be done for you. Good luck 

Bundles xx


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## Richl84 (May 11, 2017)

Hello bundles I'm sorry about my late reply, me and my wife have just gone to menorca for 2 weeks which couldn't of come st a better time really! I hope they can do something, Ithe fact that the 2nd sample showed some sperm (7 abnormal sperm) but goes to show that there is some production hit obviously something's not right. Just hope it all works out and reading all the post on here has made us feel better as we are not alone! Thanks agai, richard🙂


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## MadameG (Jan 13, 2012)

Hi Richard, it's a good sign that there are a few there at least, perhaps you have a blockage somewhere. There is always surgical sperm retrieval that means you can use it for ICSI, so plenty of options available out there if you can't get a good sample out the old fashioned way! Wishing you the best of luck


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## dileas (Sep 4, 2016)

Hi Richard. We have been in similar situation - first semen analysis no sperm and second saw 8 after spinning. We found a lot of helpful information reading through the non-obstructive azoospermia thread in the diagnosis section so you may find it worthwhile having a look through there. Definitely a good sign that there were some found in second analysis. Our next steps were blood tests to check hormone levels like testosterone and fsh and to check for any chromosome issues. Like many others we also saw Jonathan ramsay and started medication which altered hormone levels and this led to having enough sperm to freeze some samples (still small numbers). I have to say that seeing Dr ramsay was a bit of a turning point for us so may be worth looking in to it. Hope this helps!


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## Dory10 (Aug 6, 2013)

Richard

We too were in a similar situation but after taking a range of supplements we managed to get enough healthy sperm for our eggs for ICSI.  It's been a long road but we are now blessed with our beautiful baby.  I hope you've been given some advice on supplements and medications that may help.

Dory
Xx


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## Richl84 (May 11, 2017)

Hello everyone i hope your all well! sorry i've not been on here to reply, I have just come back from a couple of weeks in Menorca which has done us the world of good! Thank you (MadameG/dileas/Dory10) your words have really cheered us up. Just before our holiday the Doctor reffered us to the fertility clinic and we have a date already which is next friday so i hope to find out more options then, I dont know what to expect i imagine it will just be questions and saying i need to give blood? Does anybody know what would usually happen at the 1st appointment obviously this is all new to us?

We got some news from my brother yesterday saying that they are having there 1st baby which i am pleased for them but really down at the same time and its kind of hard to put energy into being happy for them when i was on the phone when he rang me. we have had in the last 4-5 months 6 couples friends/family annonce that they are pregnant which is sods law really when everybody seems to be pregnant but I will remain hopefull and i'll go and try anything to get what we want which is our baby.

Im really hopefull the nhs will help and not go all the way to help us as ive heard some people say that sometimes they dont go that extra mile. I have heard alot about John Ramsey if we had the money we would go to him 100%, I think its £200 to have an appointment with him? Me and my wife work hard but dont have the best wage going so if we were to go to something like that I think my wifes mum said she'd help us which is nice. Hearing from all of you has been fantastic and this forum is such a good place to let your thoughts run free, thank you for your kind words and hope to hear from you all, also i will keep everyone up to date about our appointment thank you!
[/quote]


MadameG said:


> Hi Richard, it's a good sign that there are a few there at least, perhaps you have a blockage somewhere. There is always surgical sperm retrieval that means you can use it for ICSI, so plenty of options available out there if you can't get a good sample out the old fashioned way! Wishing you the best of luck





Dory10 said:


> Richard
> 
> We too were in a similar situation but after taking a range of supplements we managed to get enough healthy sperm for our eggs for ICSI. It's been a long road but we are now blessed with our beautiful baby. I hope you've been given some advice on supplements and medications that may help.
> 
> ...





dileas said:


> Hi Richard. We have been in similar situation - first semen analysis no sperm and second saw 8 after spinning. We found a lot of helpful information reading through the non-obstructive azoospermia thread in the diagnosis section so you may find it worthwhile having a look through there. Definitely a good sign that there were some found in second analysis. Our next steps were blood tests to check hormone levels like testosterone and fsh and to check for any chromosome issues. Like many others we also saw Jonathan ramsay and started medication which altered hormone levels and this led to having enough sperm to freeze some samples (still small numbers). I have to say that seeing Dr ramsay was a bit of a turning point for us so may be worth looking in to it. Hope this helps!


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## Richl84 (May 11, 2017)

Hello everyone, we had our appointment on Friday which was abit of a palaver. The oppoinmentbwas for 10am and didn't get seen till 11.30, which didn't bother us that much but what did was I was supposed to be seen by the consultant but think he was busy so he passed us to another consultant with no fertility experience. The consultant we were supposed to see is a gynaecologist so don't know if he's that experienced with male infertility? I had to answer general questions and they took my bloods but hardly any info given but at least they are investigating it which will hopefully find the root of the problem? They made an appointment to see him in 8 weeks but they said it's 15 weeks now!!! Don't know if I can handle that long a wait if not knowing! Does anyone know what they look for in bloods etc? Also is it possible for my GP to refer me to dr Ramsey? Just feel I need a specialised consultant? Thanks everybody! Rich.🙂


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## WatermelonBelly (May 18, 2017)

Oh dear... sounds like a bit of a waste of time. Gynaecologists are for women. Men see urologists. If seeing dr Ramsey or another relevant doctor is an option, I'd do that.


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## dileas (Sep 4, 2016)

Hi rich, I would imagine the blood tests will be for various hormones like testosterone, fsh and lh. They usually check how high the fsh is as it is often raised in situations like this. My husbands is around 15-16. They might also be looking to see if testosterone is low. My husband also had blood taken to check for any issues with y chromosome. We were a bit apprehensive about paying so much for appointment with Mr R (think our last one was £250) and we had to travel all the way from Scotland too but in our case it was money very well spent. Perhaps if you are in England it may be possible to get a referral. I think I might have seen people on here saying they saw him that way?


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## Dory10 (Aug 6, 2013)

Hi Rich

Sounds very normal and what happened to us in the first instance, the fertility specialist at our local hospital was an obs/gynae consultant.  You can also ask your GP to refer you separately to a urologist, this again will be at your local hospital so not Mr R but they can give you more of an idea to what might be happening so thT you can decide whether or not to pay privately to see him.  Our local hospital doesn't offer IVF and so this was just a stepping stone to us being referred on to a specialist fertility clinic. We had a list to choose from an opted for a private facility here the NHS paid for our first cycle.  We then remained with them paying for our own treatment for the next 2 cycles.  We found that once at the private clinic they were far more knowledgeable about our infertility issues and able to offer more advice/treatment solutions.

It does seem never ending in the early stages but once at the clinic things move far quicker 

Good luck

Dory 
Xx


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## Richl84 (May 11, 2017)

WatermelonBelly said:


> Oh dear... sounds like a bit of a waste of time. Gynaecologists are for women. Men see urologists. If seeing dr Ramsey or another relevant doctor is an option, I'd do that.


Hi watermelonbelly, yeah that's what I thought! I spoke to my dr yesterday she said sounds like your in the right place but I'm still not sure, to not be seen by him was poor I think so left without any real info. He may have qualifications in male infertility but I looked him up and says nothing about male infertility about him.


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## Richl84 (May 11, 2017)

dileas said:


> Hi rich, I would imagine the blood tests will be for various hormones like testosterone, fsh and lh. They usually check how high the fsh is as it is often raised in situations like this. My husbands is around 15-16. They might also be looking to see if testosterone is low. My husband also had blood taken to check for any issues with y chromosome. We were a bit apprehensive about paying so much for appointment with Mr R (think our last one was £250) and we had to travel all the way from Scotland too but in our case it was money very well spent. Perhaps if you are in England it may be possible to get a referral. I think I might have seen people on here saying they saw him that way?


My dr said yesterday that my testosterone was fine so don't know if she's had that part of test back already but only had bloods fri just gone. Donyou know how long all the blood work takes to test? I don't think I can wait until late sept, so was wondering do you think my dr would be able to see them at her end or is it just the hospital? I also asked her about referring me to dr Ramsey and she said she can't see why not but advised me to get all tests and see what nhs will offer in last week sept at the earliest appointment they have, but I don't know weather just to go back to dr and push for a referral as I imagine the waiting list for him is huge! Thank you so much for replying I really do appreciate it! Rich&#128578;


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## Richl84 (May 11, 2017)

Dory10 said:


> Hi Rich
> 
> Sounds very normal and what happened to us in the first instance, the fertility specialist at our local hospital was an obs/gynae consultant. You can also ask your GP to refer you separately to a urologist, this again will be at your local hospital so not Mr R but they can give you more of an idea to what might be happening so thT you can decide whether or not to pay privately to see him. Our local hospital doesn't offer IVF and so this was just a stepping stone to us being referred on to a specialist fertility clinic. We had a list to choose from an opted for a private facility here the NHS paid for our first cycle. We then remained with them paying for our own treatment for the next 2 cycles. We found that once at the private clinic they were far more knowledgeable about our infertility issues and able to offer more advice/treatment solutions.
> 
> ...


Hi Dory thank you again for taking the time to reply, yeah it just seems so slow doesn't it but I suppose we'll get there in the end, just a very long wait until 22nd September. I may ask my dr to refer me, like everyone here I just want the best chance to be a biological father and hear sometimes the nhs don't go extra mile sometimes obviously it's right for nhs. Did tour DH blood work take very long to get back? Don't know if my dr will get the results so I don't have to wait till sept? Thanks again Dory! &#128578;


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## Mercury (Jan 31, 2012)

We've been in a similar situation and asked to be referred to Mr Ramsay on the NHS. He runs clinics around Hammersmith which wasn't our local hospital and details for GP referral are on his website. There's s longer waiting list than seeing him privately but we were seen within about 2 months.


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## Jes87 (Aug 22, 2013)

Hey Rich,

Your experience sounds quite similar to mine (male). I'll try and dig out my timeline from my history...

EDIT: Found it. copied and pasted from an old post:
*
- Initial GP appt after 12 months trying to conceive. (Dec 2012)

- Wife had some blood tests, I got sent for semen sample (dec 2012)

- Results: Wife fine, my semen had no sperm. I had to give second sample (Jan 2013)

- Results: No sperm again, referred to fertility consultant (Feb 2013).THIS PART WAS THE WORST! No information, and appt with specialist wasn't until the end of May.

- Appt with specialist. My FSH was very high, indicating azoospermia. Advised I was very unlikely to be able to provide sperm for IVF. Was advised we could try SSR (had to self fund), but chances of success very slim. BUMMER! (May 2013)

- It moved quicker now, which was good. Also, knowing the issue helped massively even if it wasn't great news. Had my SSR in August 2013, which failed. We then had appointments pretty much monthly to prepare us for IVF with a sperm donor and started IVF in November 2013.
*

We saw a gyno, who was kind of useless in the initial stages in my opinion. Basically, didn't explain all the different types of sperm retrieval or anything. I was told I was having an operation to try sperm retrieval, but I worked out for myself that it was going to be micro-TESE and there are loads of other options that should have been discussed. If I were you, I would research the crap out of your options before your next appointment so you're prepared and understand your options.

Good luck my man!


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## dileas (Sep 4, 2016)

I am not sure if blood tests take different times in different places but ours for fsh, testosterone, lh and oestradiol always take just a few days through our GP so blood taken on a Monday and results usually back by a Friday. The blood test checking chromosomes took a lot longer. I think we had them done in August and got results in the october.


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## Dory10 (Aug 6, 2013)

Hi Rich

We were lucky in that our GP was very organised in obtaining bloods/semen tests before we went to see the first NHS consultant so that saved a lot of waiting.  The only additional tests she ordered were the karyotyping ones which had to be sent to a large pathology department at another hospital and she allowed a month for those results to return although in practise they were probably back sooner.  Once the blood tests are back your GP will be sent a copy so I'm sure if you make an appointment in 3-4 weeks he/she will have them back but may not be able to tell you the implications of the results where as the fertility specialist would.

We then also both needed the HIV etc blood tests which needed to be back and clear before we could finally be referred to the private fertility clinic.  

My husband was referred to the urologist alongside our joint fertility clinic referral.  Our time line was roughly this:

Jan - NHS fertility consultant apt.
Feb - me HSG scan, DH karyotyping bloods.
Early March - DH urologist apt.
Late March - NHS fertility consultant  apt to discuss results.
Early May - GUM HIV etc tests
Late May - NHS fertility consultant apt once all clear results were back, we then selected our private clinic.
Late June - Initial nurse  consultation at private fertility clinic inc Follicle count scan for me.
Early July (week later) - consultant apt at private fertility clinic where we received protocol and could have started on next day 21 of my cycle 2 weeks later but we decided to postpone for a month as had booked a holiday.
Late July - DH gave a sample to be a frozen back up - no sperm so returned a week later, some sperm so that was frozen.
August - started ICSI cycle.

Hope that helps 😊


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## Richl84 (May 11, 2017)

Mercury said:


> We've been in a similar situation and asked to be referred to Mr Ramsay on the NHS. He runs clinics around Hammersmith which wasn't our local hospital and details for GP referral are on his website. There's s longer waiting list than seeing him privately but we were seen within about 2 months.


Thank you Mercury, that was really quite quick waiting f dr ramsey then, Ill think we'll have a word with our Dr. Thank you!


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## Richl84 (May 11, 2017)

Jes87 said:


> Hey Rich,
> 
> Your experience sounds quite similar to mine (male). I'll try and dig out my timeline from my history...
> 
> ...


Wow thanks Jess thats really informative and builds a picture for me now, thank you. I just left feeling wow i was hoping for a lot more info but I suppose the nhs is so stretched but I have to get in my head that once the blood tests etc are done then maybe we will know abit more and narrow down what it is and I have to give another semen sample in tommorrow too, they found none in the 1st and then found 7 in the 2nd 4 were motile but all abnormal. Thanks again your post has really helped us!


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## Richl84 (May 11, 2017)

Dory10 said:


> Hi Rich
> 
> We were lucky in that our GP was very organised in obtaining bloods/semen tests before we went to see the first NHS consultant so that saved a lot of waiting. The only additional tests she ordered were the karyotyping ones which had to be sent to a large pathology department at another hospital and she allowed a month for those results to return although in practise they were probably back sooner. Once the blood tests are back your GP will be sent a copy so I'm sure if you make an appointment in 3-4 weeks he/she will have them back but may not be able to tell you the implications of the results where as the fertility specialist would.
> 
> ...


Hi Dory! my wife was tested 1st and all came back good but then i had to gve semen sample but didnt ask for bloods which might have speeded up the process, i might give my dr a ring next week or so and try and get those results at least, I have to give a 3rd semen sample tommorrow but dont know why asking for a 3rd maybe because they found 7 in last one or they just want us to be tested together. Thank you so much for your time to give me this info it really does help and the help and the support on this forum is fantastic! Thank you again! Rich.


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## Jes87 (Aug 22, 2013)

Yeah it's a bit of a slog going through the NHS, but it was free for us so really can't complain! Good luck mate, this part that you're going through is rough. I always found that not knowing anything and having to wait for appointments to be the worst bit of the whole journey.


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## Jessica7 (Sep 1, 2014)

Hi Richard

I’m so sorry this is such a late reply. I’ve not been on the board much for a while. I am the mother of a two year old boy born through icsi, with the sperm retrieved through mr Ramsay. We had zero sperm in all samples, and yet mr Ramsay got ten vials from a surgical retrieval! Our morphology isn’t great but the Lister (our clinic) reminded us we only need one good sperm. So I hope you got a referral to a urologist - but if you are still looking for options, I know mr r works with nhs clinics. You do have to pay him (I think we paid £1500 for the procedure) privately - but if you can some of the rest on the NHS then you can make it work. The reality is that you have to push for male investugations and there just aren’t many specialists around. If you are in London I believe mr R does his NHS work at the Hammersmith hospital. But we moved our sperm from there to our clinic. 

Good luck x


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## Richl84 (May 11, 2017)

Hello everyone, it’s been a long time but thought I’d come and give an update on our treatment. We found out in may 2017 that we’d struggle to have children as my tests had nearly zero sperm. In our first nhs appointment my consultant recommended we go straight to donor as we’d only have 1 attempt on the nhs, as time went on he referred me to Dr David Ralph at uclh for a micro tese and the operation was done by Dr Pippa sangster who was fantastic. They mangaged to get enough sperm for 6rounds of ivf/Icsi and was amazed as I wasn’t expecting a result, this was conducted in August 2019 and covid hit so we didn’t actually start our first cycle until June of this year. Thankfully it worked first time as my wife is nearly 22 weeks pregnant and we are absolutely delighted and still can’t quite believe it as we both were not confident it would work and were given low chances of success, also we are the first time Leicester fertility have had a successful micro tese pregnancy. I just wanted to give an update to show people that there is light at the end of the tunnel. Thank you all for all the input and well wishes you have a few years ago.


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