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An_206290 posted:
I am looking to get some additional information regarding the next steps in our journey. My husband went to see the urologist and it was determined he had azoospermia, with the next step being a biopsy. The doctor said all labs came back normal. He is thinking that a possible cause is a back surgery my husband hand in 2004. He prolonged the surgery for about 6-9 months. The urologist reports that the signal might not be getting from the brain to the testes. Is this signal needed to produce sperm or needed to release sperm? My husband is planning to schedule a biopsy but I am curious as what we can expect from the visit and how likely there might be viable sperm found. He has a 11 year old son from a previous relationship, though we've been told previous fertility has no weight on future fertility. Any information you might have would be greatly appreciated. Thank you!!
AmyAALC responded:
His doctor will likely do an exploratory testicular biopsy to search for sperm cells within the testicle. This sperm will be used for in vitro fertilization (IVF).

If his hormone levels look good it is likely he'll have some sperm in his testicles but the amount may be limited.

Keep us posted on the outcome.

Amy Perkins, MS, TS
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy Reversal
curious1299 replied to AmyAALC's response:
Thank you for the information, I will keep you posted. The urologist report did mention that sperm precursors were found during both SA. Not sure if that is a positive for finding sperm during the biopsy. Any insight into what this might mean?
Sheldon_Marks_MD responded:
I am not sure I agree with the idea that postponing his back surgery has led to him having no sperm. Doesn't make any sense to me. I suggest that you seek out a specialist urologist in male fertility.
AmyAALC replied to curious1299's response:
It is possible that his body doesn't take those precursors and turn them into complete sperm cells, testicular failure.
curious1299 replied to AmyAALC's response:
Thanks for the information. The appt he did attend was just a informal evaluation, more test that should have been taken at our local urologist office. He was sent to the University of Minnesota clinic offices for his most recent visit. He did not undergo a biospy as of yet. As far as testicular failure, are there treatment options for this? The MD at the U of MN said that a biopsy would not be an option until we are ready to undergo the whole process since if sperm is found, we would then go through ICSI process at that time.
Sheldon_Marks_MD replied to curious1299's response:
Makes sense...though if you do the biopsy and the doctor finds no sperm are you way too deep financially and emotionally in the IVF pathway to stop or are you then psychologically cornered and forced to use donor?

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