QuestionQUESTION: my husband and I have been TTC since November 2007 but to no avail. DH had a semen analysis done and it came back with:
26% normal and 74% abnormal (Morphology).
a-2% and b-63% Sperm motility.
Ph (7,5) and voume (56m/ml)
My HSG test and hormes are fine. Are we missing anything? Is it possible to get pregnant with such results?
Thank you for your help.
ANSWER: Hello,
You didn't give a sperm count with the semen analysis, but two of the parameters are abnormal: morphology (26%) and motility(2%). This may be the problem.
If you are not already under the care of a reproductive specialist, then I would go see one. With these semen results, you may need to undergo either IUI or IVF, depending on the count (is the 56 m/ml the count rather than the volume?)
Sincerely,
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.
---------- FOLLOW-UP ----------
QUESTION: Dear Dr,
Yes, the 56mio/ml is the count.
The volume is 2,4ml
I am seeing a reproductive specialist, however, he did not prescribe my husband anything. He told us not to worry about the motility because adding a and b together, the number is 50% which he said was fine.
AnswerHello Again
Thanks for the clarification because it makes a big difference. I am still not sure what "a" and "b" means in your note, however the important parameter is what we call the "total motile count." That is the count x motility x volume. In your case it is 56 million/ml x 0.02 (2% motility) x 2.4 ml = 2.69 million. This is a very abnormal count as the normal should be 20 million minimum. This does not mean that you cannot achieve pregnancy, however. It just means that some type of treatment will be required. The treatment of choice is to do IVF with ICSI, as these sperm usually have a functional disorder as well. That is, they do not fertilize well as shown in previous IVF studies. Therefore, they need to be injected into the eggs to allow fertilization to occur.
Another option would be a trial of medications, Clomid 50 mg per day and Proxeed 3 times per day. You would have to wait three months to retest the semen and see if it works. If it gets the total motile count above 10 million, then IUI can be done. If it gets it up to normal, then you can try on your own. If no change, then IVF/ICSI is recommended.
Sincerely,
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.
