Still a blank shooter

[bchjetdrvr]

All,

It's been years since I posted here. Some of you might have seen my story on the front page. (Tyler) All is well and I'm still around. Before TC I was single, over weight and out of shape. After the wake up call - Newly engaged, home owner and just finished Ironman Wisconsin. Wahoo.

But there is one thing in my life right now I am really really pissed off at. Retro grade ejaculation. I'm 37, my soon to be wife is in her 40's. We want a child. When I went through this I didn't do enough thinking and didn't bank sperm.

I had my RPLND in Oct 2004. Still nothing. Dr S in NY did the RP. A few times I tried the "sudafed" experiment. Nothing.

So what I wanna know is - Has anybody here had kids AFTER the RPLND while experiencing retro grade ejaculation? If so - how!?

Do I visit a Urologist or a fertility doctor?

I called the urologist and his secretary told me to see a fertility doc. I called the fertility docs and they seem to only concentrate on women.

-Tyler
http://www.aircrewphotos.com/news.html

[Margaret]

Tyler:

First of all...great news on the new and improved YOU...impressive.

Second, I know there are ways to conceive after RPLND even with retro-grade. I will look on the web for some medical advice. Our doctor told us they can harvest the sperm from your urine. Once you ejactulate and the sperm goes into your bladder, they can collect the urine and take the sperm from it. I am sure it is more complex than I am explaining it...but do-able.

I have also heard of other methods such as accessing the sperm from the testicle. Not sure how this works either but our urologist was a fertility doctor in his first life and talked to us in depth about it.

Of course there is always sperm donation, which you could consider or adoption, but those are very personal choices. I believe if you have the desire and love for a child, you will be blessed with one.

If I am able to find anything, I will post a link...in the meantime, I would seek out medical advice as a next step.

[Margaret]

Here are some tid-bits I found:

Retrograde ejaculation caused by diabetes or surgery may be improved with a medication that improves the muscle tone of the bladder neck. A urologist experienced in infertility treatments may assist with techniques to promote fertility, such as collecting sperm from the urine and then using the sperm for artificial insemination.

Testing for retrograde ejaculation requires a man to urinate into a small cup immediately after ejaculation. The urine is checked for sperm and if any are present, he has ejaculated ‘backwards’. These sperm can be collected and prepared for assisted reproductive technologies if the problem can not be corrected. Oral medication may be needed before the test to neutralise the urine environment and reduce the damage to the sperm while in the acid environment if collecting sperm for assisted reproductive technologies.

Retrograde ejaculation occurs when semen is ejaculated into the bladder instead of exiting through the penis. Anatomically, the spermatic duct joins the path of the urethra for the semen to exit the body. Retrograde ejaculation is a malfunction in the valves that control the flow of urine versus semen through the urethra; this rare condition is sometimes the result of diabetes or the removal of the prostate gland. If a man's system operates as it should, the valve between the bladder and the urethra constricts during ejaculation or conversely, the valve between the vas deferens and the urethra closes during urination. Sperm can still be collected from the bladder although the urine may be toxic to the sperm. A man with retrograde ejaculation can empty his bladder and have a catheter inserted to fill the bladder with laboratory solution (media). Then, after ejaculation, the fluid is collected, the liquid removed and the sperm remains. More commonly, men are treated with oral sodium bicarbonate prior to collecting a sample to counteract the acidic nature of urine and convert it to a more alkaline state. The urine is collected and using a centrifuge the sperm are harvested.

http://www.fertilityjourney.com/aboutFertility/maleInfertility/physical/index.asp?C=33863393579525347222

The most common fertility treatment method involves retrieving the sperm from the man's bladder and artificially inseminating his wife. This is the technique I tried with Michael and Shelley T. Since sperm cannot survive in an acid urine, I asked Michael to take one teaspoon of bicarbonate of soda in a glass of water four times a day for two days prior to Shelley's most fertile time of the month. About twenty minutes prior to collecting his semen, I asked Michael to empty his bladder. After he ejaculated into a jar, I catheterized Michael to collect his semen together with a small amount of urine. I then washed the sperm and using a syringe placed the sperm into Shelley's cervix.

The success rates are quite good, provided the couple can stick to the regimen.
Although Michael wished to avoid catheterization, this frequently provides the best specimen for AIH. I can obtain a semen sample by first asking you to void. Then I will insert a catheter through the penis into the bladder and drain any excess urine before placing a small amount of sperm nutrient media into the bladder. The man is asked to ejaculate and then voids the nutrient media into a specimen cup. The sperm are separated from this liquid, concentrated and placed into the uterus.

http://www.ivf.com/ch8mbpg2.html

[mk6439]

I would start with the fertility doctor, they may also refer you to a urologist, but my guess is the fertility people will coordinate the treatment plan. There are a few really good clinics in the NJ and NY area: Saint Barnabas, RMA, Cornell and NYU, I would go to one of those. Actually, I did go to one of those, St. Barnabas.

[Karen]

Tyler,
Welcome back! I not be great with names but I never forget an avitar, and I remember you! Good advice already given, so all I can say is it's great to hear from you and so very glad you are doing so well health-wise and life-wise! I'd go to the fertility doc, and I agree with Margaret that harvesting sperm from the testicle is an option.
Let us know how it goes and congrats on the "sonn-to-be-wife" !!!

[Scott]

It's been years since I posted here.

Believe it or not, it's been almost exactly a year. It's great to hear from you, Tyler!

[sldl1106]

Dr. J Hochman, NYU

Tyler -

I saw a doctor at NYU (I see you're from NJ) named Jospeh Hochman because I had a fibroid problem... he performed a surgery on me, was a wonderful doctor - you might want to call him. It turned out he is a reproductive endocrinologist and infertility specialist. I don't know if he deals with retro issues, but perhaps he can or can direct you in the right direction.

His phone number is 212-263-6474.

Good luck, we're rooting for you!!

[Lori]

My husband has retrograde ejaculation and we are working with a fertility clinic now. Although we did bank sperm, they talked to us in detail about the methods Margaret described in her email. There is a way, so find a clinic that will focus on you. Good Luck!

[Russell's Mom]

BC...your statements of achievment were very encouraging. Can't help but think it will just be a hop, skip and a jump, until you are successfully connected with your next goal! Thanks for sharing...appreciating those who are paving a path!! LIVESTRONG!! Sharon

[bchjetdrvr]

Hi all,

Thanks for the replies. I should have updated my control panel. I'm not in NJ anymore. Residing in New Port Richey FL (North of Tampa).

Kelley and I are going to see a fertility company in a few weeks. The frustrating part is that we're not married so were not on the same insurance plan. Her insurance carrier doesn't cover artificial insemination.

Still looking for someone that has gone through this and had kids. There's got to be somebody somewhere.

Maybe it will have to be me that posts here how this goes.

T

[LoneNutTheorist]

Hello:
My situation is different, but I say you definitely need to go to a fertility specialist as opposed to urologist. This is way above the capabilities of a urologist.

The good news/bad news here is that you will most likely bypass IUI (artificial insemination) and jump right to in vitro. An embryo would then be implanted into your girlfriend's uterus and if all goes according to plan, you'll be parents. Why good/bad? Because, fact is, in vitro is hardly ever covered by the majority of insurances. This means that there are a lot of financing options available thru a fertility specialist.

I am basing this on the fact that there are male and female factors involved here (woman over 35 and your TC and retrograde ejaculation, plus the fact you had cancer). They they are going to try to extract enough sperm to do the fertilization, and in vitro can be done with a much smaller sample.

I am basing this on my own experiences. I was stage I and had no rplnd, but my wife and I seemed like we could not get pregnant. We tried for a year and were about to go the in vitro route.

And it looks like we might have some good news to report. I'll save that for a separate thread. My goal here is to provide any information I learned thru the process of going to a fertility specialist.

In vitro without having to extract sperm from your bladder would cost in the $20K range. I don't know how much this other procedure would cost. There is a shared risk financing option where you pay more for the procedure, but if it is not successful you get your money back. I don't know all of those details, though, and it seemed a bit dodgy (although it was through the financing company).

Good luck!

Hi all,

Thanks for the replies. I should have updated my control panel. I'm not in NJ anymore. Residing in New Port Richey FL (North of Tampa).

Kelley and I are going to see a fertility company in a few weeks. The frustrating part is that we're not married so were not on the same insurance plan. Her insurance carrier doesn't cover artificial insemination.

Still looking for someone that has gone through this and had kids. There's got to be somebody somewhere.

Maybe it will have to be me that posts here how this goes.

T