Low sperm motility and low fsh levels - what do they mean as far as ttc?

[Moomin]

A good friend of mine has been tcc for almost 2 years now. She has a ds who is 4 who was conceived with no problems. She and her dh sought help after 1 year ttc because of their ages (both 37). After inital tests, her tubes and cycle were fine but his sperm had low motility. They have been considering what the next stage would be and are open to private treatment. She had another appt last night (with her NHS consultant) and was told she has low fsh (?is this right?) levels and would probably not produce good eggs. She's very down and is querying even going to the next level, whatever that would be.

When I had trouble ttc the next stage I had was clomid, but with her dh's low motility would this not be considered? I'm confused. What does her low level fsh mean? I would have thought iui would be a good thing to consider next but it doesn't seem to have been mentioned by her consultant. Personally I think they should maybe go for a private consultation with a fertility expert and get a few things spelt out but of course it's not for me to say this at the moment. I'm consdering phoning her for a chat and wondered if anyone has any info on the above so I can talk a bit more informatively to her as I feel a bit useless.

Zinc is needed to promote the mobility of sperm and ova in the body so you may want to suggest to your friend that she and her DH start taking zinc supplements. Also, if she uses tampons tell her to stop because tampons dry out the vaginal region and the lack of fluid will hinder the movement of sperm and ova.

HTH

Do not think that IUI will be of any benefit here because of the poor motility.

Low FSH can be indicative of poor ovarian reserve. Was wondering whether her LH level was tested as well.

Going private may be an option but would say that there are many privately run clinics out there that offer poor treatment. Not all of them do but some certainly are poor. It will pay them dividends to do their researches thoroughly with regards to clinics and ask lots of questions before parting with their cash.

Zinc supplements won't do any harm but sperms are complicated things and there are many things about them that are not understood.

low FSH would mean everything was OK... it has to be below 10 to stand good chance of getting pregnant -- as you egg reserve diminishes, it gets higher... Agnus Castus might help with this...

sperm motility means that ICSI would probably be their best option (ie sperm injected directly into egg) but IUI could help as sperm placed high in uterus just demands how immotile they are!

That can be improved with lifestyle choices -- stop binge drinking, boxer shorts, zinc etc...

Really she needs to see a specialist and quickly... I had similar issues and got pg with IUI at her age... so inportant thing is to not worry and get some facts..

sperm are complicated. Has he had follow-up appointments following diagnosis? Has he been referred to a urologist? My dh has low sperm count and low motility and has been told that although he is not infertile, he has low fertility. If your friend has low fsh level it's possible she is not ovulating or that the eggs she does produce are not of good enough quality to result in a baby even if her dh's sperm problems are resolved.

I would advise her to do a lot of research before paying money to private clinics, if she were to go down the route of IVF, it's likely she would have to have icsi due to her husband's sperm motility.

It would be useful to know what sort of consultant she saw. eg if it was an NHS fertility consultant "going pravate" for a second opinion would not necessarily provide any benefit. For example our local NHS hopsital the consultants do a combination of private and NHS. Same with people like Prof Winston.

Sounds like it would need ICSI or IVF - Im my very humble opinion.

My husband was told he had very low motility and morphology and had the same results from a second test quite soon after.

When we went to the IVF clinic (a well respected one in London)4 months later to talk about ICSI and they retested him and everything came up normal.

In the interim period I got him to take various vitamins and stopped him having too many baths. Don't know whether it was that or just that the IVF clinics test was more accurate but something seemed to change. (2 months after the 'good test' got pregnant naturally after TTC for 18 months. Am 37 as well).

My be worth retseting especially if he's only had one test so far.

Have made HUGE error and misunderstood her jumbled text last night - turns out she has HIGH fsh levels (20.9) which I know is not very good, is it? Have asked her if this was based on just 1 test or an average of several as with no menopausal symptoms these levels can fluctuate can't they? Am waiting for reply.

Their hosp does NHS fertility treatment and is quite well-thought of; the private hosp they are considering has an excellent rep. My own consultant works there when he does his private work and is a top top bloke.

Her dh has had 2 tests btw

that's a really high FSH level.

It is isn't it? Feel gutted for her

Your poor friend must see the picture as being quite bleak.

We need IVF/ICSI because of male factor. Re the DH - it depends on how bad it is as to whether assisted techniques will be required. Semen samples can vary enormously. And lots of couples do report great improvements following life style changes.

Is your friend ovulating? From what I have gleaned, even with high FSH, pg is still possible. Was she tested on CD1 - CD3? She should have been. The problem your friend will face is if IVF/ICSI becomes their only option because of the male side. At that level, it is unlikely that she will respond to the stimulation drugs to produce multiple eggs - because her body is having to pump out so much just to produce one. Hence why clinics have FSH cut off levels, commonly 10 or 12 though the Lister takes less regard of FSH level.

There's lots of stuff on the net about how to lower FSH but how much is fact based I don't know - eg wheatgrass. There is a High FSH yahoo group but I don't have the address. There's also a book by Someone? Indichova who conceived after being written off as having FSG too high.

Some other resources that may help with information/suggestiosn are www.fertilityfriends.co.uk - there's a board there for FSH issues and also Male Factor. www.ivfconnections.com - ditto. Zita West's book is quite good too.

Finally, acupuncture gets good press when it comes to fertility issues and know some women use it to treat high FSH.

I do think it's worth your friend's while to have a consultation with a good fertility unit, or perhaps even a couple.

Just thought of another resource for the male side of things. www.sharedjourney.com > Forums > Dr Smith's board on andrology/embryology.

May be useful to post some questions re the semen analysis if your friend has been given a hard copy of the results.

A FSH level of 20.9 is not good I am sorry to say. Would be very hard to stimulate the ovaries.

Having said that though, if this is the only FSH test that has been done it needs to be repeated. Also her LH level needs to be measured and compared against that of the FSH.

Good prog on Radio 4 Woman's Hour today if you want any more info.