We had massively failed SAs, more than once. They seemed to get worse, not better even after loading DP up on supplements, etc and seeing a reproductive urologist. We were also told that IVF with ICSI was our only option. And then almost died at the cost. And then did some more research. We decided against it in the end for a multitude of reasons, but the primary ones being the toxic load for me of all the drugs and the extremely high likelyhood that any sons we conceived would have to deal with infertility as well. I was also concerned about what we would do with the potentially large number of "left over" embryos.
There is a clinic in Montreal, affiliated with McGill that does unstimulated IVF cycles, which would address a lot of the toxicity and "left over" issues for you, if that's something you're concerned about. If I remember correctly, the price is also a bit lower. It's called IVM (In Vitro Maturation).
We did have DP tested up the wazoo looking for the "why" of the crappy SA, including genetic testing (carriers of CF are often infertile, and some defects with the XY chromosomes can be virtually without effect until you get to the fertility side of things). Nothing.
We looked in to embryo adoption, and actually found a family on MDC who were willing/eager to give us some of their left over embryos. In the end though, we were dealing with the same drug load as for IVF, and high travel costs, and it just didn't feel completely "right".
In the end, we wound up using donor sperm. First from a sperm bank (2 failed cycles), and then a known donor. We've done three cycles with the known donor, and have a 21 month old and a to-be-born in December babe. It was absolutely the BEST decision we could have made, and we were so, so blessed by wonderful friends who wanted to help us out in this incredible way.
BUT, it took DP more than a YEAR to come to a place where using donor sperm was a good thing (or even an option!) for him. It was hell. I really recommend getting some counselling. Read as much as you can. There's a book called "Lethal Secrets" about donor conception. It's a bit dated, but it's a good read anyway. Read the blogs written by the angry donor conceived children (now grown) who would rather not exist than have been donor conceived. Read DI Dad's blog (
http://di-dad.blogspot.com/). His older stuff is more relevant, so dig in to the archives.
And, brace yourself. You are now no longer a "real" member of the infertility community. *You* don't have the problem, so you are often not going to be accepted completely. You are going to have to deal with "You should adopt, it's more ethical!" If you use a donor, there is a whole new level of stigma involved. I find that couples who need to use IVF are typically empathized with, or even pitied, but rarely are they told they are immoral in comparison with couples who use donors.
It's still a decision I would make again. We're nothing but satisfied and at peace with our decision and feel moderately confident that our kids will be well adjusted, happy, normal people. You just have to go in with your eyes open.
Anyway. There are a lot of things you can try to improve SA numbers, and the supplementation regimes are easy enough to dig out. Look into varicocele detection/repair, as that has really beneficial effects for many men. You don't have to rush in to anything. Hang in there. There's always a solution, and you'll find the right one for your family.
