I have a fertility app on my phone called iPeriod. Before we found out Mr.E had zero sperm I was using it to track LH surges, morning basal body temperature, pregnancy tests, etc. Now I mostly just use it to track my period.
Anyway, I was looking at it several weeks ago and realized that Mr.E’s mTESE is scheduled for exactly 6 weeks after my next period is supposed to start. Six weeks is exactly the minimum for how long it takes to do an egg retrieval cycle. So I thought, “Is this a sign? Should we try to do a fresh-fresh cycle?”
What do I mean by “fresh-fresh”? I mean fresh (not frozen-then-thawed) eggs and fresh (not frozen-then-thawed) sperm. What difference does it make?
First we have to define what “success” means. For most, if not all, infertility patients, success would be considered taking home a healthy baby while success in the laboratory might be considered making lots of grade A embryos or simply surviving the freeze-thaw procedure. For this post, “success” means taking home a baby.
I think all studies agree that fresh eggs are always better than frozen eggs. So if possible, you always want to use fresh eggs.
Some studies show that fresh sperm is better than frozen sperm. Other studies show that fresh and frozen sperm have the same chance of success. I think there’s even one that shows frozen is better than fresh (think survival of the fittest).
For us, I think fresh-fresh is going to be the best option. Why?
– not 100% guaranteed that all/any sperm will survive the freeze-thaw
– only 80% of subsequent mTESE procedures are successful (meaning sperm found on the 2nd mTESE)
By doing fresh-fresh, we’ll have the same number of sperm frozen (minus the 8-12 used to fertilize any eggs retrieved), plus we get to do the fresh-fresh. It’s like a two-for-one deal.
And if no sperm are retrieved, we will have more eggs frozen for use in the future should anything change in the realm of azoospermia treatments.
Our clinic prefers to do fresh-frozen because they don’t want to put the wife through stimulation and egg retrieval if they don’t have to. In fact I kind of had to talk them into doing my first egg retrieval. But I felt really strongly about preserving my fertility and I just kept talking until they agreed to do it 🙂
Not all clinics will do fresh-fresh when mTESE is the sperm retrieval method, so be sure to talk to your clinic about it! And don’t be afraid to ask to speak with the director of your lab to get their opinion on all of it.