Siblings, male and female, both diagnosed with infertility

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howzats
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Siblings, male and female, both diagnosed with infertility

Post by howzats » Tue Jan 02, 2018 9:36 pm

Hope you can help. Haven't been able to find anything on this topic. 2 sibs:- sib (2) F 31, husband 33, diagnosed with "unexplained infertility" 2 yrs ago after TTC for 12 months. All preliminary tests within normal range; Female, AMH, FSH, LH, Serum Progesterone, Hysteroscopy. Husband SA results described as "fine". RE did not suggest HSG or any exploratory measures as concluded unlikely PCOS, ovulation is occurring, cycle slightly longer, ovaries polycystic in appearance but no other symptoms. Healthy BMI. Chlomid or injectables with IUI not suggested? RE also said unlikely any endo or lining irregularities so straight to a fresh IVF cycle? Question how they conclude this based on lack of symptoms alone? Poor response due to RE concerns about OHSS so full stim was not administered, (1 fertilised egg from 4 made it to blast and transferred, failed at day 19). Sibing (1) 33, elder brother of Sibling (2) recently diagnosed with NOA (Sertoli only). Looks to be idiopathic, No sexual abnormality. Testosterone in the lower of normal range. Slightly elevated FSH, Y chromosome tested OK. Negative for Klinefelters and CF, mTESE failed. Could there be some connection, something the doctor's are missing? Should there more emphasis on looking further into genetics. These 2 siblings were born 1 yr apart to parents who were in early 20's at the time of their birth. Father's only sibling (F) no children, difficulties, 1 chemical at 39yrs. Paternal g'father's only sister unable to conceive. Paternal g'mother, difficulties in conceiving. Nothing of note on maternal side. Maternal g'mother conceived easily, first child at 39, 2nd at 40. As a family, it is devastating as the male sibling diagnosis came very recently after seeing female sibling struggling to conceive for 3 yrs. Can this be more than coincidence? Also is it ever worth it to do another mTESE after some drug therapy? Hope terminology is understandable as not as familiar with fertility language. Suggestions, repeat tests, further tests, second opinions?

Dr. Wisot
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Re: Siblings, male and female, both diagnosed with infertility

Post by Dr. Wisot » Wed Jan 03, 2018 9:36 am

I doubt that yours and your brother's problems are related or genetic.

For you with all your tests normal and at your age I would be trying a few cycle of clomiphene or injectables with IUI before returning to IVF. If you do need IVF you can almost eliminate any concern about hyperstimulation by using an antagonist protocol with Lupron trigger.

For your brother, a urologist who specializes in fertility could give you the best opinion on whether TESE is really possible.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

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