Male factor - natural improvement possible?

[Archduchess]

Hi everyone,

My lovely partner and I have been TTC for about a year. We found out yesterday that he has a low sperm concentration (1.5 million/ml) and slightly low motility (40%). Morphology was 7% I think.

What do you reckon - could lifestyle changes and vitamins increase the count enough for us to conceive naturally? It seems a big jump to the 15 million/ml count cut-off that the doctor said would be normal. Is there any evidence, or do you have any stories, of how often a jump of this size does or doesn't happen?

He doesn't drink a lot of alcohol, or smoke, but he does sleep quite irregular hours (and often very late - say 3am to 10am), his diet could be better and he does almost no exercise... His job is sedentary and he spends a lot of time in the evenings and at weekends on his computer, often with his laptop on his lap. (He says it's on his thighs, not the jewels... )

I am 32 and he's 34 so he's said he'll try for at least a few months to improve things through supplements, diet, exercise and better sleep habits, before getting a second analysis. We will see how disciplined he is about sticking to these changes!!

Ultimately I suppose we would go to ICSI if the count doesn't improve, but if we can avoid the cost, stress and medication of all that, obviously I would be very happy!

I'm going to nudge a friend from another thread to come here, as she got her husband's count up from 8m to 59m through a long slog of supplements. So it totally can happen!

Thank you Bananafish!

I've had a bit more time to consult Dr Google, and this page has a collection of research findings on boosting male fertility. It looks a little bit more reliable than the Wikihow and Yahoo Answers posts I'd been reading before!

There's a female version too in case anyone's interested.

Honestly? Post 30, I'd just get on with the IVF.

It's really not so bad, and male factor (especially if morphology is ok) is so easily overcome with ICSI.

We tried (and miserably failed) for 4 years with a similar diagnosis to you (success first round of ICSI). I wish more than anything that we had just got on with it earlier.

You got there before me banana! Saw this thread and immediately thought of her too...
Good luck OP

DH has an incredibly low sperm count as a result of testicular cancer a few years ago. We tried for 1.5 years for a miracle before starting the journey of IVF, and amazingly conceived naturally following our first IVF consultation with an incredibly low sperm count of 100,000 (nope, I haven't missed off any zeros, we count hubby's sperm in thousands not millions!). We now have a beautiful baby girl.

I hope this gives you motivation to keep trying naturally even if you do start down the IVF route, it really only does take 1 sperm! But realistically the chances are low so best to have a timeline in mind about when you will seek help and be aware that the process can take a long time, especially if you go down the NHS route. Also be aware that since your DH does have some sperm the NHS will make you wait the 2 or 3 years (depending on your area) before allowing you IVF. So if you go to GP it wouldn't harm to say you've been trying a bit longer than you really have...

In terms of improving the count, I'm really not sure how much impact it would have. My DH is slim, fit, healthy, great diet, non-smoker, non-drinker, excercises, no laptop on knees, loose boxers, cold showers etc. His count is 800,000 now but I think that's due to the time since chemo. We're now trying for another miracle...

I wish you all the very best x

Hi Arch!

These lovely ladies above (Banana and Chandelier ) are referring to me!

Just over 6 months ago my DH had his first SA which came back as 8 million count. We were told under no uncertain terms that we would need IVF with those sorts of numbers.
I did A LOT of research and came up with a plan to try to improve DHs numbers. Here is what we did:

1. Diet- We changed it to a low carb, high protein diet with lots of fruit and veg including lots of juicing and fresh fruit and veg smoothies (one for breakfast and one for lunch) with a healthy and protein rich dinner.

1. Exercise- DH starting running again. He built up gradually until he was running 5k 2-3 times a week. He also lost a little bit (he didn't have much to lose) weight as a result of this which I don't think hurt

1. Alcohol and caffeine- we made sure that he significantly reduced his intake of both. We didn't cut them out completely, but alcohol only in moderation at weekends for instance.

1. Supplements- This is the thing I think helped most!!! I fed him heaps! 1000mg Vitamin C, 100mg Co enzyme Q10 Ubquinol, 15mg zinc, Vitamin B complex, 800mg calcium, 5 mg Vitamin D.

So after one month of this regime his results went from 8 million to 14 million. Then after another month it went up again to 21 million! Our UK consultant was gobsmacked by such a huge change in such a short space of time.
By the time we reached over 6 months of doing the things above, his most recent SA was 59 million per ml and 320 million overall sample!!!! Our Czech consultant (In the end it turned out that we had to have IVF anyway because I do not ovulate naturally or with oral meds) was blown away by the improvement. I can only put it down to the above things!!!!

So my advice would definitely be that if there's nothing wrong with you and its only your DHs SA which is the problem give yourselves a few months to put the above things in place and see if it can make a difference before going down the route of more invasive procedures like IVF (It is the most emotional and physically difficult things I have ever done, and not something you should go into lightly).

Good luck! x

Hi Arch - just to add my 2 bits, they can't tell much from one SA - it's worth having a couple to see if there's a general picture (though often there's not!).

My DH's first SA result a year ago was 11 million, 20% morphology, 32% motility. By this point he hadn't had a drop of alcohol or caffeine for 2 years and was taking Wellman Conception, Pycnogenol, high dose vitamin C and E, selenium, Omega 3, 6, & 9, etc. Healthy diet, regular (though not too strenous) exercise, showers instead of baths, boxers instead of briefs, no phones in pockets, laptops on lap, etc. We were desperate and had been doing everything by the book. Lifestyle-wise, there really wasn't much room for improvement.

All my tests were fine. They declared DH clinically subfertile and said our only choice was ICSI. We dragged our feet - we'd been pregnant before naturally ( after 2 years ttc) but lost the baby. We kept thinking we weren't infertile, there must be a way without IVF if we just gave it a bit more time...

The next SA was 21 million, and 51% motility but only 3% morphology, and anti-sperm antibodies. We hadn't changed anything, lifestyle-wise, in that time - he was on exactly the same cocktail of supplements, same healthy diet, same total abstention from caffeine & booze. So it was nothing he did or didn't do that caused the count to double - or the % of normal forms to plummet so dramatically, or the antibodies.

We discovered he had a testosterone level that was on the lowish end of normal, and certainly low for his age. So he took Clomid for 4 months (this is used in the US sometimes to raise testosterone levels & has had some success with improving sperm quality). Next SA was 24 million, 4% morphology, 51% motility, and no anti-sperm antibodies. But he'd become a raging aggressive maniac, so I made him go off it. I've come to believe that low testosterone is the key to a happy marriage .

Between the first SA and now, we've had 2 pregnancies - but both have miscarried. I'm 39 next month. Started TTC 5 years ago, and always thought it would work for us if we just changed our diet, took more supplements, etc. Kept thinking, am I not doing enough yoga? Should I make DH do yoga? Should we live as though we have diabetes? Would that help? Should we pee on these PH sticks twice a day to see if we're alkaline enough? Should I up my intake of wheatgrass shots? Might colonic irrigation help?

I'm starting IVF next week.

So my advice would be - if there are lifestyle changes your DH can make (biggest one I'd say is laptop on lap - thighs are close enough to jewels to be cooking the contents!), then go for it, particularly if it'll make you healthier & happier in the long run. But don't beat yourselves up - there's so much that's beyond our control, and so, so little is known about male fertility in particular. If you're doing the basic things and getting nowhere, accept help.

Good luck!

Thank you so much everyone.

Having now seen your posts on the conception message boards: huge congratulations on your pregnancies bananafish and chandelier and very best of luck to RoseBud for the results from your IVF. (Apologies for the stalking. I was curious about which thread you were all on and I ended up reading the whole of the current PCOS one... Possibly a bit weird!)

What an amazing result, ScottishGirl, many congratulations on your baby daughter and good luck for the second. Those 100,000 must have been real troopers - it can be about quality not quantity I guess!

And BipBippadotta, I very much hope your IVF goes well - good luck!

I can totally see, BipBippadotta and Bespoke, that we could be misguided in trying for too long to make marginal changes. Too much hope is not useful I suppose. So here is my unilateral plan - complete with timeline as you recommended ScottishGirl! - which I will try and get my partner to agree to... I'll go shopping for the supplements you suggested RoseBud and with luck my partner will manage to stick to at least some of the lifestyle changes. If, despite that, he gets a second set of not-so-hot sperm analysis results in three months' time, we'll go to a urologist, in case there is something treatable. After that, maybe we'll wait another three months before going to IVF/ICSI.

And I'll get a HyCoSy in the meantime. Confession - I haven't actually had any proper tests yet, just talked through my history with the doctor at the clinic where my partner had his sperm checked. So I don't know that I am in tip-top condition myself. The doctor was very sanguine about me because there are no obvious signs of problems from my cycle or history, but I probably shouldn't pin everything on my partner yet! I have heard of plenty of people who would never have known about their blocked tubes until they had trouble getting pregnant and had a scan.

Ah, bless you Arch; that's some read! Thank you for your good wishes. All the best for the future. Will look out for your BFP post!

Thanks chandelier, fingers crossed..!

I'm not necessarily saying you're misguided, but the trouble with the internet is that there will always be a tale from an individual who's individual experience 'bucks the trend' - the person who conceived naturally at 45 with 0% morphology and blocked tubes for example, or the person like Rosebud who experienced such a huge improvement.

That doesn't make that the norm at all, and certainly doesn't 'disprove' the overall trend.

It is really important to remember that stats (esp those from the HFEA, or from a large and established clinic) are based on very large data sets and, although they're not perfect, they do give a much more reliable prediction of how things are going to go for you.

I'd be super-wary of gambling such high stakes on the basis of what some randoms on the internet tell you. Look at the proper data and make your decision based on that. All the data points to the fact that your chance of success with IVF declines with every month you age. I really wouldn't hang about.

Good luck!

Arch That's so cute of you! Thank you for your well wishes. I absolutely love our thread- very fortunate to have such a supportive and understanding group of ladies.
I know you don't have PCOS that you know of, but if you fancy joining us i'm sure we can bend the rules We have a few ladies with male factor issues too.

I think your plan to do another SA after a couple of months, and in the meantime get tested thoroughly yourself, is a good one! It might be worth looking into getting referring for IVF in the meantime just to keep your options open (I think the normal minimum requirement is to have been ttc for 2 yrs for NHS IVF treatment) and it is highly likely that there will be a waiting list so absolutely no harm getting the ball rolling.

Good luck!

Ps with my Czech IVF clinic (Reprofit) there are minimal success rate differences below the age of 35. It's only after that age that rates decrease at speed.
You're 32, I'm 31, time is still on our side x

Thanks Bespoke, you are absolutely right of course about it not being rational to look for success stories. I've obviously done exactly that by asking whether natural improvement is possible.

It is a gamble to wait and it clearly has an opportunity cost. But, here are my reasons for doing so:

1. Although I know it works safely for the large majority of people, IVF involves risks and (as a private patient) significant costs.

2. There do seem to be large-ish studies which show that, on average, some supplements and lifestyle changes improve sperm count, e.g. the link I posted up-thread. They aren't all perfect randomised controlled trials, but together I'd say they indicate strongly there is a basis to nutrition helping some men. I know that by no means guarantees supplements will help my partner. And any improvements may not be enough for natural conception anyway. But it's enough to make me feel it's worth trying.

3. I'm also hoping that there may be a random improvement in his sperm, even if the deliberate changes don't help.

4. My partner's baseline situation is of a fairly unhealthy lifestyle (though admittedly not with the big known sperm killers like smoking or heavy drinking) so if general health has anything to do with count - which it seems it does - then there's room for him to make changes. These might also benefit his sperm before IVF, and should benefit him in the long run.

5. If we do end up going for IVF, we'll go straight to a private clinic, reducing the waiting time compared to the NHS.

I'm totally aware that I'm not getting any younger, though! I won't be mooning around for more than a few months before starting out on the IVF route.

Does that make sense or do you still think I'm barking up the wrong tree?!

Thanks very much RoseBud, sorry I cross-posted while I was ruminating on my post just now!! That's reassuring to know that things are generally reasonably stable up to 35-ish. I think I'd be too much of an obsessive message-checker to join a regular thread (trying not to feed my smart phone addiction) but that's really nice of you to say I could join!

I'd also add that fertility doesn't magically fall off a cliff between 34 and 35 - the reason the stats look so different between the

Aww Arch, I'm sure you've thought it through and you don't have to justify yourself to me! You sound pretty switched on and you obviously understand the risks of seeking out success stories - although we've all done it!

Re your approach, we're all so different. I know that for me waiting around to see if we could conceive naturally was just prolonging the agony if that makes sense? One of the things I was most grateful for in my treatment was my wonderful, but very direct consultant eventually telling me straight that it was most likely a case of 'ISCI, or no baby'. Hearing it like that really flicked a switch in my mind and we just rolled up our sleeves and got on with it.

We all want to be that one in a million for whom a miracle natural conception occurs, but the chances are we won't be and valuable time will have been lost on the way to that.

I wish you every success in whatever path you choose.

Just wanted to post an update here, as everyone who replied was really helpful... I have just got a (faint and early) BFP! I'm very surprised as it's only three weeks since my partner got his poor SA result. I don't think his lifestyle changes would even have had time to kick in, so there must have been just enough lucky, plucky swimmers in there.

Now I'm just really hoping the little blastocyst (or embryo?) clings on!

Very Important PS! - I hope everything is going well with all of you!