New MicroTESE overcomes zero sperm

When Adrian gets in from work every evening the first thing he is greeted with is “Daddy!” and the outstretched arms of his toddler Michael.

Being a Dad was something which Adrian, aged 50, had always believed would never happen to him. He had been told as a child that he had a condition which would impact his fertility, and this was confirmed when he was in his twenties after a doctor told him that he had a very low sperm count.

Told at 20 would never be a dad

“Adrian told me when we met that he couldn’t have children,” says Adrian’s partner Michelle. “He actually told me before we started going out, I think that it was something which really worried him because it had caused problems in relationships before.  At the time it didn’t really concern me because I was still quite young and was focused on my job.”

The couple moved in together and Michelle’s priorities changed. “My sister had children and I used to spend a lot of time with them and it made me reflect on my own future. I was working long hours and my enthusiasm for my job had started to wane. I started to think about what else mattered in life.”

When Michelle turned 30 she stopped taking the contraceptive pill but Adrian was not optimistic that she would conceive. “In my mind I was thinking ‘miraculously I might fall pregnant,’” she says.

A woman’s fertility declines with age and at the age of 35 a woman’s chance of becoming pregnant naturally each month is just 10% (for a woman in her twenties it is 20-25%). Seven years after Michelle stopped taking the contraceptive pill she was still not pregnant and she knew that, at the age of 37, time was not on her side. She realised that she had been avoiding a conversation with Adrian for far too long.

“In the end I said to him, ‘I really want to do something before it is too late. We don’t really know why you can’t have children and science might have moved on since you last sought advice and there might be something which can be done.’”

Eligible for NHS funded treatment at Bourn Hall 

The couple went to see their GP and were referred to the James Paget Hospital for tests. “By this point Adrian was in his 40s and I was in my late 30s,” says Michelle, now aged 41. When tests confirmed male factor infertility Adrian and Michelle were told they would be eligible for NHS-funded fertility treatment and they chose to go to Bourn Hall Clinic, which has clinics across the East of England.

“I really had to push Adrian to take a leap of faith,” says Michelle. “There was that fear of disappointment again, being given hope and then possibly losing it. In the end I had to say to him, ‘I really want to try something, can we see if we can do it together?’”

Parenthood at last for couple who took ‘a leap of faith’ with medical science

Told there was hope – MicroTESE can overcome zero sperm

The couple went along to Bourn Hall Clinic and were given the stark news that Adrian was producing no sperm at all. “We sat there and thought, ‘oh, well there is nothing that can be done for us,’” reveals Michelle.

Specialists at Bourn Hall, however, explained that even a zero sperm count doesn’t have to mean that it is impossible for a man to father a child.

Adrian admits that he was emotionally quite thrown by this revelation. “ To sit at Bourn Hall and be told that even with a zero sperm count I might be able to father a child using my own sperm came as a complete shock.”

MicroTESE (micro-surgical testicular sperm extraction) involves using a surgical microscope to identify tiny tubules most likely to contain sperm – and then removing them for analysis in the laboratory. If sperm are found they could injected directly into an egg during IVF treatment.

Oliver Wiseman, Consultant Andrologist and male infertility specialist at Bourn Hall Clinic explains: “It is important that men with no sperm in their ejaculate or with very low numbers ask to see an andrologist who can undertake this surgery if it is indicated, as this will give them the best chance of being able to proceed with treatment using their own sperm.

Most men with low testosterone levels are given Clomid to try and boost their body’s own testosterone production, as normal levels of this are important for sperm manufacture and may increase the chances of finding sperm with microTESE.”

Adrian was prescribed Clomid for three months and then went back to Bourn Hall Clinic for the MicroTESE procedure. The couple were told that Adrian had responded to the medication and sufficient sperm were then found at surgery for the couple to have IVF treatment.

Slim chance 

“Our specialist at Bourn Hall was very honest with us and told us that he had found some sperm, but not very much,” says Adrian. “He was very honest with us about the risk of failure and the chances of success.”

“It is such an upheaval in your life,” says Michelle. “You feel like you are constantly in limbo. I stopped work, I didn’t want to put myself under any addition stress and we focused purely on achieving our goal.  Adrian said that until he was holding a baby in his arms he wouldn’t let himself believe it could happen, so much could go wrong. He said he just wasn’t going to count on anything happening.”

Michelle had been told during her treatment that one of her ovaries had stopped working and when the couple decided to go ahead with a third cycle of treatment they felt as though it was their last chance.

“We were down to our last sample of Adrian’s sperm which had been extracted and we decided to throw everything at this treatment,” says Michelle. “I had an endometrial scratch and intralipids before transfer because they are thought to reduce the risk of miscarriage.”

MicroTESE overcomes zero sperm

The couple were delighted when Michelle’s treatment worked and her pregnancy went to full term. On October 6, 2016 she gave birth to son Michael, who they named after Adrian’s own father who had sadly passed away some years before.

Michael is now a bubbly toddler and ‘a real little character’ laughs Michelle. “I am so glad that I did insist we sought help because if I hadn’t Michael wouldn’t be here. I didn’t want to end up an old lady asking myself if I could have had a child. My one regret is that I didn’t push for us to get help a little sooner, or had my eggs harvested when I was younger, as we might have had the opportunity to have a second child. But that is with the benefit of hindsight and you don’t think about that at the time.”

Adrian is a doting Dad. “Michael is a carbon copy of me,” he laughs. “Being a Dad has totally changed my life. To have been told from an early age that there was very little possibility that I would father a child and then to be 50 years of age and have a young son is just incredible.

The procedure used to retrieve my sperm is relatively new and so didn’t exist as an option for me when I was younger. I am just so grateful that we put our faith in medical science. There are no words to describe what has happened to us, it is a miracle.”

More information about MicroTESE

New procedure overcomes infertility caused by cystic fibrosis

“It’s a Celfie”, says Rachel showing a picture of her baby’s first picture. For her and her husband Tom, their lives would be very different now had it not been for the NHS funded IVF treatment they received at Bourn Hall Clinic in Colchester.

Rachel starts: “We wanted to try for a baby as soon as we got married, which was in 2010. After 18 months of trying nothing had happened so I thought we should go to our GP and get the ball rolling.”

Cystic fibrosis causes male infertility 

The couple had to have blood tests and Tom provided a sample for a semen analysis. This revealed that he had a sperm count of zero. Further tests at the Broomfield Hospital and the UCLH showed that Tom was a carrier of cystic fibrosis and didn’t have any vas deferens.

Around one in 25 white Europeans in the UK is a carrier of the cystic fibrosis gene. Carriers of the gene can have problems with their fertility. Some men are born without vas deferens – the tubes that transport sperm from the testicles to the penis. Without these tubes, sperm cannot mix with the seminal fluid and so there is no sperm present in the ejaculate.

Rachel continues “knowing the cause of our infertility was a like a big relief. It was good to know what was stopping us from conceiving, that there was something that could be done for us and we could put a plan of action in place.”

Testicular sperm aspiration brings hope

After further testing Rachel and Tom were sent back to their GP. They were referred for NHS funded IVF treatment which they chose to have at the Bourn Hall Clinic in Colchester.

“I was apprehensive before our first visit to Bourn Hall Clinic, but as soon as we were there, I was put at ease” adds Tom.

Rachel continues: “In March 2013 we started treatment at Bourn Hall. We met with our consultant urologist at the Colchester clinic. They decided Tom would need a treatment called TESA to find sperm.”

Testicular sperm aspiration (TESA) occurs when a fine needle is inserted into the testis and samples of tissue containing sperm are obtained through gentle suction. For Tom, the procedure was a success and produced two vials of high quality sperm which were frozen for use in future IVF treatment cycles.

Later that month Rachel began her treatment at Bourn Hall. She had blood tests and ultrasounds, and was shown how to inject herself with the fertility drugs.

Rachel returned to the clinic in May 2013 for her egg collection and produced 16 eggs, nine of which were successfully fertilised using Tom’s sperm. Five of the embryos developed to 5-day Blastocysts. Four embryos were frozen for use in future cycles and one was transferred to Rachel’s womb.

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“It was such a surprise!”

From then Rachel and Tom had a nervous two week wait before they could take a pregnancy test to find out if their treatment had been a success.

“I couldn’t bear to wait the two weeks before taking the test. I did it a bit earlier” reveals Rachel.

“We went through treatment thinking the first cycle would just be a trial go and to treat it like a learning experience. I had convinced myself it wouldn’t work so when I looked at the test and saw it was positive I couldn’t believe it! It was such a surprise!”

Looking back on their treatment, Rachel feels that for them being open helped a lot.

“Both of us were honest with our friends and family from the beginning. I think we felt much more comfortable with everyone knowing. It meant we had a whole support group to confide in and help us through it.”

Delighted that they had been successful on their first round of IVF treatment, Rachel and Tom looked forward to the arrival of baby. Amalie was born on the 27th March 2014.

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Beating the odds

Tom says “the staff were always honest with us about our chances of success. I’m just so pleased we beat the odds!”

“You can’t prepare for it” says Rachel on what it feels like to be a mum. “One day you just come home with another person! It hasn’t been chaotic yet; just everything takes so much longer than you think!

“We are both so grateful to have been able to have our treatment on the NHS: it meant everything to us. Without it we wouldn’t of had a chance and we’d never of had Amalie. We are so thankful to them and Bourn Hall for their help in giving us the family we’d always wanted.”

More information 

Fertility testing provides information about sperm quality.

Bourn Hall has consultants with specialist knowledge of male infertility. 

To find out more come to one of our Fertility Awareness events. 

The Cystic Fibrosis Trust has advice about the condition

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Cancer survivor now father thanks to TESE procedure

When Kevin from Cambridgeshire hugs his two young children, he feels as though he has a multitude of reasons to count his blessings.

A childhood cancer survivor, Kevin was told as a teenager that he would never be able to father children of his own but thanks to pioneering treatment at Bourn Hall Clinic he has gone on to become a dad – not once but twice. He also recently conquered cancer for a second time and is looking to the future with a renewed sense of optimism.

“Being a Dad is something I thought would never happen and now I have two beautiful children,” says Kevin, aged 40, as he plays with two-year-old Arthur and cradles latest arrival, nine-month-old Evelyn. “I have also just been given the all-clear from cancer, having had a second shock diagnosis last year, so I feel ‘extra double’ lucky!”

Childhood cancer

Kevin was four when he was diagnosed with non Hodgkin lymphoma, a rare cancer that affects the body’s lymphatic system. He battled the disease for two years and had chemotherapy, which can cause a man to become infertile.

Kevin had always accepted that he wouldn’t be able to father a child until he met his future wife Natalie, a midwife.  She remembers:  “I had to think hard about whether we had a future together if we couldn’t have a family.  Being a midwife, surrounded by pregnant women and babies, it could become difficult to cope with.  I loved Kevin and wanted to be with him, so we chose to cross any difficult bridges when we came to them.”

TESE procedure enabled IVF

When a sperm analysis showed a zero sperm count, Kevin and wife Natalie were referred to Bourn Hall Clinic in 2011. They saw the clinic’s male fertility specialist Dr Oliver Wiseman who encouraged them to try a procedure called TESE  – which would involve retrieving viable sperm from tissue extracted from Kevin’s testes. The couple agreed and the procedure was successful, enabling Natalie to undergo IVF treatment using Kevin’s sperm. Arthur was born in 2013 and a further embryo was frozen.

For the couple baby Arthur was a miracle and although they held little hope that this would be repeated, they both felt they needed to try again with the single frozen embryo.

Natalie says: “Despite the chances of success being slimmer with literally just one frozen embryo for treatment, we decided to go ahead. I didn’t build my hopes up too much but Kevin and my mum were absolutely convinced it was going to work.

“My treatment second time around was much less stressful as I didn’t have to have the hormone injections to stimulate my egg production. Three days after treatment we moved house and so I managed to keep my mind busy on other things and tried not to think about the pregnancy test. I was amazed when it came back positive. In fact I re-took the test ten more times just to double-check! We were absolutely over the moon!”

TESE

Another battle with cancer

Unfortunately their elation was to be short-lived. Kevin became unwell. Initially thinking he had food poisoning he got more and more ill over a six-week period until he couldn’t keep any food or drink down and lost two stone in the process.

After being admitted to hospital and undergoing tests Kevin was stunned to be given the news that 35 years after his first diagnosis he once again had cancer.

“I was absolutely shocked and devastated that this had happened right in the middle of something which should have been so amazing,” he says.  “My primary concern was for Natalie, our unborn child and Arthur. I kept asking myself whether I was going to see my children grow up”.

Kevin underwent a 10-hour operation to remove parts of his pancreas, bowel and stomach, which was then followed by six months of chemotherapy. Throughout this period, Natalie had to remain strong for everyone.

“When Kevin came home after his operation, Arthur and I were so pleased to see him and it felt as though things might get back to normal,” says Natalie. “Then one Friday I went off into Ely to have a beauty treatment, got back that evening and settled down on the sofa with Kevin to watch England play in the Rugby World Cup. We were half-way through the National Anthem when my waters broke, I was only 28 weeks pregnant!”

Premature labour

A neighbour was drafted in to look after Arthur whilst Natalie and Kevin rushed to Addenbrooke’s Hospital, where Natalie works. She then proceeded to go in to premature labour.

The couple are convinced that the stress of the previous few months played a part in the turn of events and so having thought they would be having a Christmas baby welcomed daughter Evelyn in to the world much earlier than planned on 29 September 2015.

“Working at Addenbrooke’s I knew that I was in the best possible place to have a premature baby,” says Natalie. “I didn’t doubt for one minute that she would be okay but I was frightened at how tiny she was. She came out with a full head of hair and screamed and screamed, she made far more noise than Arthur ever made! We fell in love with her straight away.”

TESE

Natalie was sent home after a few days but Evelyn stayed in Addenbrooke’s until the middle of November and so Natalie spent vast amounts of her time at the hospital either with Kevin whilst he underwent chemotherapy or visiting Evelyn.

Although Evelyn was allowed home for Christmas, with Kevin’s cancer still hanging over them, it was a muted affair. “Arthur had presents but he was the only one who did and we just about managed to get a Christmas tree up,” says Natalie. “We just wanted to get to the end of the year and see the back of it.”

Looking to the future with optimism

2016 was shaping up to be a good year with Kevin being given the all clear from his cancer in March.

“I am now just looking forward to what lies ahead, seeing the children grow up and watching how they turn out and hopefully having a healthy, happy future for myself,” he says. “I am just so grateful that I am still here and that I have got a complete family with two beautiful children who I once thought I would never have. I am just so lucky to have them both and to have my health back.”

Natalie is also looking to the future with optimism:

“I am going back to work and trying to get back to normal,” she says. “We are trying to put everything behind us and move forward and enjoy our children that we have thanks to Bourn Hall.

“We are so grateful to Oliver Wiseman at Bourn Hall for his efforts at the very beginning andlooking at whether Kevin would be able to father his own children. We are a complete family now and I would say to anyone that even if the odds are stacked against you, if you want something, keep going forward and fight for it and hopefully you will achieve your dreams.”

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