What now? Abnormal Semen Analysis

posted 1 year ago in TTC
Post # 2
Member
3875 posts
Honey bee
  • Wedding: October 2013

My husband has male factor infertility causing us to need IVF. At his first urologist appt they did a repeat sperm analysis (I guess each sample can vary so they don’t rely on just one). They also did a testicular ultrasound to try to find a cause for his low numbers. They did and he was diagnosed with varicoceles (like varicose veins in testicals), which is sometimes treatable. We didn’t have success even after vein removal. We successfully did IVF with ICSI for my daughter, and then somehow got pregnant naturally with baby number 2 and I’m 20 weeks pregnant! Take it one step at a time and see what the next tests say. I know for my husband, and for most men, it’s a huge blow to their confidence to find out there’s a problem with their sperm, so he may need some time to process the information. Best of luck to you! 

Post # 4
Member
2156 posts
Buzzing bee
  • Wedding: August 2014

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katie62018 :  I’m really sorry you had that experience! Was this a reproductive urologist? If not, i might consider a second opinion because it sounds like this doctor was not used to dealing with infertility issues.  

If you are going to pursue treatment, I would absolutely move on to an RE. An Obgyn is not trained to *get* you pregnant, that is an RE’s job. I’ve seen a lot of people in other infertility groups get really bad advice from an OB. 

As to whether you can get pregnant without intervention – it might be possible! But, the person best equipped to answer that question is an RE. If I were in your shoes, whether I aggressively pursued fertility would depend on age and how long I’ve been trying. We moved to the RE fairly quickly in our infertility journey – our first infertility appointment was less than a year after we started trying. I felt strongly that tme was not on our side although I was only 32 at the time. Almost 3 years later, still not pregnant so I absolutely do not regret moving to that step as quickly as we did but obviously that’s a very limited view. 

If I were you, I’d recommend at least a consultation with an RE. See what they say about the abnormal sperm analysis. Maybe they will recommend a second appointment with a infertility urologist. If you aren’t ready for treatment yet, then take your time. But at least if you meet with the dr, you may get some better answers. 

Post # 5
Member
8986 posts
Buzzing Beekeeper

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katie62018 :  get to an RE and don’t bother with an OB for fertility issues. The RE should have a urologist they work with that can help you too. My husband has a varicocele and retrograde ejaculation and we had our daughter via IVF with ICSI. They can do amazing things – we lucked out that the day of my retrieval my husband got a good sample but we had some frozen sperm that they extracted from his urine as a back up. Seriously science is wild! We actually got pregnant naturally after her but it ended in miscarriage. 

Post # 6
Member
2684 posts
Sugar bee

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katie62018 :  definitely get to an RE and don’t pursue any fertility stuff with an OB at this point. They aren’t equipped for most issues. As for the urologist, I would be stumped too. I’m not sure what that all means but I would just have a consult with an RE, where they can further explain the meaning behind things and also give you information on your options. I’m guessing the recommended route to a child will be IVF with ICSI. 

My husband has a diagnosis of azoospermia, in other terms no sperm. It was a blow but we came up with a plan of donor sperm and we are on our third cycle of IUI. 

Post # 7
Member
675 posts
Busy bee

Are there andrologists in the US? The urologist we worked with was horrible, but the andrologist suggested certian things for us to do.

Post # 8
Member
2370 posts
Buzzing bee
  • Wedding: August 2017

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katie62018 :  normal semen morphology is >4%, so 3% isn’t that far from normal. There are vitamins that he can take if you get a copy of the book It Starts with the Egg.

Post # 9
Member
467 posts
Helper bee

My husband has low morphology. It was 2% and a few months later it was 3%. We did conceive naturally a few months after he started making lifestyle changes. Lots of supplements,  better diet,  less alcohol and wearing snowballs underwear. Unfortunately it was an ectopic so we have moved onto ivf. My clinic feel the low morphology isnt really an issue but I see many clinics recommend icsi. But it can be improved. 

Post # 10
Member
765 posts
Busy bee

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katie62018 :  There is hope. I am in the same boat. Dh has less than 1% morphology so your numbers are great by comparison! As others have said, go see an RE. OBs really don’t know that much about fertility and are really useless in this scenario. I am not a doctor but based on my own experience, as we are going through this right now, you may need IVF with ICSI to conceive with low morphology. IUIs may not be successful for you (they were not for me), but everyone is different. You can try taking certain supplements (Dh has taken Proxeed) however this did not improve his morphology. There is very little research out there on how those numbers can improve. I had a previous RE tell me it’s hopeless with low morphology. I left that RE and am now working with one who says all you need is one good sperm per egg. For many women in IVF that’s less than 15. So although it is overwhelming and invasive, IVF with ICSI is most likely your best shot. 

Post # 11
Member
2180 posts
Buzzing bee

Sorry that urologist wasn’t helpful. Depending on how long it’s been, I’d definitely do a repeat SA. DH had a reading of less than 1% normal on his first test and when we retested 2 months later he had 9% normal and a high enough count they weren’t concerned.

We ultimately pursued IVF for other reasons, but 2 of the 3 REs I talked too weren’t terribly worried about morphology since his count wasn’t also low — even if it stayed at <1%. 

In your shoes, I’d definitely see an RE, even if you’re not looking towards treatment now. By the time you’re doing testing, it’s best to see someone who specializes in fertility. Your OB’s job is to deliver healthy babies; getting people pregnant isn’t really their field of study. I’d recommend meeting with a few to make sure you’re with a doctor who is a good fit for you.

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