Where do we go from here - Secondary Infertility

[AllChangeLife]

So... I have one DS - 3, and we have been trying for 15 months for our second. Both in early 30s...

Had first line tests recently, I'm ovulating as normal (despite being quite overweight - I need to lose 1 stone to get me to a BMI of 35 - which is apparently what I would need to be if I was being referred on NHS). I'm getting there....

DH has 3% sperm morphology - which we were told today by the duty dr. We can't see another Dr until mid April, so were just wondering where we go from here really.

NHS won't see us for IVF/IUI because we have a child already. We can go private, but can't figure out if we have gone as far as we can go with the NHS, and where we go from here....

Feeling very lost - and reading the boards have been totally confused by lots of terminology - I've googled of course but can't work out the normal course of events!

Any advice that anyone has would be gratefully received.

Thanks!!

[MPP81]

Hello allchange.

I'd like to start off by saying I'm by no means an expert on this stuff but I didn't want to read and run. Our situation is similar to yours. TTC for 18 months (20 cycles) and were referred to the fertility clinic back in December. In our area, the wait is approx 18 months, though from what I understand from reading others' stories, most places have a much shorter wait.

Like you, I already have a child, so we will not be eligible for ivf/iui with the NHS. DP'S sperm analysis shows a very low count and we have been recommended ICSI so we've decided that we will be going private as it's unlikely anything else will work for us. What were your DH's other figures like? If it is a male factor issue, then perhaps going for private treatment would be an option for you, as you already have a likely reason for not conceiving. However, if you still have no explanation, it may be that the extra tests provided by the fertility clinic may uncover a reason they can help with. I believe they can also provide clomid if needed, though as we haven't had our appointment yet, I can't be sure of this.

That said (and believe me, I hate it when people say it to me, so I apologise) after 15 months there is still a chance it will happen naturally. The exact statistics elude me at the moment, but I believe the majority of couples ttc will concieve within two years (I know, it seems so long and horrible and disappointing each month). Did it take long to concieve dc1?

As I said, I'm no expert so I apologise if any of my info is wrong, and I'm sure someone with more knowledge will be along soon, but I wanted to try to help. If there is any terminology you would like help with, please ask. My excessive googling may be of use.

Good luck!

[MPP81]

Oh, and these are the current SA guidelines from WHO.
semen volume: 1.5 ml or more

pH: 7.2 or more

sperm concentration: 15 million spermatozoa per ml or more

total sperm number: 39 million spermatozoa per ejaculate or more

total motility (percentage of progressive motility and non‑progressive motility): 40% or more motile or 32% or more with progressive motility

vitality: 58% or more live spermatozoa

sperm morphology (percentage of normal forms): 4% or more.

There is a fab thread on the conception boards for people trying to concieve for over ten months. There are lots of lovely people there who are very friendly and helpful. Please feel free to join us if you would like :)

[AllChangeLife]

Thank you for all of that,

Dh wasn't told exact figures as it was a duty doctor not our regular Dr. But all other numbers were ok. 3% is under the who numbers you put, but not far so I don't know if that is what is actually stoppig/slowing the process....

Private is an option and part of me wants to do that ASAP so that it all happens sooner

Dc1 happened within 3 weeks. So I wasn't expecting a issues!

I get a bit lost on the big threads, I struggle to keep up (need notifications!) But I'll give it a go!

So you got referred to a fertility clinic to find out what is happening despite them saying that I if is off the table through nhs? I guess that is our next step then. We have been liaising with gp so far...

Thank you!

[MPP81]

No worries :)

Our GP did start some basic tests for me, but when DP'S low figures came back, I think he decided that, since that was the obvious reasons, he would just refer us. He didn't give any real info on what we could expect due to aleady having a DC, do my info on that score again comes from Google. What I learned was that, in cases like ours, the fertility clinic will do everything up to, but not including, ivf/iui - so investigative tests, clomid etc. As we have already learned that there arent enough of DP'S swimmers and that ivf with icsi is recommended for us, we decided to go private because even if anything else is 'wrong' having it fixed will likely still not lead to us having a baby (eg. Giving me clomid isnt going to help his boys get where they need to be). We have since had some additional tests done privately and discovered no further issues, so we thought that waiting the 18 months for the fertility clinic was a bit pointless for us. Of course, as I said, if you don't have a reason, they may be able to find one for you that is 'fixable' without having to go down the private ivf route.

As to your DPs morphology (and again, I'd like to point out that I'm far from an expert!) 3% doesn't seem far off the recommended numbers, but his overall count could be a factor. For example, 3% of 80 million is significantly more than 3% of 20 million if you see what I mean.

As always, apologies if any of my info is incorrect. I'll find the link to our thread in conception for you and post it, but if you don't feel like joining just yet, feel free to keep posting here. I'll keep trying to help, and I imagine that others in the same situation will see your post and join too :)