TCC: Male infertility and IUI questions. Advice/experience appreciated!!

posted 3 weeks ago in TTC
Post # 2
Member
367 posts
Helper bee
  • Wedding: November 2013

My Darling Husband and I did IUI with male factor infertility.  We have similar scenarios, Darling Husband is a little overweight, smokes on occasion and could improve his diet some.  I am a normal weight and have pretty good overall health and diet.  We are currently 36 (me) and 40 (DH).  Last year we were worked up for infertility after trying over a year to conceive our second child.  DH’s sperm count was only 4mil for all the samples we tested.  I don’t remember the other stats, but I believe his morphology and motility was OK.  He also produced small samples.  Our doctor was on the fence about us doing IUI because his counts were so low, but we started at the infertility clinic wanting to try IUI and were not ready to commit to IVF.  We had one failed IUI with a washing and decided our money was better spent on IVF as the success rate of IUI isn’t very high. 

We ended up moving on to IVF and doing ICSI and getting one good embryo which successfully transfered. 

I hope IUI works for you guys.  My boss successfully conceived twice with IUI so it is possible. 

Post # 3
Member
1989 posts
Buzzing bee

First of all, it depends on how bad the sperm analysis results are whether its really worth trying IUI. We did three rounds of IUI because my husband’s results were sort of close to normal but it did not work for us.  I think IUI actually works better when the infertility is on the female end and they can induce and monitor ovulation and then time the sperm just right but people try it for male factor too.  On all three rounds I did some form of medication as well to boost ovulation and ovulate multiple eggs to give the sperm more chances. This was optional but given that it had been over a year with no sperm inseminating any eggs we gave it a go, risking a multiples pregnancy.

“Washing” the sperm is a process where they can weed out some of the bad sperm and concentrate a sample of the best sperm to use.  They also take out most of the fluid and leave just the sperm.

We took breaks in between cycles due to travel and need to mentally have a break but you could keep going back to back months.  I think if it works for you that bodes well that it could work again for another child in the future.  I know a couple that used iui successfully for two children.  

For us, and I think most couples, my husband would show up in the morning at the clinic to give a sperm sample.  The clinic would wash it and grade it and I would show up a couple of hours later for insemination.  I think the first one or two my husband came back with me for the insemination but for at least the last one he just went onto work because its kind of like getting a pap smear and its over pretty quickly. 

I have a six month old now from IVF. 

Post # 5
Member
1294 posts
Bumble bee
  • Wedding: August 2017

skylar84 :  I recommend it Starts With The Egg book as there is a section on male factor infertility. It’s grest your husband is quitting smoking (smoking definitely affects semen), and is on board with some diet changes. He can also take supplements (outlined in the book). Washing essentially weeds out all the abnormal or not swimming sperm. If his counts are low, I would think you would probably be a good candidate for clomid or Femara to induce you to hopefully ovulate more than one egg (improves your chances of success). You can do back to back cycles. 

The optimal range for tsh is 1-2.5, if you are higher than that it could definitely contribute to infertility 

Post # 6
Member
222 posts
Helper bee
  • Wedding: August 2014

I did IUI and it resulted in my son. I’m hoping it will work again for a second child. 

We had issues with male factor infertility, and the sample we used was actually a very low count, but our first round worked. I don’t know the details beyond the count though. 

IUI success depends on both of your fertility, age, etc. I’ve heard anything from 5% to 20% chance per cycle, but then fertility stuff works weirdly and somehow the cumulative chances increase, but if it hasn’t worked in 3-4 cycles then it probably won’t (similar to taking >1 year to conceive normally). You can do back to back cycles. I have never heard that the first round usually doesn’t work, it did for me and at least one other person I know who did IUI and had twins.

I did my cycle unmedicated. I think they try to do minimal intervention whenever possible, but they might suggest some medications for you if you are dealing with poor sperm quality, more eggs might increase your chances. But they want to avoid the risk of multiples, so if the woman is ovulating then they might leave it, or trigger ovulation to maximize timing. The chances of a healthy full term pregnancy go down with twins +, which some of the drugs can make more likely or much more likely, depending.

Every clinic seems to do their own thing, but I have heard things like back to back inseminations (doing two inseminations around ovulation) or combining samples to increase chances. I didn’t do either of these. 

The day of, they typically get the sample from your husband, process it (sperm washing – this removes excess fluid, dead or poor mobility sperm, so that only healthy, mobile ones remain. Increases chances for all by reducing obstruction of bad ones), then you come back a couple hours later, they pop a tiny catheter up into your uterus, insert the sperm, may or may not tell you to stay lying down for 10-15 min, then you go on with your day. My clinic did a progesterone test a week later to confirm ovulation, then a pregnancy blood test 2 weeks later. 

Post # 7
Member
1989 posts
Buzzing bee

You might want to ask your doctor about pricing v IVF.  Iui is much cheaper for one round but if you do 3-5 it starts to add up to IVF costs.  Also ask the minimum parameters for the sperm they like to see to do an iui, like mine was 10 mil motile sperm preferred.  Ask about what they think about chance of success for iui v IVF.  Also ask about what other testing and procedures you need for IVF, once we wanted to do IVF it took several more months to get through an hsg, another appointment, injection training, etc.

My Husband is not overweight, never smoked, doesn’t drink coffee, hardly drinks alcohol, he does have low testosterone but it wasn’t diagnosed until we were ttc.  Seems like sometimes it’s just genetics, nothing you can do.  We did try having my husband take clomid.  It didn’t work for us but works for some people to improve sperm parameters.

Post # 11
Member
222 posts
Helper bee
  • Wedding: August 2014

skylar84 :  i don’t know for sure because we didn’t do that, but based on how long it takes some meds to clear and the recommendations for zika to avoid ttc for 3 months now, I would guess about 3 months? That being my estimate of how long it might take sperm to ‘turn over’ and be a fully more healthy new batch?

Post # 12
Member
7184 posts
Busy Beekeeper

skylar84 :  we had male factor infertility and our doctors recommended skipping IUI and going straight to IVF. I didn’t listen to them, tried the IUI anyways, and was pretty gutted when it didn’t work. IVF was the ticket for us and we have a daughter and 3 frozen embryos.

One of my husband’s issues is retrograde ejaculation. It’s when the valve to the bladder doesn’t fully close and so half of his sample was ending up in his bladder! He does still ejaculate but it is less than other guys I’ve been with so I suspected something might be up. You said your husband’s sample was small so it’s something to consider. He doesn’t have any of the common conditions that would cause this issue, but they did a post-ejaculate urine analysis and found it full of sperm! We didn’t end up needing it, but they were able to extract the sperm from his urine so that we had some back-up in case his sample on the day of my IVF retrieval wasn’t ideal. 

Post # 13
Member
248 posts
Helper bee
  • Wedding: October 2019

The sperm development cycle is 2.5 to 3 months or around 74 days. So while “new” sperm can be ready in a few hours they arnt new. If he is agreeable I’d have him work on his healthy, no smoking, supplements, good diet ect for several months before testing again to ensure the sperm used to create your baby is as healthy as possible.

Zinc and selenium or also important supplements for healthy sperm.

Post # 14
Member
1294 posts
Bumble bee
  • Wedding: August 2017

skylar84 :  agreed, I’d give it 3 months for vitamin changes

Post # 15
Member
673 posts
Busy bee

Did you get a DNA fragmentation test done on his sperm? We are facing similar issues and just had a failed IVF round. I’m now finding out that high percentage of fragmentation in sperm can make odds of success low even with IVF with ICSI. 

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