QuestionQUESTION: Dear dr. Edward, my husband did a varicocele operation since 10 months. the spermogram test is before the operation and 10 months after:
numeration of spermatozoides before :42 million after 41.2 million, usuel value:30-250 million
morphology: 60 % normal 40% anormal same after 10 months usuel value:>60(normal) and <35%(anormal)
motility: after 1 H: 25% after operation 55% usuel value: >45%
after 2 H: 15% after operation 45% usuel value:>40%
after 6H: 5% after operation 25% usuel value:>30%
so the spermogram shows an improvement in the motility. My questions are as follow:
1- with such improvement can we have a chance to concieve naturally now if i take medicament to fortify my ovaire and if he take also an hormone to increase the numeration and qualiy of the sperm?
2- if no what type of technique better to choose the insemination or the XC and what chance do we have in each methodes.
3- what is the minimum value (in million) enough for good sperm to penetrate an egg and conceive naturally as if i can analyse his new test he has around 6 200 000 million
thank you...
ANSWER: Hello Sabine from Lebanon,
Your husband's semen analysis is more than adequate for conception either through natural timed intercourse or through insemination. No other treatment is required for him. The minimum values for a normal semen analysis is 20 million count, 50% motility at 1 hr and 30% morphology. Based on these valuses, the majority of patients will be able to get pregnant by natural means.
I cannot tell you if there is anything more than needs to be done. You will need to undergo a full infertility evaluation to determine that.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
---------- FOLLOW-UP ----------
QUESTION: Dear Dr. Edward,
Thank you for your answer,but i still need a advice because my husband did a detail sperm assessment in a center specialized in fertilization and the result came:
volume: 3ml
Density: 60 million
% motile: 20%
progression: 1-2/4
Abnormals: 40% ( 20% head, 15% neck, 5% other)
Cells: 2 million
After lavage of sperm: preperation: 8 million 80% 3-4/4
after 24 hours 50% 2/4
I want to know if based on these result what will be the chance to do insemination and how many try you advice or is it best to go directly to ICSI
Please advice as till now i have different doctor opinion regarding the technique to choose.
AnswerHello Again,
Based on the repeat semen analysis, there is only one problem, which is the motility of 20%. That number should be 60%. If you are under the age of 35 years old, then I think that IUI would be a good first option (assuming there are no other problems like blocked tubes). I would not recommend more than 4 IUI attempts. If that does not work then I would recommend going to IVF with ICSI. The alternative, IVF with ICSI is a good option as well and will cover the sperm problem. With IUI, you don't know if it will cover the sperm problem or not because the natural process of fertilization has to occur on its own and there is no way to check if it happens with IUI.
Good Luck,
Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
Monterey, California, U.S.A.
for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf
