Laparascopic Varicocelectomy

The most common cause of male infertility is low sperm count. This maybe attributed by so many factor but with my DH's case it is because of his oligoasthenospermia brought about by his varicocele on his left testicle. Oligoasthenospermia according to my friend google is a condition whereby there is a reduced sperm motility (Asthenozoospermia) and low spermatozoon count (Oligozoospermia). 

Back in the Philippines, he underwent several testiscular ultrasound with doppler study to check on his varicocele. I remember his first ultrasound where it says he has bilateral varicocele. Imagine how devastated we are during that time, especially of course my DH. Starting our TTC journey with no knowledge whatsoever with infertility adds up to so many questions of why and how all mixed up in our minds causing us to be emotionally and mentally drained, not to mention financially drain. Oh, I still feel all the emotional pain we went through but at least I can say now that "I remember those times" and that is already part of our past.

The first time he met his first urologist in 2009, he was advised to get rid of his varicocele to give more chances for us to conceive. His count at that time is over a million but not over 5 million. There was even a time/s it went down the million count. From what I understand, he has to have over 10 million sperm count or more to have a good number. Thus, we went on a second opinion, and the ultrasound came out the same way as the first only that the left testis has varicocele. We were then again advised to go on varicocelectomy to open the blockage on his testicle. At least 3-4 urologist told us to consider said procedure.

The procedure back then is an open surgery and it will cost us Php100,000.00, more or less. We do not have a problem with the cost, we know can do something to get through it. We can always borrow the money or we know our parents will help us but the problem is, all of the urologists told us that there is no 100% assurance that DH count and motility will improve and worst, it can even re-occur. Thus, we decided not to go through with it. We stand by our faith that God will provide no matter how difficult it is to accept our fate with this infertility issues that we have.

Then came this greatest twist in our lives when we landed in the first world country where healthcard is so overwhelming unlimited. On my previous post, I have indicated there that my husband will finally have his varicocelectomy and he did. He underwent laparascopic varicocelectomy last 17 January 2017. So, what is laparoscopic varicocelectomy? Below is the explanation where I get from this Link, and I quote:

"Laparoscopic varicocelectomy is one of three main treatment options for varicoceles. The other two options are varicocele embolization (non-invasive) and traditional varicocelectomy (open surgery). Laparoscopic varicocele surgery is very similar to open surgery but is less invasive. It is a relatively new procedure often used as an alternative to testicular varicocele surgery with varicolectomy. Men with varicoceles associated with significant pain or those who have fertility problems often seek treatment.

A varicocele is a varicose vein in the scrotum. It occurs when the one-way valves, which are designed to allow vein flow from the scrotum and testicles to go back to the heart, do not work properly. If these valves fail to work properly, the blood pools inside the vessels, causing enlargement of the veins. Varicocele symptoms include swelling, pain, and infertility. A varicocele causes lower sperm count and poorer quality sperm and thus may cause infertility. Damage from a varicocele can also make the testicles soften and shrink. If a varicocele is causing neither pain nor infertility, then medical treatment is not always necessary. In fact, the majority of varicocele cases results in little to no symptoms at all.

Laparoscopic varicocelectomy is performed by surgeons who specialize in urologic surgery. The patient is put under general anesthesia while three surgical cuts, each approximately 5 millimeters in length, are made in the patient’s abdomen. Using tools inserted though these small incisions, including a tool to magnify the area, the surgeon can sever the enlarged veins from the healthy ones. Then veins that direct blood into an already enlarged varicocele can be tied off so that the varicocele will eventually disappear.

During a traditional varicocelectomy, one long incision is made near the top of the penis. Advantages of laparoscopy over this type of open surgery include a lower risk of damage to vital testicular arteries and reduced post-operative pain. A laparoscopic varicocelectomy procedure takes no longer than 45 minutes. Patients typically need to stay home for up to three days after the procedure in order to recover. They may experience bruising and pain where incisions were made. However, complications from laparoscopic varicocelectomy are rare. Patients usually see improvements in sperm count, sperm quality, and overall fertility within 3 months of undergoing testicular varicocele surgery. x x x"

I have not got the chance to witness the procedure but based on my DH's cuts and from what google shows below is how it looks like:

Yep, DH has 3 small cuts on his abdomen. It was not sewed like a regular surgery but there is this tape like thing on it making the cut meet into the center. It has to stay there for days until the cut closes. Thus, basing on the picture above and DH's cuts, I'm guessing that below is most likely how the procedure went:

The surgery, as per DH's urologist is a 10-15 minutes procedure and it is an out-patient one. The only thing why it took us hours in the hospital is because he underwent a general anesthesia thereby having more hours for DH to recover. On the "laser surgery" thing. I honestly do not know how they put the laser repair on it via the laparascopic varicocelectomy. Below is DH on his private bed after he went out from the recovery room. The procedure was his first. First on dextrose, anesthesia, surgery and lying there in the hospital bed all for his sole dream of becoming father to our little R. So sweet and I am so proud of him. He sometimes openly talks his own infertility problem with some of our friends. Other men don't do it because of pride but my DH fully accepts his flaws and tries everything he can to overcome infertility through God's grace.

In my entire waiting of DH's surgery, I was teary eyed, especially when I saw him coming from the surgery wing where I was not allowed to go there and was told to wait at the waiting area. I was even thinking what if they will not bring back my DH to me, LOL, perks of watching horror and thriller movies. But then again, there he is. Groggy but conscious and his varicocele already repaired and gearing up to recovery. Thinking of it makes me really happy and every time I utter the word "thank you Lord", I am really in tears. I cannot hide the happiness. If only you know where all my tears of joy is coming then you'll know why I am so very emotional with all the blessings my DH and I are receiving from up above.

Adding to the happiness is that the procedure he underwent through is all covered by our NB healthcard. My DH and I literally went inside the hospital, showed his healthcard, had the general anesthesia and surgery, stayed there for half a day and went out with no fees at all. Only a taxi fare going home. It was then I realized that we are indeed in the maple leaf country because honestly until now I can still not believe that we are in Canada. Our decision to come here is the best that we can offer to our little R. We may have leaved our loved ones back home, where they all understand why, but it is for the best for the two of us just thinking that we are no farther from becoming parents in God's most precious perfect time. 

Dear Father God, thank you can never be enough for everything that has been going through with our infertility ordeal, for all Your guidance and help. We are forever grateful. I remember those days when we almost gave up but through it all You never let go of our hands. You've always been there for us. You've seen us at our lowest point, our pains, our agonies, all our cries and the little joys we had for little improvements in our TTC. Thank you dear Father God for always, always being there. Thy will be done Father according to Your will. We know and we believe that You put us here for a reason and that reason is our little R.

Officially on Workup

Hello TTC World.

It has been a very long time since I posted in here. We made it here in the maple leaf country. The reason for moving here is discussed on my last post and I am happy to share that we finally landed here in Fredericton, New Brunswick (a maritime province of Canada) on 3 May 2016 after less than a year of waiting for our application for permanent residency to be approved.

I waited for everything to be in order before finally deciding to blog again. Why? Because in here, we cannot just go in an OBs clinic and tell the doctor we are infertile and we want to do workup. No. We need to have a family doctor first then said doctor will endorse us to a specialist, an OB and urologist for our case. We only found a family doctor on the 20th of September 2016 after more than 4 months of landing.

I bought with me all our lab tests, results, etc. of our workups from the Philippines but our family doctor wanted to check on us their way. She does not like to refer us instantly to a specialist because she wanted to check on us first before ruling out that we are an infertile couple. We are really back to zero in all our infertility workups. Read on my other blog post regarding our Meeting The Family Doctor.

During that time when we meet our family doctor, I am already a month delayed. At first, I ignored it because I know I have PCOS so sometimes, but not often because I regularly do my exercise (my medicine for PCOS), I have irregularities on my cycle but last year was a different story. However, I did a blood test to check if I am pregnant and it comes out negative. Oh well, the usual negative sign.

We did a blood lab tests on my part plus the Beta HCG and sperm analysis for my husband and the results are posted below. What I like in here is that all the tests that we did are all free and covered by New Brunswick healthcard. What I don't like is the additional waiting game for the doctor/s. We already received our tests but no one can explain us what the results says. Adding to the dilemma is that the family doctor went on vacation and I was scheduled to meet her again only on the 29th of October 2016. See, a very big difference from the day we first met. At that time, I am already on panic and paranoia mode because AF is nowhere to be found. It was the longest time AF did not visit me and adding to the emotions I am feeling that time were the twinges and unusual physical activities within me. Of course, we were also so excited about it. Who does not want to get pregnant naturally and unexpectedly? So, I was growing impatient about it and was calling our family doctor's secretary to ask what we should do next. What she did is to just schedule me on the 29th of October, amp.

Then came the next check up. You know what our family doctor just told us after waiting for more than a month, "I will refer you both now to a specialist but you will have to wait for them to call you." We are in queue once again for our respective specialists, amp. I told our doctor that I am already delayed and I wanted to at least have an ultrasound. Why ultrasound? Because I tested my urine test and it also comes negative and I have read through google that some women can be pregnant even if they tested negative on their blood and urine tests through ultrasound result. Sad thing is that our family doctor rejected my request. She told me she is not a specialist and she cannot do ultrasound. Oh my goodness, she can do pap smear and I have read that she do also labor thing but she cannot do ultrasound or at least request it for me, amp. The feeling of anxiety during that time is at its highest level. I just literally cried at the clinic and can't do anything. I am really a cry baby especially when it comes to TTC, I don't know but the tears just rolled on my cheeks. But that helps because I win the heart of our family doctor. She even hug and comforted me and told me, she'll personally ask the OB to see on my papers. The family doctor just instructed me to do a Beta HCG once again but then again it comes out negative and I am down to 3 months without a no show AF. 

Afterward, I received a letter from the hospital with an instruction from my OB on the 23rd of November 2016. At first I was really so happy because I finally have an OB but still I cannot face her yet. She instructed me to do another blood test on the 5th of December 2016. I am now delayed for 4 months. During those times, I am so bloated and gained so much weight. I just really cannot help myself so I really feel so down. I even stop believing I am pregnant and I just wanted for AF to come because it makes me paranoid when it is not showing up. I even thought maybe I am now on menopause at a very young age. I am so sad really on the waiting game. I just cry to God all night begging for AF to come. Huh, TTC is really a pain in the heart. It will eat you emotionally.

So, I did the needle work again for the 4th time here in Fredericton but I have not met yet my OB face to face. In the Philippines, I can always schedule and visit my OB RE anytime I want. In here, amp. Anyway, my OB is not an infertility specialist based on my research. The specialists are in Moncton, New Brunswick (worst case scenario, we will do IVF here). A 3-4 hours drive from where we live. Then again, I am thankful I still have an OB. I waited for 8 years and there is no way infertility will come depressing me again and again and again. Never again. I need to pick up the pieces of me and see on the bright side. I do not want my infertility to eat me again. Then the answered prayer came. I finally had a talked with my OB over the phone on the 13th of December 2016. She told me the results of my blood lab tests. I actually have a thyroid hormonal imbalance. What??? As in what??? Yes, because in the Philippines it was ruled out that I have no problem with my thyroid. I actually told all my OBs that my parents thought I have a goiter when I was younger. I have read that having one will add up to infertility so I asked all my OBs to check on it. I even had a doppler ultrasound on my thyroid and they all rule out that my thyroid is okay. Oh well, another case to me being infertile. Thus, my OB told me to pick up my medicine prescribed to me on a drug mart of my choice then after 6 weeks I will do my lab tests again. How cute my medicine is. This is refillable 3 times only and it has 90 tablets on it.

I finally can breathe now. I know now I am not pregnant although AF is still a no show but at least I know I am safe, my little R is safe. I can now also do my exercises. I quit doing it for fear that I am pregnant and will have miscarriage, but now, I can now help myself, my PCOS, by doing exercises again. I feel so bloated. I gained so much weight from 55 kgs. to 62 kgs. I feel so ... ah, I just do not want TTC to overpower me again physically, mentally and most of all emotionally. I just wanted to see the bright side of us moving here, doing our TTC once again less the financial burden of being infertile. Why? Because with all the tests that we all have for the past months, all of which are free and covered by our NB healthcard. Also, the infertility drug that I am taking now, 80% of which is covered by our medical card from our company where my husband and I are both working. 

Financially, we are now okay because of Canada's health insurances and this is the reason why we migrated after all. The help we can get from the government is just overwhelming. Like in the case of my husband, who already meet his urologist back in November 2016. He was in fact scheduled for a surgery on his varicocele supposedly after Christmas but failed to go for another lab test so the surgery were moved this year. He is now scheduled for surgery tomorrow, 17 January 2017.

Just a backgrounder, my husband have a varicocele which is causing his infertility. Back in the Philippines, we were quoted by 2 urologist of Php100,000.00 for his varicocelectomy. The procedure is an open surgery and there is no assurance of the cure of his varicocele so he needs to be admitted in the hospital. We decided not to go with it because first it is very expensive for us and the assurance is not promising. The great news is that my husband can now do the surgery because the procedure is free and is all covered by his NB healthcard. It is not an open surgery but the urologist will use a laser procedure for the repair of his varicocele through his stomach. It is a 20-30 minutes procedure and he was advised to go home after the surgery. He can actually work after because his work here is very light and he is only sitting but we decided that he go on leave after his varicocelectomy so he can rest well. I am not yet aware of the procedure but I'll keep you posted about.

We actually have so many schedules this year for our workups. Tomorrow is the big day for my husband. We are really excited about it and at the same time very positive that everything will fall into places. We are also scheduled for our respective blood lab tests on 24 January for him and 25 January for me. I also received a call from my OBs clinic that I am finally meeting her in her clinic on the 2nd of February and I am scheduled for a pelvic ultrasound on the 24th of March. Oh, and I forgot to tell that AF finally came last 3 January 2017 after being on hiatus for 150 days. I am so happy it finally showed up.  

See, that is the bright side of our infertility journey. Everything is going smoothly now. We cannot really thank Father God enough for everything He is blessing us right now. God is really so good. He will really make a way just like when He put us here in the maple leaf country. I am in tears once again while writing this because after all the pain caused about by infertility, God never abandoned us. He was always there for us despite the agony, tears and pain. The waiting is really a pain in the heart but for as long as we keep on believing and we keep our faith, we know that in God's most precious perfect time, all of these pain will go away when our little R comes.  A little more our little R. A little more.