QuestionDear Doctor,
I am 28 years old and my husband is 35. My husband was diagnosed 2 years ago with sever oligospermia. We immediately went off to do an ICSI without wasting more time. However we continued with 4 failed ICSI's since 2008. Every time the doctor would say that my husbands sperm was not of good enough quality so there could be no conception. Recently for my last failed ICSI my embryologist said that my husband had most dead sperms in his semen and that they could only salvage 3 for ICSI(although 8 eggs were retrieved from me). However the ICSI was done and 2 fertilized. I had an embryo frozen from last time so all 3 were transferred next.I was given 12 days of projesterone shots and then i had my test which was negative. This was the fourth time so i was keen on knowing the problem. My embryologist disclosed that my husbands sperm was not surviving at all. Infact the ones that he could mange to take would also not survive the washing procedure. All my husbands tests show that he is fine (no varicocele, no harmonal imbalances etc.)Then what is the problem and is there any way we can deal with this unexplained male infertility and can there be a way to get better spems for a more succesful ICSI.(My ebryologist suggested HCG weekly injections for my husband and guarantees it will help.)Please respond to my query I will truly be grateful for an honest opinion. $ ICSI's have drained the life out of me and i really need some solid advice. Thanks and regards
Vierra
AnswerHello Vierra from the U.A.E.,
Some of your description is a surprise for me. I presume that your doctor did a semen analysis prior to the IVF cycle and saw sufficient motile sperm to recommend IVF and ICSI. If that is the case, why did they not find sufficient sperm? Also, a retrieval of 8 eggs from a 28 year old is a very low number. Why were so few follicles stimulated and so few eggs retrieved? Something does not make sense. My immediate response and feeling is that maybe you need to change IVF centers.
Your husband certainly has some options that are open.
1. Your husband can collect and freeze multiple sperm specimens so that you can be sure that enough live sperm will be available for ICSI in your next IVF cycle. We call these backup specimens and the specimens can be thawed if need be in order to get the appropriate number of sperm.
2. Your husband can take a supplement such as Proxeed or Fertility blend that give essential amino acids vital to sperm production and viability. These can be ordered on the internet but it will take 3 months to see an effect. This may increase the number of live sperm.
3. I don't think the HCG shots are in order. They would only be indicated if the testicles were not making sufficient numbers of sperm, and works by boosting the testosterone levels, but does nothing for sperm viability.
4. See a Urologist specializing in Male infertility and undergo testing, as well as, testicular biopsy to see where and/or why the sperm are dying.
5. Don't give up. Failure in one clinic does not necessarily mean you'll fail in another clinic given your young age. Pregnancy rates are very specific to individual clinics.
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
