Everyone I talk to says that is way too low of a dose and not frequent enough. I am sticking to what the doctor is saying..

my recent labs before starting the treatment 19 days ago:

FSH <.300 L

LH <0.07 L

E2: 28.1

Testosterone total: 1786 H

IGF-1: 126

I've been on testosterone and steroids like 10 years. I only took a few breaks during this time. I did testosterone every week for at least 3 years straight with no break.

Am I cooked? is there such a thing as someone never recovering?

My husbands FSH is 4.1 currently. He was on anadrazole since April 22nd and had his variocecoles repaired back in may. We waited 6 months and we just did his microtese on 11/18 & it was unsucessful. we did a biospy and it just came back with maturation arrest.

any success with a similar story?

We went to generation fertility Waterloo and they recommended some tests like AMH, vitamin D test, semen analysis, dna fragmentation and all. As these tests are not covered by OHIP, I called my insurance ( sunlife) if they cover it, they said if tests are done at commercial lab it will be covered 100% but if done at clinic it would not be covered.

Has any one experienced this, is generation fertility formerly known as karma considered as clinic or lab and have your insurance covered this?

Please let me know, my partner had already paid for her tests yesterday and my appointment is on Tuesday.

Hi all. I want to share my journey through male infertility thus far, now that I've gone through almost a year with my original diagnosis and varied treatments, medications, surgery, etc.

I've posted an original and a follow-upollow up post earlier in the year for anyone looking for more background information.

I know this is a wall of text. I've included a brief outline of how I felt following the days of surgery.

TLDR; I was originally scheduled for a microscopic testicular sperm extraction surgery (mTESE) and instead received a microscopic epidydimal sperm extraction surgery (MESE/ESE) after the Dr realized my azoospermia was a function of obstruction (the exact cause of obstruction is still unknown). We were lucky and found many vials of viable sperm to be frozen down for future IVF.

For the long story:

Background Information:

To summarize: I had a childhood surgery to fix unilateral cryptochordism back in 2000 at 7 or 8 years old. I believe it was my left testicle that had not descended properly because I still have (occasional) issues with it; I have retractable testicle syndrome (this is a self-diagnosis, but it's quite evident when I can literally see and feel my testicle retract into my inguinal canal) due to an oversensitive cremaster reflex.

My first set of bloodwork and non-invasive examinations revealed higher-than-normal FSH, slightly abnormal LH, and normal-to-high levels of testosterone. The urologist recommended we try Chlomid for 6 months. I had no noticeable symptoms from taking Chlomid, and my bloodwork showed a favorable change in FSH, though it was still (barely) outside of normal range. However, sperm analyses still returned with 0 sperm found.

I was cleared and scheduled to receive an mTESE with Dr. Wayland Hsiao of Kaiser in Oakland last Friday, Nov 22nd. Physically and mentally, I was as calm as one could be staring down the barrel of a fairly invasive surgery. Emotionally, however, I was a mess; I knew this was ultimately the last opportunity to locate any sperm for future IVF.

mTESE/MESE Procedure Experience at the Hospital:

Pre-op was fairly run-of-the-mill. I got undressed onto the hospital bed, and a bunch of nurses came in introduced themselves and their roles, and began getting me set up for surgery. (It's not my first time going through surgery with general anesthesia, so I knew what to expect). They run a 5-lead ECG and an IV through the hand. I highly recommend shaving the chest before you arrive...those electrodes are sticky to remove. Dr Hsiao came and introduced himself to me

The nurses brought me back to the operating room. They have you lay on the operating bed and get you adjusted. They'll all spend 3 or 4 minutes reviewing everything as a team and introducing themselves. Then they'll give you an oxygen mask, instruct you to take a few deep breaths and count backward from 10.

10...

9...

8...

"Ok, Mr Goggles, it's time to wake up," I heard from the nurse before I could count to 7. If you've never had general anesthesia before, it's a bit of a trip because you'll go from wide awake to ... wide awake again. Only multiple hours have passed by, and the surgeon has finished operating on you.

It takes a few minutes for the anesthesia to wear off. In this state, you feel like a fucking champ. It's scary because I'm sure many of the hard drugs out there give you a similar feeling of peak confidence. And with anesthesia, there is zero filter on what comes out of your mouth. Apparently, I told the nurse I could run a marathon right then and there. She laughed. Suddenly I realized my wife was next to me too, and I immediately apologized to her for letting so many strangers fondle my balls today. She laughed.

She was ecstatic. The operation was successful and they were able to extract multiple vials of sperm. I understand this is not always the outcome and many before me did not have the same good news. I feel incredibly blessed that I was able to get some good news for once and know that my wife and I can continue our dream of parenthood.

I didn't get a chance to speak with Dr Hsiao, he was booked with other cases throughout the day. He did speak to my wife earlier, who relayed the message to me that instead of doing an mTESE they did an epidydimal sperm extraction (MESE/ESE) because when they cut into the scrotum, they learned that there was a blockage somewhere in the epidydimus where it becomes the vas deferens. I supposed this could have been identified if I had done a biopsy or some other treatments prior to the surgery, though the Doctors were all quite shocked because all of my bloodwork and medical history indicated I had non-obstructive azoospermia.

Recovery Process

The first symptom I felt when waking up was incredible thirst and a very sore throat. The nurse explained they used an intubation tube down my throat and these symptoms were common. I had some water and a sip of ginger ale, which was a mistake because as I was getting dressed for discharge, I felt incredibly weak and nauseous. I needed to vomit. Suddenly I had cold sweats and felt faintish. The nurse explained this was pretty common when eating or drinking too soon after anesthesia. After a few minutes, it wore off.

Eventually, they wheeled me out into the car, and off we drove.

Day 1 - Anasthesia, Discomfort, and Confusion

The ride home (about an hour) wasn't the worst in the world largely thanks to the anesthesia that was still wearing off. There wasn't much pain but I still felt groggy and confused, tired, and pretty blah. I had a small snack and some water and slept for 3 or 4 hours, waking up because I had to pee. This was quite difficult. They've wrapped me up in a jock strap, cut a nice little modest hole in the middle, and wrapped my sac with gauze. It was hard to point into the toilet with all the bandages.

The anesthesia had largely worn off by now, and I wasn't in so much pain I needed painkillers, rather, I took some of the prescribed acetaminophen and grabbed an ice pack. The pain scale was probably a 5, maybe 6. The best way I could describe the pain is akin to being kicked in the nuts and dealing with the ensuing stomach/groin pain that comes afterward. I stayed in bed pretty much all afternoon and kept an icepack on the boys until the evening. At this point, I felt some increased discomfort around the sutures and decided to take one of the prescribed oxycodone. This helped me sleep.

Day 2 - Discomfort

It's now Saturday and a full 24 hours has passed by since my operation. I woke up with a mild level of pain (2, maybe 3) and some of the aforementioned male discomfort from a kick to the nuts. Honestly, icepacks are your best friend. I had ordered one of these from Amazon a few days prior, and they were a godsend. 10/10 recommend - and no, I'm not affiliated with them whatsoever. They just helped significantly.

By this time I had swapped out the gauze dressing the nurses put with new ones. I was still taking the acetaminophen, the antibiotic, and a stool softener. Yea... I hadn't pooped since Thursday (1 day before surgery), and the common side effect of all the medication was constipation.

Day 3 - Boredom, Mild Discomfort

It's Sunday now, and I've been bedridden for almost 2 full days. Occasionally I got up to use the restroom, grab some water, or look out the window. Outside of the testicular discomfort, I wasn't feeling any pain. I'd sometimes get pain at night when I slept, probably because I'd roll around and accidentally squeeze my legs or something.

They don't want you showering for at least 72 hours after the procedure to allow the suture to heal. At this point in my recovery, there was some bruising along the shaft and a little in the scrotum. This is totally normal and expected. My wife brought some amazing Mediterranean food and I devoured it in minutes.

Day 4 - First Shower, A Poop, and Minimal Discomfort

It's now Monday and I woke up with very little discomfort. Occasionally I felt some, depending on how I sat down or how much movement I've been doing recently, but any pain or discomfort went away within a few minutes of sitting or lying down. Icepacks (the nutsicles, from Amazon) are still on most of the day. By now I've been on my feet throughout the day and have been able to mostly return to most activities of daily living. Since it's Thanksgiving week, I decided to take some sick time from work.

After breakfast, I felt a familiar tension in my abdomen and knew immediately what was coming next: my first poop since Thursday. This was an indescribable relief. To make matters better, I was finally allowed to shower, and it was one of the best showers I've had in my entire life.

Days 5 & 6 - A Waiting Game

The next few days were starting to look more and more normal. There was very little discomfort. Frankly, I only felt discomfort from prolonged sitting or any direct contact with the suture site. I hadn't taken any of the pain medication for a few days now, only the antibiotics. I've been able to go on short walks and run light errands. I also spent most of Thanksgiving cooking without issues. At this point, I'm just waiting for the OK to return to exercising.

Day 7 - Restlessness

I had a follow-up phone call with Dr. Hsiao today to review the details of the procedure and get a clearer idea of my timeline for recovery. Since he didn't need to do the testicular extraction, the recovery process was expected to be a bit smoother and I should be good to return to exercise soon, as tolerable. For reference, I typically cycle 6-8 hours per week and lift weights 2-3 times per week. Being inactive is hard for me, and I was struggling more with restlessness than any pain or discomfort from the surgery. I think I'll start with a long, brisk walk tomorrow. I won't get on the bike for at least another week and I probably will do light bodyweight exercises sometime midweek next week.

I know everyone has a unique case when it comes to male infertility. It's an extremely distressing diagnosis to go through. It creates immense emotional strain both on the father-to-be as well as the mother-to-be. For many months I felt a variety of emotions, including deep shame, frustration, anger, resentment, etc. I would be upset when I saw friends post their stories on Instagram about their pregnancy, their newborn, whatever it was, as it continued to remind me that I may never be able to father a child. I went through therapy to help me process and understand my emotions. I've been able to talk to a few others who have gone through similar experiences, and this has helped immensely.

Male factor infertility is not discussed enough. If you're reading this, and wish to chat or vent, or ask questions, whatever you need, please don't hesitate to reach out. Please remember that you are not any less of a man because of infertility. Your character as a man is not defined by this diagnosis. It is a long and difficult journey, but there are so many incredible opportunities with modern medicine. Please don't give up hope.

With love

Goggles

Hello all,

My sperm concentration have always fluctuated between 1-6 millions per ml.

All other tests look good (testosterone , genetic , Been eating ultra healthy, workout often, excellent sleep etc.)

I have been diagnosed with a medium size left Varicocele. According to my urologist I need to get the surgery done

For those who had this done did you see improvements ?

Hello! I just wanted to share some success we’ve had so far since this sub has provided so much guidance and support, and I want to pass along hope.

My husband was diagnosed with non obstructive azoo in summer 2022 after 3 zero SA, ruled out any obstructive issues, had low T and high FSH (12-14). He has a failed tesa as well. The urologist prescribed enclomiphene daily (25mg) which he’s been on almost two years now. Just a few weeks ago his SA showed around 100 immotile sperm! The doc said this is good enough for ivf but we’re still waiting to see him for an appt. Not sure what this means but it feels good to have some hope. We’ve been in this long enough that we’ve accepted life might not look how we had imagined but it’s a beautiful life nonetheless.

Hi everyone, looking for advice about my fertility journey and next steps.

My wife and I have been Trying to conceive (TTC), and I've had three semen analyses over the past 2 years showing a concerning downward trend. Just had a fertility consultation where they recommended genetic testing and hormonal tests, but want to know if others have been in similar situations.

My SA Results Timeline: April 2024 (First Test)

• Volume: 3.8mL (normal)
• Concentration: 11 million/mL (below normal)
• Motility: 48% (good)
• Progressive Motility: 37% (good)
• Morphology: 1.5% (below normal)

June 2024 (2 months later)

• Volume: 1.8mL (normal)
• Concentration: 7 million/mL (declined)
• Motility: 33% (declined)
• Progressive Motility: 23% (declined)
• Morphology: 1% (below normal)
• Vitality: 60% (good)

November 2024 (Most Recent)

• Volume: 2.8mL (normal)
• Concentration: 7 million/mL (still low)
• Motility: 6% (significant drop)
• Progressive Motility: 4% (significant drop)
• Morphology: 1% (still poor)
• pH: 3 (below normal range)

Current Situation:

• Fertility specialist is recommending:
  1. Chromosomal Analysis (Karyotype)
  2. Cystic Fibrosis Screening
  3. Hormonal Blood Tests
• IVF has been suggested due to declining parameters
• Wife's tests all came back normal

Questions:

1. Has anyone experienced similar declining sperm parameters (especially motility dropping from 48% to 6%) despite being on supplements, and what helped improve them?
   • Current supplements: Wellman Conception Max, Ashwagandha (600mg), Maca (500mg), Shilajit (333mg)
   • Should I increase to full recommended doses of Maca (1500mg) and Shilajit (1000mg)?
2. Is pursuing genetic testing (Karyotype, CF Screen, Hormonal) worth it before proceeding with IVF, or should we move straight to treatment given the declining numbers?
3. What additional tests helped others with similar numbers improve their sperm parameters, particularly motility and concentration?

Additional Context:

• Located in UK
• Navigating between Private hospital and private fertility clinic
• Taking supplements daily
• No known health conditions
• No smoking/drugs
• Moderate alcohol consumption
• Regular exercise

Any advice or shared experiences would be greatly appreciated. This whole journey is pretty overwhelming, and I'm particularly concerned about the dramatic drop in motility despite taking supplements.

I have a non malignant tiny pituitary tumor. It affects all hormones. I had to get onto TRT at 19.

Now with trying to get pregnant I’ve been on 9000 units of HCG a week and clomid 50mg every other day for 9 months without testosterone and no success.

Just had a semen sample waiting on results.

My FSH and LSH are (naturally) low due to the tumor. Idk if an FSH injection would help or why that topic has not been discussed by my doctors?

Either way. Has anyone out there had a pituitary micro-adenoma and had success with pregnancy?

So I am male 36 active and try to eat well. I took a sperm exam because after our first child we havent had luck for another. I feel like the dr didnt give me the attention I wanted to help me understand my results. Maybe I read them wrong? We have been trying for 3 years now. Exam results are as follows

Sperm total: 97,510,000

Morphology:

Oval: 1

Piriform: 90

Im assuming this is a percentage ?

Motility:

1 hour 43

Second hour 34

Some other info the day before the test I drank like 7 beers I had told my wife I wanted to take the test the next week but she was really stuck on going the next day. We had also made love 2 days prior to test. My question is the dr said everything look ok just a bit low on the morphology and to take some supplements and to stop drinking energy drinks. The assistant forgot to write the supplements I need and every time I call its busy. What can I take and what can i take to help with morphology and increase good swimmers with oval shape ones.?

Hello, i am from india married since 2 years.

Recently i have been detected azoospermia. I was treated for undescended testicles at age 6(having this condition since birth). So i had ultrasound scan for the same and it's been detected that my testicles haven't grown fully(4cc volume) my doctor has suggested some meds to decrease fsh and increase testosterone and try again after 3 months.

What are the chances of finding at least 10 mil sperms?

I wife is not ready to have sperm donation.

Please advice

Okay, I've finally got confirmation...I'm getting my MTESE done mid Jan. What can I do that will increase my chances of finding sperm? Food,supplements? what type of fitness?
Currently taking multi vits, COQ10 and zinc. I'm trying to eat more walnuts and salmon. I've been slack with the gym side but go about once a week, but I'm motivated to go more.
Also I've been doing intermittent fasting. Roughly 20 hour fast. Does anyone know if this is any good for me right now.
I know fasting in general is good but is this process good for sperm production?

Using a throwaway account for privacy...

Wife and I have been trying to get pregnant for about an year and a half now.

We're generally healthy and I went in to get a sperm test recently as we haven't been able to conceive.

Everything seemed ok (was my second test)

However, in the additional MiOxysis test, my result came back as 2.05 mV/mio/ml vs a standardize sORP of 1.37.

How worried should I be about this result? If I have solid values otherwise, how likely is it that this number (tbh I have no reference as to how severe this level is) is what's causing us to not conceive?

I have been taking Lexapro for 3 years now. I am in the process of getting off it - I was at 20mg and have gradually reduced it to 5mg with the help of my doctor.

I recently took a home fertility test for men, and came to know that my sperm count is less than 20million / ml (the accepted threshold). I was wondering if someone was able to reverse fertility issues that they experienced while they were using SSRIs.

I understand overall health and lifestyle changes have a lot to contribute in this area, just looking for some ray of hope I guess.

My husbands initial sperm test came back as semen ph 8.3, an abnormal amount of gel, gray in color, a volume of 5.0 mL, but no sperm was found. A second semen analysis confirmed no sperm was found. He had an inspection of his testicles, was told everything felt normal and testicles were a normal size. After a blood tests, we found that his prolactin was slightly elevated at 21 ng/mL and his testosterone was low at 178 ng/dL. Testosterone, bio available was also slightly low at 107 ng/dL and sex hormone binding glob was low at 8 nmol/L. All other blood tests were in normal ranges with LH at 4.4 mlU/mL and FSH at 4.4 mlU/mL.

Considering these things, the thing that sticks out to me is the fact that testosterone is so low but LH and FSH are within normal ranges. When testosterone is that low, LH and FSH should be elevated. So when I researched this, it pointed in the direction of secondary hypogonadism which is an issue with the pituitary gland. I know if that’s the issue, there’s treatments for it such as hormone replacement therapy and even some medications because this would be a hormonal issue and not necessarily an issue with the testicles.

All that to say, our doctor told us that medication would not help because raising the testosterone would not help and he wanted us to go in for a tese as a first step. He was pretty set on the fact this was a testicular failure issue. I’m just worried that a tese isn’t necessary if it could in fact just be a hormonal issue. I’m obviously no doctor and don’t want to say I don’t trust our doctor, I just feel like a second option wouldn’t be a bad idea. Looking for advice or insight on our results and wondering if anyone had similar results?

Results of Semen Analysis:

The good:

Volume: 2.8 Liquefaction: Normal PH: 8 Progressive motility: 45% Non-progress: 18% Total Motility: 63% Normal Morphology: 9%

The bad:

WBC>1 Sperm Concentration: 14.7

I’m going to have a consultation with my doctor after the holiday but how would I go about increasing this concentration?

Hi everyone. I had a failed FNA (Fine Needle Aspiration) procedure, also known as sperm mapping, by Dr. Turek earlier in the year. It showed SCO (Sertoli Cell Only) in each location. I am currently on multiple medications and am planning to have an MTESE sometime next year.

Has anyone had success with an MTESE after a failed sperm mapping or a diagnosis of Sertoli Cell Only? If so I would love to know your results. Both positive and negative. Or anyone who had an MTESE and how did it go and what was your circumstances?

This is a hard process. I am so glad for this group and everyone on here!

Collection time, semen View trends Value 1051

Semen volume View trends Normal value: >=1.5 mL Value 2.0

SEMEN, TIME READ View trends Value 1135

Liquefaction, semen View trends Normal value: NORMAL Value NORMAL

pH, semen View trends Normal value: >=7.2 Value 7.0

Spermatozoa, motile % View trends Normal value: >=40 % Value 20

View trends Normal value: >=32 % Value 15

Spermatozoa, immotile % View trends % Value 80

Spermatozoa, nonprogressive % View trends % Value 5

Viscosity, seminal fluid View trends Normal value: NORMAL Value NORMAL

Appearance, semen View trends Normal value: NORMAL Value NORMAL

SPERM COUNT, SEMEN View trends Normal value: >=15.0 M/mL Value 92.8

WBC COUNT, SEMEN View trends Normal value: <1 M/mL Value <1

Spermatozoa, morphology View trends Normal value: >=4 % Value 3

this might sound funny but my anxiety is killing me rn

I don't know if this post belongs here or not but here I go:

15M from India and I have very bad health anxiety and I recently came across this rare condition called 46,XX male which when a male gets chromosome of female i.e XX and my anxious brain made me believe that I have it and I started to see symptoms of the condition that are: Short height Gynecomastia Wide hips Feminine face Low Testosterone and other related symptoms...

And I really want to get tested for it but the only way is to get a karyotype or chromosome analysis from an endocrinologist which is pretty hard for me because I don't know how to tell my parents about this and it would be so embarassing to go to a doctor for this rare condition that only has a 1 in 20,000 chance of happening so there are chances that even doctor does not know about this.

But I found a cheaper and easier solution that I would get a fertility test because no recorded person with this condition has active sperm, they are basically sterile so If I get a fertility and I have active sperm that means I don't have this condition and it is also cheaper because the test for this would be like ₹4,000 along with doctor's fee.

There was very low chances of me having this disease and high chances of just late puberty and low T in general but I still need your help to know how to get a fertility test as I have saved some money for this.

And I know this might sound crazy but just help me pls

Anyone here with SCO who has been to Dr Peru or knows someone with SCO who has been to him; and actually was able to produce fully mature sperm post treatments?

I found this article on his website -which if true -is a miracle.

https://celalettinperu.com/en/serpil-ali-y-family-achieved-their-desire-in-the-4th-tese/

The only person I talked to, who was an SCO patient and was in turkey, said no sperm was found with him.

I always thought I would come on here one day and share a positive update to give hope to others in this situation. However, with a heavy heart I am posting regarding our failed mTESE. Its day 2 of surgery and the doctor has informed us that they are still searching but at this point it seems highly unlikely they will find something.

I wanted to ask for advice as well thoughts/opinions.

My husband was diagnosed in Feb 2023 with NOA. Testing revealed everything normal including Test in the 500s however FSH was 12.4 miu/mL.

Through testing we have also found that he is a carrier for a rare cf mutation. But based on the failed mTESE and also a failed TESA in June its 100% a production problem.

One interesting thing is most of his semen analysis have been 0. However, we have had 3 semen analysis showing 1 motile sperm, 3 motile sperm and again 1 motile sperm.

Based on the fact that he has had ejaculated sperm before we want to see if there are any other possible options out there? Does anyone have any insights/advice or thoughts?

Thank you in advance and I am truly sorry to those of you in this same situation. It sucks.

Hey group, I am hoping that I can get some advice from guys who were on TRT, got off it and used HCG to build sperm count etc. My wife is 40 and we want to have a baby. She is fertile, her readings were really great, but time is not on our side.

I just found out today from my urologist that I have non-obstructive azoospermia.

Before starting TRT, my bloodwork showed a 320 total test, and FSH level was 32. I have been taking TRT for about 9 months - .5ml 2x a week. I feel great ever since I got on TRT.

The Urologist told me that I need to get off TRT and start taking HCG with Clomid. I have heard good and bad stories about Clomid, and my TRT provider even suggested not taking it.

I was under the impression that I'd just only take HCG, but after talking with my TRT provider today, he gave me his protocol:

• 1,500 IU HCG: x3 week
• 75 IU FSH/HMG: x3 week
• Glutathione: 200mg a week
• Selenium
• Coq10
• Vitamin C/D/E
• Musinex
• And then he also says I can take HGH 2 IU M-F, but this is a little costly.

I am wondering what others have done with getting off TRT. What protocol did you use / what worked well to get you fertile?

Has anyone else tried this mix of HCG / FSH / Glutathione?

And once you started taking HCG did you completely cut out TRT or did you take lower doses for a couple of weeks while you started taking HCG?

In the perfect world I'd love to continue taking TRT and take HCG along with it, but from what I hear from many it is best to cut out TRT.

Any insight would be awesome. Thanks a bunch.

When I read online, it says that the normal range is 4-14%, but my test say the normal is =>30%. Does this mean my SA is using a less strict definition of "normal"?

The doctor's notes say my count and motility are good, but my normal morphology is low at 8%.

I was a regular cannabis user that just quit to try to improve that number and I got off of testosterone about a month ago.

Hi, everybody! I´m 32 and my total sperm account is 62 million and my progressive motility 9%. Considering my wife is 42 doctos suggested us to go straight to ivf. I did a sperm culture and it shows staph aureus. I wanted to know your experiences dealing with this bacteria.

Thanks a lot!

Hey, so a few questions here. My most recent analysis was:

Concentration - 75 m/cc Volume - 1.5 ml Motility - 19% Progressive Motility - 15% Morphology - 2.5%

1. From what I am learning, it looks like I have low motility but not bad concentration? With multiplying my concentration, volume, and motility. Does that help my numbers at all?
2. I just want the hard truth. Are these numbers at all good enough for my wife and I to conceive naturally?
3. I actually had another analysis 6 months ago and my motility was slightly higher.. I don’t smoke, drink and I’ve been taking a bunch of vitamins. Any suggestions on what else I can do here?

Hello brother azoos,

I was given the brutal NOA news just ~2 weeks ago, and I've been diving deep into research about mTESE. Here’s what I’ve learned and some thoughts I have on what might make for a better procedure.

1. Starting with one testicle as opposed to opening both
   • The first reproductive urologist I spoke to explained that he opens both testicles, spends 1.5–2 hours extracting tubules from both, and then sends the samples to a lab. I've seen some online references that other doctors that open only one testicle, and if they find enough sperm there, then they stop the procedure without needing to open the other. Why would you damage both testicles if you found sperm in one?
2. Live Embryologists During mTESE
   • From my research, it seems some doctors have live embryologists examining the material in real-time as it’s removed, while some just send the material to the lab after the procedure. Having a live embryologist (or two) seems like it could help guide the surgeon better.
3. Extended Procedure Times (being open to more than 3 hours if needed)
   • Some doctors reportedly work closely with embryologists and may spend more time, whereas the first doctor I spoke to seemed to spend only 1.5-2 hours.
4. No back to back mTESEs
   • I’ve listened to one doctor (on YouTube) who only schedule one mTESE procedure per day to maintain maximum focus and improve success rates, as the procedure is such a heavy mental burden. He seemed like a great doctor, but unfortunately is in Australia, so not that feasible for me (in the US).

Does anyone have experience with surgeons who follow the best procedures? Is this the accurate way to look at it? Any advice or resources would be greatly appreciated... thanks so much and best of luck through all of your journeys.

Kinda worried maybe I just can’t produce. Can’t even get into urologist till February. Anyone have similar stuff and end up alright? My uncle can’t have children and I believe that’s it in my family line.