Male factor infertility

Any and all topics infertility-related, including treatment, emotions, and questions.

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Re: Male factor infertility

Postby kdbriner » Sat Mar 16, 2013 7:43 am

Hello to all! I am brand new to these forums and occasionally i linger and read many of the posts hoping for some answers and since we just found some i figured it was about time to get some opinions. My husband and I just went to a Urologist on thursday and we have been referred to a RE in Kansas City, MO. The Urologist didnt do any kind of blood work or tests which i thought was odd. He just did a general questioning of DHs history and did a physical(awkward! lol but it was okay) We have been actively trying for 3 years(I am 21 and he is 22). His first semen analysis was in 2010 and it showed Azoospermia. Absolutely nothing but it said his volume was 4.0/ml and the viscosity was 1+? It also showed morphology with a 'C' and it states that 10-20 WBC's seen/hpf. What does this mean??!!
On his most recent SA it goes as follows:
Liquefication-normal minutes
Semen Volume-5.0ml
sperm motility(progressive) [L] 5%
Sperm count per mL and out to the side it states'see comment million/mL and below that it states:
'Very few sperm seen. 0-2/HPF(WHAT DOES THIS MEAN?? )
Also it states-Normal forms(WHO criteria)-NA % and below that-'normal forms not performed on counts<2million.
White cells-Increased

Can anyone please explain these two to me? I know none of it is good but is the 2nd one any better than the first? The first didnt even show motility. Just 0.0 EVERYWHERE. The Urologist did an exam and felt no varicocele veins and his vas deferens was fine(DH said this physical was painful, is that normal?) We are so new to all of this because we are just now in the position to start figuring out what exactly is going on. Is there any hope of this being a blockage or a hormone problem? Or is IUI a possibility or are we going down the road to IVF?
I have been trying to get as much information as possible just to keep myself from going to a deep dark place which i feel myself slipping into daily. We have never even had a . No signs that anything is wrong with me either. My thyroid is enlarged(has been for a long time) i was tested for my thyroid by two doctors who said the labs were normal. And my recent pap smear came back abnormal but i am negative for HPV. My periods are a little abnormal because they range from 30-40 cycle days and they last about 5-7 days. I think that i ovulate because i have done the OPKs and they show LH surges. I tried charting a couple of times but cant make sence of them. Sometimes i think that i did ovulate when i use them and then i look again and think well maybe i didnt? Does anyone elses DH have similar SA reports? Any ideas of what we are getting into? Thanks in advance for anyones advice. Also good luck to everyone on their journey! I look forward to seeing where your journeys take you!
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Re: Male factor infertility

Postby fiver18 » Sat Mar 16, 2013 3:46 pm

Well I am not an expert on SA but I do know that azoospermia means O sperm. With 0 sperm everything else would be zero because there is nothing to measure. The second test is very few sperm which means that is was probably close to zero again. THis is obviously not a good thing becuase with no sperm it is impossible to get pregnant. But that doesn't mean that there will never be sperm as there could be a blockage or hormone issue but what's odd to me is that the uruologist didn't run any tests. I know our RE sent us to the urologist when my DH sperm count came back low as they are the experts in this area. I would ask the RE when you go in why the urologist didn't do more testing and I would have a list of questions for the RE when you go (especially the questions you have asked us).

I hope that was helpful, sorry I couldn't be of more help but like I said I don't know a lot about this.
Me - Amber - 31
DH - Dustin - 30
TTC - 30 months
IVF Fresh 5 day Transfer - April 14, 2013
Beta 1 - 178 (8dp 5dt)
Beta 2 - 442 (10dp 5dt)
Beta 3 - 3083 (14dp 5dt)
U/S may 11 - twins!!!!
Baby a - 119 baby b - 116

http://fertileclimb.blogspot.ca/
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Re: Male factor infertility

Postby shiftworker29 » Sat Mar 16, 2013 10:04 pm

Hey Ladies just an update, AF showed up today and it has been really painful, and heavier then normal, I am assuming this has to do with the HSG test i had last month as of late they have been light and pretty painless...So guess its on to our first round of clomid starting Monday...I will be taking 50mg days 3-7 with blood work on day 21...hoping it works and we get it with out having to go to clinic!

I think things work differently up here in Canada, I beleive the fertility clinic is all encompassing, so they will do all tests DH needs there as well as repeat my tests. Not sure though as I have never been through this process.

Good luck ladies and keep us posted on your journey! Hoping we all get our :bfp:
TTC #1 Since Mar/2012
Me 31 DH 30 Done 3 rounds clomid.
BFP June 12/13 round 2 of clomid (sadly mc at 6weeks)
Took 2 cycles off clomid and met with clinic starting 3 more rounds of clomid 50mg days 3-7. Hope we get lucky again!
Mar/14 IUI #1 50 mg clomid 15mil post wash BFN
April/14 IUI #2 currently in tww 100mg clomid this time post wash count 19mil
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Re: Male factor infertility

Postby kdbriner » Sun Mar 17, 2013 11:08 am

fiver18 wrote:Well I am not an expert on SA but I do know that azoospermia means O sperm. With 0 sperm everything else would be zero because there is nothing to measure. The second test is very few sperm which means that is was probably close to zero again. THis is obviously not a good thing becuase with no sperm it is impossible to get pregnant. But that doesn't mean that there will never be sperm as there could be a blockage or hormone issue but what's odd to me is that the uruologist didn't run any tests. I know our RE sent us to the urologist when my DH sperm count came back low as they are the experts in this area. I would ask the RE when you go in why the urologist didn't do more testing and I would have a list of questions for the RE when you go (especially the questions you have asked us).

I hope that was helpful, sorry I couldn't be of more help but like I said I don't know a lot about this.



Thank you for your response :) Any opinions are helpful! Im glad im not the only one who thought it odd that the Urologist didnt do anything. I dont even think he really reviewed the paperwork because i got to looking at both analysis and they both show increased white blood cell count which i have read could be infection so i am very disappointed that he didnt even mention or run additional tests. We also put on the 'symptoms' of the paperwork that my DH had blood in his urine on his physical back in September for work. He just said that we needed to speak to an RE so i guess we will just wait until we get the call back.
I know this is sort of personal but for those that have been to an RE: Did you have to pay for the testing up front? Or did they bill everything to insurance? My insurance covers some things but nothing relating to infertility. I know that they cover anything that is "medically nessicary"(which is a crock of ****!). Oh, and we are making a 3 hour trip to see this RE so do you guys think that if we talk to them and they know the situation that they will perform tests one day and then (were planning to stay in the area for a week) give us the results to all of the tests and get a gameplan going as far as treatment within a week? Well anyways i will try to keep updates on our progress, i am just hoping that this is a blockage or something that can be fixed with medication! Good luck to all TTC!
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Re: Male factor infertility

Postby fiver18 » Sun Mar 17, 2013 3:35 pm

I live in Canada so things are different here. We don't have to pay for testing just the procedure and medication so I can't help you out there. But I do know that the RE and the Urologist do different things. My RE sent my DH to the urologist becuase they are the expert. The RE knows a lot but an 'expert' opinion is always the best.
As for the testing I would call them before hand and explain to them that you live out of town and will be in town for the week. I know here we have to book all the tests so unless we gave them notice that would be impossible. THey obviously won't be able to pre book the tests becuase they won't know exactly what they will be testing for but I would just ask if this is a possbility for the weke that you are there. If not maybe ask them if they could book them all on one day in the future so you only have to make 1 trip.
Ive found the more questions I ask the better and I always walk in with a page of questions when I arrive. I'm paying good money for the procedures and their time so I only think it's fair that they are patient with you and answer and questions you may have. If they rush you or seem preturbed I would move clincs.

Good luck!
Me - Amber - 31
DH - Dustin - 30
TTC - 30 months
IVF Fresh 5 day Transfer - April 14, 2013
Beta 1 - 178 (8dp 5dt)
Beta 2 - 442 (10dp 5dt)
Beta 3 - 3083 (14dp 5dt)
U/S may 11 - twins!!!!
Baby a - 119 baby b - 116

http://fertileclimb.blogspot.ca/
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Re: Male factor infertility

Postby shiftworker29 » Sun Mar 17, 2013 7:49 pm

Hey Fiver where a outs in Canada are you? I'm in Alberta.
TTC #1 Since Mar/2012
Me 31 DH 30 Done 3 rounds clomid.
BFP June 12/13 round 2 of clomid (sadly mc at 6weeks)
Took 2 cycles off clomid and met with clinic starting 3 more rounds of clomid 50mg days 3-7. Hope we get lucky again!
Mar/14 IUI #1 50 mg clomid 15mil post wash BFN
April/14 IUI #2 currently in tww 100mg clomid this time post wash count 19mil
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Re: Male factor infertility

Postby vraklis » Tue Mar 19, 2013 3:14 am

shiftworker: I'm so so sorry! Good luck with this next cycle. :noaf:

kdbriner: I had to lol about the awkward physical, I too was taken aback to watch my husband's junk being fondled. LOL! It was not painful for him, and I really wonder about the UR you saw. He should have explained the SA to you and ordered a blood test. Sheesh! Since he doesn't have a physical problem, then he could have low testosterone. But with his white blood cells higher, you def should ask about infection. I'm alarmed by that and the blood in his urine, and also that he found it painful. These to me are all points that should be brought up with the UR.

Unfortunately the print-outs we got for our SA's were different so I really don't know what those things mean on yours, sorry. It doesn't sound good though, and i hope they can figure out what's wrong and fix it so he can start producing sperm again. With his count the way it is, IUI definitely would not help. They need to have millions to work with, and if his first one was 0, then I'm guessing the second must be not much better so he needs a lot of improvement before an IUI would help at all. IVF may be an option if there's nothing the doctors can do, that's another subject you should bring up to the doctor.

I used to have Graves Disease which caused my thyroid to be enlarged, and also my eyes bugged out. But your labs wouldn't be normal if you had that. Have you had an MRI on your neck to make sure it's not cancer or something (sorry, I don't mean to scare you, it's just the only possibility I could think of).

I used fertilityfriend.com to chart, and if you sign up there they will teach you all about it so it will make sense.

As far as paying the RE, we did not have to pay up front as they will send the bill to your insurance first, even if the insurance won't cover it. You may be surprised like I was, I knew my insurance didn't cover infertility but it actually did cover the doctor visit, the blood work that he ordered, even the sonogram to check out my uterus and ovaries. For my insurance, it turned out that as long as it's diagnostic and not IF treatment, it's covered. We had to pay upfront for our IUI, but that was the only thing we paid up front for.

I agree with fiver (and have learned the hard way!) that asking questions is so important, and writing them down is so important too because you will not be able to remember them all.

Good luck! Keep us updated!
"Let your hope make you glad. Be patient in time of trouble and never stop praying." Romans 12:12

Me: 35 DH: 48
TTC since 2000
MF, delayed ovulation, low estrogen, luteal phase defect, low
DS conceived through first donor insemination 11/23/13
DIUI April 2015 - BFN, AF came 9DPO
DIUI with estrogen, Ovidrel, and progesterone 3/9/16
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Re: Male factor infertility

Postby Snuggles » Tue Mar 19, 2013 4:17 pm

Hey ladies,

I hope you don't mind if I join the thread. DH has done the first SA and everything looked fine except for the morphology which was at 2%. We are currently trying to find a urologist to send him to and schedule the second SA. He's on a ton of supplements and we are really praying they will improve the morphology. Once we get that done we'll meet with the RE together and probably move on to IUI soon.

Just wanted to come out of lurking and introduce myself. 8)
MARRIED MAY 2008 * TTC#1 SINCE DEC 2011
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Cycles 1-7:BFN
Cycle 8: Chemical pregnancy
Cycle 9: BFN
Cycle 10: Annovulatory
Cycles 11- 16: BFN
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Re: Male factor infertility

Postby vraklis » Tue Mar 19, 2013 9:46 pm

Hi Snuggles! My hubby also has low morphology. It started at 9% and after 4 months taking supplements, it went up to 30%. Pretty impressive! Though that does give you an idea of how long it takes to make an improvement naturally. Good luck to you and keep us updated!
"Let your hope make you glad. Be patient in time of trouble and never stop praying." Romans 12:12

Me: 35 DH: 48
TTC since 2000
MF, delayed ovulation, low estrogen, luteal phase defect, low
DS conceived through first donor insemination 11/23/13
DIUI April 2015 - BFN, AF came 9DPO
DIUI with estrogen, Ovidrel, and progesterone 3/9/16
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Re: Male factor infertility

Postby VPatel » Tue Mar 19, 2013 11:39 pm

To the new ladies here - welcome to the group! The more the merrier - so good to have a little team here. We can all spur each other forward :)

Just a quick update - we are doing our first IUI today. Actually heading to the clinic shortly (went earlier for hubby to give the sample for preparation). Feeling absolutely worried that it won't work (as sucky as that may sound)..so nervous.

Hope you all are having good days wherever you are in your cycles! X
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Re: Male factor infertility

Postby vraklis » Wed Mar 20, 2013 12:50 am

Good luck VPatel! That is so exciting!!!!!! I just had my first four days ago, so we're going to be really close in time in our TWW. Let us know how it went!
"Let your hope make you glad. Be patient in time of trouble and never stop praying." Romans 12:12

Me: 35 DH: 48
TTC since 2000
MF, delayed ovulation, low estrogen, luteal phase defect, low
DS conceived through first donor insemination 11/23/13
DIUI April 2015 - BFN, AF came 9DPO
DIUI with estrogen, Ovidrel, and progesterone 3/9/16
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Re: Male factor infertility

Postby VPatel » Wed Mar 20, 2013 1:41 am

Just done! Currently lying on y back waiting! Had 3 follicles between 1.8 - 2.0 and hubby's numbers were good. Doc was pleased so now I am in your camp - waiting time.

Fx for everyone!! Xx
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Re: Male factor infertility

Postby Snuggles » Wed Mar 20, 2013 5:53 am

Vraklis - wow! That's a huge improvement! If you don't mind my asking, why did they feel IUI was still necessary? I thought anything above 14% was considered high ... I ask because DH really wants to conceive naturally if at all possible. If his jumped from 2% to 12% I could see him wanting to try naturally for a bit longer and hold off on IUI.
Love the verse in your siggy too - I needed that today. Hope your IUI takes!!

VPatel - thanks for the welcome, and good luck with your IUI! How was the procedure?
MARRIED MAY 2008 * TTC#1 SINCE DEC 2011
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Cycles 1-7:BFN
Cycle 8: Chemical pregnancy
Cycle 9: BFN
Cycle 10: Annovulatory
Cycles 11- 16: BFN
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Re: Male factor infertility

Postby vraklis » Wed Mar 20, 2013 11:47 am

Snuggles, unfortunately none of the sperm were swimming even though the morphology was better. The count didn't go up either, it was still at 3 million. He is still on the vitamins because we hope that over time, we will eventually be able to conceive naturally. But with him being 45, we don't want to wait a year or more to see if it happens, so we went ahead with a donor in the mean time (they can't use DH's sperm at all for an IUI b/c like I said, it's not moving so it would go nowhere, even if placed on top of an egg). We'd been talking about using a donor for a long time so the transition once we knew we couldn't get pregnant on our own was not as hard as it would have been for most couples. We'd discussed it a lot and were already ready to do it before we found out it was our only choice besides IVF (which we can't afford).
"Let your hope make you glad. Be patient in time of trouble and never stop praying." Romans 12:12

Me: 35 DH: 48
TTC since 2000
MF, delayed ovulation, low estrogen, luteal phase defect, low
DS conceived through first donor insemination 11/23/13
DIUI April 2015 - BFN, AF came 9DPO
DIUI with estrogen, Ovidrel, and progesterone 3/9/16
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Re: Male factor infertility

Postby VPatel » Wed Mar 20, 2013 6:59 pm

Morning Ladies,

How are we all doing?

Snuggles - glad you joined the thread its so nice to have a chance to share here! And ask questions and rant and be worried or happy whatever you are feeling! The thing with morphology is that its the least studied of the three major components of the SA. There is so much available for motility and count but morphology not so much. FX that your upcoming steps can help things move forward to you and DH.

Vraklis: How are you feeling?! My IUI was a tiny bit painful - although I am happy because I didn't tense up and it all went smoothly. My pain threshold is so low the tiniest thing can throw me off! Wanted to ask you - what supplements is your hubby on? My hubby is taking folic, vit E, fertilaid,count boost and motility boost. Plus eating more fruits, working out more and as we live in a REALLY hot country, swimming more as the heat is unfriendly to his little fellas! DH was generally pleased yesterday at his figures - whether the IUI is successful or not, it was nice to get a good result. Doc was happy with the follicles and told me to hope for twins!

I am doing my utmost to stay busy and not over think about it all. Just stay happy and know that when the time is right it will work out! FXFXFX for all! xx
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