So lost.. someone please help

[knjsims323]

I am so very lost...

Background: We were TTC for over a year, thought that maybe my endometriosis (hadn't had a lap in 2 years) was the cause and went in to get evaluated. My primary doc ordered an SA for DH. Came back 0 count. After a round of antibiotics (for a possible infection) and a month waiting period, another SA came back 0 count. At this time the total testosterone was 346 (normal range at our lab is 250-1100), free was 45.6 (normal range 46-224), and bioavailable was 101.8 (normal range is 110-575). Did some more blood work and repeated another SA a few weeks later (still 0 count). FSH levels was 15.6 (lab normal range was 1.5-12.4), LH was 8 (normal range 1.7-8.6), prolactin 15.6 (normal 0-16), albumin was 4.9 (normal 3.2-5.1), and sex hormone binding globulin was 31 (normal range 7-49). Repeated the testosterone, albumin and SHBG and they were all lower the second time around (total test: 273, free test: 39.9, bioavailable test: 90.7, albumin: 5, SHBG: 26). Dh's has been seeing a urologist since all of this started happening (late July-early Aug) and since that time all the doc has done is order the 3rd SA and the last round of testosterone testing. He also ordered an u/s (which was normal)

Now the urologist is saying that he can't treat my husband so he was referring him to RE. (Actually, as soon as I started asking him about ordering certain labs, tests, etc, he got really nervous and made it obvious he has no clue about male infertility) We got our referral (we're military) and called the clinic they sent us too (Center for Reproductive Medicine in Mobile, AL) and they told us they don't treat MFI. They will do a SA when a female patient comes in, but if the SA is abnormal they send the male to a urologist. We finally got sent to another clinic that says they will help us try and find out what's causing the azoospermia, but as RE they don't really specialize in MFI. I think their exact words were "We can help diagnosis through labs, biopsies, etc, but we don't treat MFI"

I guess my confusion is, do we need to go back to the urologist or just wait it out with the RE? Our biggest problem right now is what is causing his azoospermia? At this point we don't even know if it's OA or NOA.. It's just so frustrating because it seems like all the doctors we have seen (and since they've all been military thus far, I guess it's too be expected) starting with our primary doctors, it seems like they all want to pass us on to someone else. With the exception of the clinic we are going to see... They sounded like the generally cared about helping us to the best of their ability.

So can anyone tell me exactly what kind of doctor is typically considered an expert in MFI?

Ugh.. I'm just tired and frustrated and the waiting and going back and forth and back again is just taking its toll.

Thanks for listening everyone!

[nycmomma]

Not all urologists treat IF, some do cancer only, some do ED only, and some do IF. I think the most important thing your DH should do next is a scrotal and/or transrectal US to find out if the azoo is obstructed or not. My DH had the US (it took about an hour) and they found he had no vas. We were able to do TESA and got pregnant our first cycle. Good Luck.

[knjsims323]

Thanks! He had a scrotal u/s and the radiologist (not the u/s tech) told us that everything looked normal. No blockage that he could see, normal size, etc..

[mk37994]

nycmomma is right I ended up going to a specialist / male infertility urologist, they do a much better job handling this area.

[knjsims323]

DH finally got through the urologist today and he explained that he has no clue when it comes to infertility so he wanted him to be seen by RE so they could diagnosis him and then at that point DH's primary doc will choose whether or not to have the RE actually treat him or send him to a civilian infertility urologist for treatment.

I'm just glad we had some clarification..

thanks everyone for listening to me vent! I never thought it could be so helpful typing out my frustrations and knowing that someone out there was reading it and understood!!