Azoospermia and the Andrology Lab

As you may know, Mr.E has NOA (non-obstructive azoospermia) which means he has no sperm in his semen. The only way to get sperm is with a surgical procedure. We’ve chosen to do mTESE (microdissection testicular sperm extraction). Depending on who you talk to, mTESE has between 50-70% chance of success (finding sperm).

Mr.E’s mTESE is scheduled for January with Dr. Hotaling at the University of Utah. Dr. Hotaling just finished his fellowship with Dr. Neiderberger in Chicago (who is one of the top 3 surgeons who perform mTESE).

We chose Dr. Hotaling for a few reasons:
– U of U is closer to us than Dr. Schlegel in NYC
– the surgery is less expensive in Utah (though truth be told I don’t care how much any of it costs, I just want my miracle babies)
– the U of U has an amazing take-home-baby rate at their reproductive clinic (almost 70% success rate in the under 35 male factor category)
– Dr. Schlegel doesn’t have Dr. Doug Carrell

Who is Dr. Carrell you ask? Dr. Carrell is not an MD, he’s a PhD. He’s the director of the Andrology Lab at the U of U.

I let you in on a little secret: the real stars of the show when it comes to IVF are the people in the lab. If you’ve got seriously low egg reserve, then maybe the star of the show is the Reproductive Endocrinologist that gets your body to produce good quality eggs. But otherwise, the star of the show is the lab.

This is really just my opinion, but I firmly believe it’s true. Why? The lab sifts thru the testicular tissue looking for sperm. The lab chooses which eggs are mature and then freezes them for fertility preservation (eggs are very hard to freeze properly because they have so much water in them). The lab chooses which sperm to inject into your eggs for ICSI. The lab is responsible for keeping your eggs, sperm, and embryos in the perfect environment to mature, stay alive, grow, and freeze. The lab thaws your eggs, sperm, and embryos. The embryologist in the lab chooses which embryos the RE will transfer to your uterus.

The lab really is the star of the show. Doug Carrell, PhD is the best andrology lab director in the world. Doug Carrell is the real reason we’ve chosen the U of U.

Now, don’t get me wrong, we really like Dr. Hotaling. If we didn’t, we probably would have gone with Dr. Schlegel. Dr. Schlegel has performed over 1,000 mTESE procedures. Dr. Hotaling had only performed about 80 when I talked to him during the summer of 2013. 80 is still a lot. The doctor has to be willing to stay in the operating room until he’s successful! I think Dr. Hotaling will be just as determined as Dr. Schlegel to find sperm and that’s what counts.

Factor that determination in with Dr. Carrell’s expertise and the excellent team of REs and I think we’ve got an all-star team.

I think Dr. Hotaling and Dr. Carrell will become an unstoppable team for male infertility. I’m excited to see where they are in 5-10 years. I think the U of U will become the new center for male infertility issues.

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7 thoughts on “Azoospermia and the Andrology Lab

  1. Hi i just saw that i forgot to put the link in my previous comment ๐Ÿ˜ฆ i just have a question. ur hubby got the surgery for varicocele done, my husband as well. our doctor wants a sperm analysis 90 days after the surgery. we have to wait 30 more days. but did u guys do a sperm analysis after the surgery?

  2. oh ok ๐Ÿ™‚ but the TESE is in January anyway…so u still have december if u wanna do another semen analysis. our doctor told us that the testis needs 80-90 days to produce semen. but we will have our TESE in January as well if we dont find semen in the ejaculate.

    • Yay for January! Are you nervous? I’m nervous. If I think about it for more than a few seconds I get butterflies in my stomach.

      80-90 days sounds about right for spermatogenesis. We will do one last semen analysis the day before or morning of the mTESE, too, just in case.

      Fingers crossed for both of us!

    • Hi, Didi! Yes, we have used FertilAid actually! That was our first vitamin added to Mr.E’s regimen. But Dr. Schlegel was a little wary of it because there aren’t enough studies done on their proprietary blend of ingredients (specifically the maca root, grape seed extract, and Asian ginseng). He recommended ConceptionRx instead.

      Mr.E took ConceptionRx for about 9 months. Then we found out that he is heterozygous for MTHRF A1298C, so he stopped taking that because it has Folic Acid (which is no-no for people with the MTHFR mutation). Now, he takes the same quantity of ingredients that were in the ConceptionRx but in separate pills so he can have the correct form of folate (5-MTHF instead of folic acid). A bonus is that taking them separately allows him to get mixed tocopherols (vitamin E) instead of just d-alpha.

  3. oh ok. that makes sense…our doctor approved fertilaid. so we will see if it works ๐Ÿ™‚ wish u all the best for the mTESE. dont forget to do an update. our next step is the first sa after the varicocele surgery. im extremely nervous. but finger crossed for both of us!!!!

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