Semen analysis, advice wanted

[notsofertilemyrtle]

Hi!
TTC for 14 months and DH has had a semen analysis done, lucky him.
His count shows as low, 4million/mL but motility fantastic at 60%. On the report it says “no results for morphology, too few sperm”.
Does anyone have knowledge or expertise here?
The sample was 2mL so I’m surprised that out of 8 million they can’t test morphology. The WHO handbook even states a method for 6million motile sperm twice, with 3 month gap between testing.

Something feels off about his report. Time to analysis, lack of morphology and it took 15 days to receive the report (after chasing for days) when analysis was done 65mins after reception :(

Hi OP, I'm sorry to hear about the issues with your clinic, that sounds pretty off to me. Is it private or NHS? I feel like I'd be tempted to pressure them for a re-test.

Can I ask what you thought of the Yo test? I've been tempted to order this for DH!

@lawandgin hi! It does doesn’t it :( it’s private but the same clinic our local hospital uses. Unfortunately due to Covid, my GP isn’t able to refer for semen analysis so we had to pay for it.

The Yo test seems good to us, he wanted to do it to see how things were before paying full whack but obviously now there’s this major discrepancy (he got >6mil motile sperm, and 60% motility on report from clinic so can assume the count is around 10mil but with good motility hopefully that's ok). The Yo test was very easy as long as you follow instructions to the letter. It’s an app and you take it step by step.

You also get a video of the little swimmers 😂

My only complaint, and I knew it beforehand, is the you don't get a quantified number. It makes sense as I doubt software could handle that on a home device. You get either normal/moderate, normal/high or low. The threshold is 6 million motile sperm.
You then get a Yo score, not sure what it reads if you're under 6mil but he's had 10/100 and 20/100 in the 2 tests. So that's normal/moderate.

I think we might have to bite the bullet and chose another clinic, more carefully, and repeat testing. It's really bothered him though and he's being really inadequate that there weren't enough soerm to even analyse the shape. I'd like an explanation for the lack of information on morphology though as it seems incomplete to me! I could be wrong though, perhaps you need more than 8 million to do it?!

*Feeling inadequate, not being of course!

@notsofertilemyrtle haha that typo made me chuckle, but I knew what you meant!

You definitely don't need 8mil... my DH has a full report from surgically retrieved sperm (both epididymal and testicular) and there were just a handful of sperm! We got full info on morphology and motility. This was done during his vasectomy reversal. Now we just need to know if it's worked!

@lawandgin bloody typos! Poor fella has taken it all quite badly but I feel it's misinformation, from what I know it's the total motile sperm that do the job anyway.

How's your DH with it all? I hope the reversal worked!

Very interesting to hear you got morphology even on a handful. After reading the guidelines it sounds like they take a small amount, analyse and multiply it up to get the final figures. So it makes sense to me that surely they can test morphology even on a small number of sperm, so you'd think they'd have their pick from 8 million...

Tempted to call their info (sales) line and pretend I'm enquiring and ask a few questions, throw that one in there, that we need morphology but worried they can't do it with a low count.

We keep just getting automatic replies saying we'll be in touch soon...not impressed!

@notsofertilemyrtle ooh cunning! That's a really good idea! You could even record the call in case you need to rely on it later on...

Thanks, we don't think it has worked. It's a bit of a long story, but basically when we met I was very young and didn't want kids then, but knew I wanted them in the future. DH was divorced and as his ex didn't want kids, he'd had a vasectomy. Then she buggered off (nice). So we decided to get the reversal then, so hopefully we'd be good to go when we were ready. We had a SA analysis done shortly after the reversal which showed no sperm present, but we were supposed to get a repeat a couple of months later and never did.

He's okay about it, I think sometimes he feels a bit guilty that we'll probably have to have IVF and he feels like it's his fault. I don't blame him, these things happen and he didn't expect to end up divorced! I do hate the ex though, haha. I think it's very common how your DH is feeling, but it only takes on sperm and you're in it together 💛

@lawandgin very true, it only takes one!

Sorry to hear it seems like it hasn’t worked :(
Bloody ex, it’s a lot to ask and then leave!

Hopefully we both get our babies in the not too distance future ❤️

@notsofertilemyrtle I hope so too! My brother and SIL are planning to start trying after xmas and I'm already feeling gutted they'll probably get their BFP before us - I'm 4 years older and my brother already has a son who is 7, nearly 8!

Fingers crossed for you, I'd love to know how you get on x

@lawandgin hi again! I just wanted to update because so much has happened.

We went back to the clinic for a retest and got more info but very low morphology (basically 0% but 2% had usuable heads for ICSI) and count was 5 million/ml. DH has been taking supplements like a trooper since July, but it occurred to us that those technically wouldn't show up in his sperm until mid-October...his analyses were done in Aug and then again in early Oct.

NHS gave him an appt and said they wanted their own semen analysis doing. So he had that early Nov. His results have DRAMATICALLY improved! Count is now normal at 18million/ml, morphology was 3% which is just under 4% normal cut-off and motility 42%. He actually improved his sperm!!! I'm not pregnant, but I am so thrilled that all the gross supplements seem to be paying off 😍

I just wanted to share with someone, it feels like a huuuuge win.

@notsofertilemyrtle hello, that's great news, I bet you are both so pleased! What's the next steps for you both going forward then?
Can I ask what supplements he was taking? And do you think it's solely down to those, that there's been such a drastic improvement?
We got my partners SA results at the beginning of the month, morphology was 3% and motility only 15%, everything else was in the normal ranges. He's started taking wellman conception so hopefully will help!

@dogmam hi there!

I think he's generally been taking better care of himself but he's not a smoker, nor a big drinker. I've switched a lot of household things to less perfumed versions as I've read there can be hormone disruption but I doubt it's that if I'm honest as it's been more recent.

He wanted to try Proxeed but at 60quid a month it seemed a lot. He also takes the Wellman conception ones! I researched it and found that it's l-carnitine and acetyl l-carnitine that's not in the Wellman Vs Proxeed. The private clinic recommended Proxeed and said it's the only supplement they really bother with as it's well researched.

He now takes the Wellman, plus these two:

Solgar L-Carnitine 1500 mg Liquid... www.amazon.co.uk/dp/B003FFJL9S?ref=ppx_pop_mob_ap_share&tag=mumsnetforu03-21

Yamamoto Nutrition Acetyl... www.amazon.co.uk/dp/B074P5XJFK?ref=ppx_pop_mob_ap_share&tag=mumsnetforu03-21

Altogether it costs a lot less than the Proxeed and the three combined contain the same ingredients (slightly different ratios). Our GP was super impressed with the improvement!

Just for info, the liquid is apparently gross but he mixes with juice first thing in the morning as it has to be on empty stomach. The other capsules are just huge but he manages to swallow those better than the Wellman. They also made him smell weird for a few days but it passes. He smelt exactly like the vitamins themselves, so weird!

Apparently l-carnitine (LC) and acetyl l-carnitine (LAC) can be effective for motility:
"Results: The results showed LC, LAC and PF significantly increased the sperm motility."
www.ncbi.nlm.nih.gov/pmc/articles/PMC4163266/

I always take things things with a pinch of salt as I'm no medical expert, but for 25quid extra a month, I'm willing to gamble!