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Male factor ?s

post #1 of 24
Thread Starter 
My doctor's office called today with my husbands SA results. All she said on the phone is they are abnormal and we have a referral to a clinic.

So, what can I find out about between now and getting an appointment to actually get the details of the results?

They referred us to Seattle reproductive medicine which is definitely more convenient for me but reviews online make Pacific Northwest fertility seem like a better choice. But very difficult for me to get to on work days. How do we decide where to go? Is it dumb to let schedule trump online reviews?

He's 31, I'm 31 in June, ttc since June 2011.
post #2 of 24

Abnormal is not very specific.  You would want to know exactly what is abnormal.  Count, motility, morphology?  Low count or no sperm is an issue.  Lots of sperm that aren't moving is a motility issue.  Lots of moving sperm that are abnormally shaped is a morphology issue.  If the morphology is abnormal, the sperm won't be able to conceive a healthy pregnancy.  I have seen a lot of women here have success when their partner did acupuncture and/or took supplements like FertilAid for men. 

Do the two clinics offer free consultations?  Perhaps you could check them both out and see where you feel most comfortable.  I hope they help you come up with a successful plan soon!

post #3 of 24
Thread Starter 
The person who called me said that we need to make this other appointment and they will give us the details of the results. I have no idea what is abnormal. I don't think they offer free consultations and at any rate we don't have the luxury of time off to spend going to heaps of appointments, so I was hoping to do some research so we know what questions to ask at the first appointment.
post #4 of 24

Hi Polyhmnia! I'm glad you may finally have a reason for your struggles, but sorry you having to go down this road. I believe you have a right to those results and could probably get them if you really tried. Anyways, a consult at a clinic will generally run you in the $250 range. If you have infertility insurance coverage, this visit should be covered. For us, we also live in an area where we have the privilege of "shopping around" for a fertility clinic. We started at the one my Dr. recommended and did not have a good experience. We ended up going with the second place we checked out! Best of luck!

post #5 of 24
Thread Starter 
We don't have any coverage greensad.gif but the bigger concern is that I am a teacher, and dh works in a different city and commutes via bus, so getting to appointments will be difficult. I'm not so sure we want to go down this path but I don't see that we want to give up yet, and I think we need to get the results first to know what we are working with.

Does it make sense for them to do a full work up on me too, so we have all of the info? My doctor said she wouldn't order the tests on me unless there was no problem with him but I'm hoping the clinic will be willing to do it? Summer is coming up so there is a chance of being able to do some treatments then with easier logistics, is that too soon? I have no idea how long to expect it to take to get an appt, etc. dh tried to phone Friday for an appt but their scheduling system was down so they said call back Monday.
post #6 of 24

Yes, it absolutely makes sense to get a work up on you! Any RE that I have met with or heard of will do a work up on both partners. For example, wouldn't you hate to get things sorted out with your DH only to discover many months later that you had blocked tubes? It can take a few months to get an appt. at a clinic as a new patient. Be sure to ask them to call you if they have any cancellations before your scheduled appt to call you and see if you can come in earlier! If you have regular cycles it should only be until your next AF until you can get your work up. The blood work is scheduled for cycle day 3 and an HSG is usually done around day 10 I believe. After you receive the results and your RE devises a treatment plan for you, you should be able to move forward the following cycle! The summer sounds perfect! Best of luck on what you decide!

post #7 of 24

My DH and I have dealt with male infertility.  Our clinic had openings for the initial consult rather quickly - a couple of weeks later - both DH and I had a whole range of blood tests done and because of DH's ultra low sperm count, we were scheduled in to do sperm freezings at the "big clinic" (we were being seen at a satellite clinic) and worked toward freezing enough sperm for an ivf cycle. 

 

We did the whole "fertilaid for men, countboost, and motilityboost" over the course of the summer and it was the only thing that brought my DH's numbers from zero (his first sperm assay where we were basically told no biological children) to 25 sperm (after 8 weeks on supplements). We stopped the supplements after DH had enough sperm frozen and when he gave a fresh sample this spring for our ivf after stopping the supplements 8 months before, again his sperm count was zero. Supplements take about 3 months to really do any changes, so it might not be a bad idea to start them now, before you go to your first appointment as a precautionary step.  It may make no difference, but then again it might so supplements are worth 6 months of trying in my opinion to see if things get better.

 

Getting the HSG done for me was key as well to make sure all was clear (although frankly what would it matter since they just put the fertilized embryos back in the uterus with ivf, not down at the end of the fallopian tubes, but whatever). I think the HSG is more important when IUI is done. Best of luck and I hope that what you find out when you visit with your reproductive endocrinologist will be helpful.

post #8 of 24
Thread Starter 
Can you give me some more infor about the supplements, maybe links to where to get them?

I called my doctor back Friday and asked her to mail us a copy of the results so hopefully we will have those soon too. Dh will phone Monday to the clinic. The problem with cancellations is that logistically it doesn't work, I have to put in for a day off in advance and dh needs to know the day prior so he can drive instead of take the bus to work. Isn't that stupid?

Will they do the full work up on me prior to the initial visit if we can't get an appointment for awhile? I am cd 15 today and was 26-29 days pretty regularly, then last mont was 33, so who knows. Last April I had a 31 day cycle so I'm figuring April is a weird month for me... Guess I will have dh ask that on Monday too. I absolutely agree it makes sense to do the work up on me also so I was baffled my doctor wouldn't do it. I heard if I do it through my regular doctor instead of the if clinic it has a better chance of being covers by insurance.
post #9 of 24

fertilaid for men, countboost and motility boost

http://www.fairhavenhealth.com/male-fertility.html

 

Be warned that DH said these things taste terrible (even when he is just swallowing a capsule) and there are pills to take in the a.m. and p.m.  We went with the 3 month supply the first time, then reordered another 3 months when we saw it was making a difference in DH's counts.

 

Trying to schedule RE appointments was the most annoying, because they aren't exactly easy because consults are only done during specific hours of the day at least at my clinic and the early morning is reserved for women who are cycling and need to have their ultrasounds for follicle counts done.  How insurance pays all depends on how they code.  You may want to check into your insurance about what codes would be covered and which won't. Be prepared for the insurance person to be clueless about male infertility.  Duh, it takes both sperm and egg to make a baby.  Without sperm, doesn't matter what you do, nothing will happen.  The insurance people were all like "oh, it just the woman's problem."  Um, no.  Both the woman and the man have to have everything working well to get pregnant.  I am still amazed at the miracle of pregnancy and how anyone ever does get pregnant.

post #10 of 24
Thread Starter 
My insurance said they don't cover any infertility... The clinic will apparently submit it but we figure it will be denied.

We got his results in the mail today. These are the things that were circled as abnormal, the other things were all within normal ranges, but holy hell it seems like a lot of things wrong greensad.gif don't know how interconnected they may be??

Volume 1.4 ml
Concentration 5 million per ml (normal above 15)
Motility 15%(normal above 40)
Forward progression 2 (normal 3-4)
Morphology 0 ( normal above 4)
WBC 1million/ml (normal less than 1)

So... The morphology is scaring me? But I am feeling relief that at least there is something there?? Going to go look for those supplements next, he had a busy day at work and didn't get to phone for the appt but will try tomorrow.
post #11 of 24
Thread Starter 
We have an appt Monday morning!

I would love any resoueces or books to read in advance so we can be prepared with. Questions & get all necessary information...
post #12 of 24

Try these

http://www.asrm.org/Sperm_Shape_Morphology_factsheet/

 

http://www.mayoclinic.com/health/male-infertility/DS01038/DSECTION=tests-and-diagnosis

 

http://www.aia-zavos.com/strict_sperm_morphology.html

 

You have 5 million to work with so that is a definite good thing.  With that many sperm I would think you would have at least a few that are normal morphology (the sperm analysis only looks at a portion of the sample, not every sperm in the sample). There are ways to use just a few sperm like Intracytoplasmic sperm in jection with IVF.  I think I have even seen some women do IVF with that many sperm, once the other numbers were up some. 

 

http://www.mayoclinic.com/health/sperm-morphology/AN01305 - this website talks about the wait and see approach with sperm. This is because sperm take so long to mature that the ones you are seeing now were created several months ago. 

post #13 of 24

Yes, Hi I'd like too hear about you appointment too. Lilacvioletiris gave some good websites. My husband  has .6 as the count and 1 for progression and motility is 1 but his morphology is 10. We did manage  through ICSI to fertilize several eggs and have a son born 2 years ago.!!!!

post #14 of 24
Thread Starter 
Appt details (copied from the ONE thread)
Appt this morning seemed singularly unhelpful, although we really liked the doctor (and he has very good ratings, is highly recommended and lots of experience). He wants dh to redo the semen analysis (which the doc kept saying semenalysis, is that a thing?) and have the lab be more specific about a couple of things,namely white blood cells and specifics about morphology. He wasn't really interested in talking to us about treatment options yet, wants more info first. I'm a little bummed cause I wanted to talk logistics of ivf so we can start discussing, preparing, thinking, whatever...

He did confirm that unless further tests improve we are looking at ivf instead of iui so I guess we know something, said he likes 5 mil motile sperm to do iui and we don't have that. Dh had 1.4ml of 5 mil/ml, with only 14% motile. He also agreed that dh's sleep medicine isn't an issue which is a relief to me as dh thought he might go off it, which I think is silly as he's a grouch when he doesn't sleep. Lastly he suggested vitamin e supplements but nothing else, said fertile aid, etc are a waste of money. Think we might try that anyway though.

but I also didn't get a sense of urgency from him and I think that is disconcerting. I know we aren't "old" but 31 seems older to me especially since we'd ideally like 2-3 kids, and needing to do treatments to get them will take more time and money...
post #15 of 24
Polyhymnia, that sounds a lot like the first appointment we had with our urologist. Understandable about the repeat sperm assay since things can be different from on assay to the next. Our doctor had said too that the fertilaid was a waste, but given my experience where when DH wasn't taking it he had NO sperm to when he was taking it he had 25 sperm, it was worth the money for a biological child. Thankfully you have some sperm to begin with even if it is a few, so ivf is doable even if you need icsi to make fertilization a possibility.
post #16 of 24
Thread Starter 
Thanks. I am going to order up some fertile aid. A friend of mine, her husband had a low count and they switched to a paleo/primal type diet, and then they got their daughter. Then when they tried for another they got pregnant really quickly too.

I don't know if that's worth trying that since he has the motility and morphology issues too?

Our clinic's local office only does the semen analysis on Tuesdays so he is going in next week.
post #17 of 24
So many things can affect sperm count and you have to remember that it is what happened to DH 3 months ago that is affecting the sperm of today. Hope the sperm assay next week yields some better results.
post #18 of 24
Thread Starter 
Yeah, I'm not optimistic because its less than a month different and clearly something is wrong or we'd be regnant by now! But I'm hoping this doctor gets the specifics he wants.
post #19 of 24
Their office might do a more indepth semen analysis since you said it was at a clinic. Hopefully they find the info that can help you both the most and then create a plan for further action. As I have travelled through male infertility with my dh, there were lots of sit and wait periods, things never progressed quickly until the month of our IVF then everything happenedso fast.
post #20 of 24
Thread Starter 
Thanks for sharing your experience. I was hoping we could do ivf in aug, since I teach...
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