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Trying to conceive with low sperm count

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Hello, I am a 29 year old female. My husband and I have been trying to conceive for just about a year. My husband is 35 years old. We went to a fertility specialist in our area who ran several tests on both my husband and I. All of my tests were normal but my husband was diagnosed with low sperm count. His first count taken was 1mil (taken Nov.4) and his second was 8million (taken nov 29.) In both cases, his motility was low, the shape count (I don't know the medical name for this) was low, and his volume was high. On his own he started taking vitamins and we attributed the jump in his sperm count to the vitamins. However, when we visited the specialist he stated that he was not convinced vitamins really help one way of the other.

We were expecting to hear that he had some ideas on treatment for my husband such as a fertility medicine such as Clomin but he stated that he does not treat males and he does not see benefit in that. His recommendation was to go straight to IVF. As a female under the age of 35 who is perfectly healthy I thought this was rather jumping the gun also considering my husband had such a jump in his sperm count. It is also important to note that my husband and I are both active healthy individuals whom have no other medical problems. We are very interested in your advice and expertise as to whether we should get a second opinion or to go ahead with the IVF. I should also say that the doctors suggested we could try IUI but that conceiving would be unlikely. Can men be on medicine for low sperm count? And would that make our chances at a successful IUI more likely?

Sorry for all the info- I just wanted to make sure you are given all of the information necessary to guide us. Thank you so much, you advice is so greatly appreciated!

Category: Infertility Specialist

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Category: Infertility Specialist
Dr. Aarti Vazirani is online now

Expert:  Dr. Aarti Vazirani replied 4 Days.

Thanks for your consult at DoctorSpring.com. I appreciate the clarity and directness in your query.

The sperm count is definitely low in your husband's case. Also , what you mean is the sperm morphology ( percentage of normal looking and normally formed sperm ) that is very low. Could you upload the report as follow-up.

Now, your question basically boils down to this - is the abnormal semen analysis treatable ? And my answer would be - it depends on the cause. A lot of times, an abnormal semen analysis is caused by factors such as ageing, stress, recent surgery, fever or illness, heat exposure locally, alcohol, tobacco, drugs, radiation etc.

In certain conditions, removal of the offending factor can reverse the abnormal results. Such as , stopping drugs , tobacco or alcohol, maintaining an ideal weight, limiting exposure to hot tubs or saunas , minimizing work and personal life stress.

Other reasons for a low count could be - genetic causes ( generally untreatable ), hormonal deficiencies ( responds well to clomid or gonadotropin supplementation from outside ), blockage of the ducts ( reversible surgically ). Thus, the cause determines whether medication would improve the count.

You need to tell me if a diagnosis for the low count was established. This is generally done by a detailed semen analysis ( generally repeated twice at suitable intervals), semen culture, hormonal level measurements, ultrasound and Doppler of scrotum, physical examination and other complementary tests.
Offhand, without knowing the cause, it is impossible to say if medications and antioxidants / vitamins would help.

Also, for a low count, IUI / IVF generally DO yield good results, especially IUI is a viable option since it is less invasive / less expensive too.

All the best.
Do feel free to write back for a further discussion.
Take care.

Dr. Aarti Vazirani
Category: Infertility Specialist
Residency: Obstetrics & Gynecolog, BJMC,Civil hospital, Ahmedabad, 2008
Post Graduate: MS (Obstetrics & Gynecology), B.J. Medical College, Ahmedabad, 2008
Medical School: MBBS, B.J. Medical College, Ahmedabad, 2004
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