IVF/ICSI questions, DH extremely low sperm count

[Imisscoffee2021]

Hi, I've been trying to concieve since May 2021 and haven't had even a snifter of a pink line on a pregnancy test. Because I'm ovulating like clockwork (use opks and temp) and really target the fertile window well we were getting worried so we got a few tests done. The results for DH's sperm analysis were extremely poor, it really shocked us as he has a healthy lifestyle and doesn't smoke, drink to excess etc etc.

Its so low on all counts its looking like we will have to have ICSI and I was hoping to hear from people who had had it, how long from referral to embryo transfer it took and how many rounds they got on the NHS as its something that seems impossible to find on the web! I know it differs by area, I'm in the London/South East UK. Just looking for some real experiences as all my friends have managed to get pregnant easily and naturally, and just had a floodgate of lovely pregnancy announcements that still hit home that we don't have that baby yet.

Xx

Hi me and my husband had icsi but this was back in 2019 his sperm count was actually fine but motility and morphology were really bad we live in West Yorkshire it was 8 months from referral to positive pregnancy test but not sure of wait time now because of covid, he can take vitamins that can help such as co enzym q10 and zinc also no red hot baths etc sorry I couldn't be more help good luck ❤

Thanks for a speedy reply! His was so low on all counts, morphology, concentration count snd motility, not good! He is taking supplements now with those you highlighted but I suspect its something either congenital or physiological with him that would be tricky to improve with lofe style changes only, as it was suchna low figure, way below the baseline on everything. 8 months isn't too bad to wait, I just turned 34 and thought I'd have a sprog by now, so patience is becoming a way of life! Do you mind me asking how old you were when you got it as I've been reading that some boroughs only give over 35s IVF/ICSI?

We were told we would need ICSI as DH sperm were so useless on all counts! We decided against as we already had one and it would have cost a lot of money but DH started taking lots of supplements (can’t remember which, they were specific sperm ones) not carrying his phone in his pocket, not cycling, no right boxers etc… We did conceive but it look us the best part of 2 years from start to finish. About 6 months on supplements for DH.

He can always try other ways to help while you wait.

Good luck.

We had ICSI in 2015. Took ages to get there as we TTC for 2 years, then referred for unexplained infertility and then 2 years later had our final tests for IVF and it was discovered DH had antisperm antibodies. Unexpected and totally unclear how they occurred. We had ICSI at that point and created 4 grade AA embryos which were all frozen as I had OHSS.

We had a frozen embryo transfer in 2015, he's now 6 We had another in 2017 and she's now 3 We have 2 frozen embryos still in storage.

In 2021 I had a weird period and went off my morning coffee... She's now 5 months

Don't worry about it being ICSI, it makes minimal difference from your perspective. Best of luck to you

@Addictedtovinted thanks for the info that's so encouraging to hear that lifestyle didnchange things, a surprise pregnancy like that would be a dream! So both your transfers went successfully then? Again dream scenario, the statistics for IVF just look so scarily low sometimes.

Apologies I meant to say @Rosser regarding lifestyle changes! Im trying to concieve our first child so thinking ICSI is the only way, but a surprise pregnancy would be fantastic to say the least!
@Addictedtovinted, thanks for the comprehensive reply :) Lovely to hear from real experiences, hope this year is the year for me xx

I really recommend attending a virtual open evening (or few) for any clinics near you. They usually go through a PowerPoint of what to expect. It’s very general information as it’s not tailored to your specific situation but it’s helpful anyway to get a better understanding of what to expect from the process.

Hi @Imisscoffee2021

They can decide between ICSI or IVF on the day depending on the sample given - it really isn't very different at all. I would highly recommend your OH seeing a urologist. The NHS tend to just refer you for IVF without prodding and poking the man when actually a comprehensive understanding of his issues will either a) help you conceive naturally or b) improve your chances via IVF. I also recommend you read BIG FAT NEGATIVE and listen to the podcast.

I'm SW London and was referred end of Jan and I've had 2 phone consultations and we could call this month technically to get things started but we want to try a bit longer first... so that is exceptionally quick I feel. We only have 1 funded round.

Oh and research Proxeed - but if you think it's a physiological problem that would be a waste of money, so confirm that first. Hope that helps x

@flyonthewall89 Thank you for the info! I'll look into proxeed, can't hurt to take care of that element in case it helps at all. I have a call with my GP next week where I'll really push for referral, they're quite good so don't think it'll be a problem. Definitely want him to be thoroughly examined by a urologist to check for physiological and hormonal issues before going for IVF.

Do you mind me asking why you only received one round funded? Was that an age criteria or simply the amount in your given area? I saw it differs between 1 and 3 depending on area, I'm also SW along on so imagine I'll be in the same boat, but ots a relief to hear its quite an efficient process at the moment.

We didn't go through the NHS as wasn't eligible but privately, we began consultations in August/Sept (after 6 years of TTC!!) and began the protocol in November. Opted for ICSI as success rates were higher than IVF.
I also developed OHSS, but they got 23 mature eggs. Only 5 fertilised and 1 made it to Day 5 - Grade C! Despite all of that, I'm currently 18 weeks pregnant after the one cycle!

Congratulations @cherrytreecottage! What a wonderful outcome after all that! It's amazing what can be done these days, and thank goodness! I was so naive with it all as I've never been on hormonal birth control, knew my body like clockwork and thought it would be a cinch to get pregnant, we never dreamed it would be DH with the potential issue but so glad we got tests done! Wishing you a lovely rest of your pregnancy :)

I almost forgot to ask too, do they take into account weight for IVFA too? I'm not hugely overweight but could probably lose a good half stone to a stone and be an ideal weight, and I have a very physical job that means I have alot of muscle so my BMI isn't exactly indicative of my body shape but I've read they check that.

@Imisscoffee2021 no it's purely down to area. We are SW London. I'm 33, super healthy and so is my partner. Sadly it's a postcode lottery and so often doesn't work first time!

I think the BMI is 30 and they're pretty strict about it. I know one of the reasons is because of the sedation for egg collection and higher BMI people are at higher risk of complications.

For the referral you'll need to have had day 3 and day 21 bloods, transvaginal scan, STI test and your partner's SA.... he should be asked to repeat it in 2/3 months too... 1 SA isn't reliable.

X

Hey sorry for the late reply I was 30 when we started our icsi we were only offered one round but that's not age its the area we live that's all the funding you can get however if it fails you get up to 4 frozen transfers on the nhs they just won't fund another fresh cycle I also paid to have my amh levels tested which were low for my age at 12.9 I think so we had to have short protocol with the highest dose there was no question of just ivf with us because of dh results and you have to have a bmi under 30 or 35 to get nhs funding hope this helps xx

Hi @Imisscoffee2021

My husband and I are in a very similar situation

We have both gone into panic mode and are quite upset by the whole thing! I just wondered how you both are getting on and whether anything helped?

Hi @alt22 , I'd forgotten about this thread, its nice to be reminded of points in this journey! So sorry you're going through the same thing but hopefully our time since that first post in March last year will encourage xx

So since finding out my husbands SA results, we went to a private urologist to check for a varicocele. When we first got together in our early 20s he thought he had a varicocele but a GP examined and said no. Turns out he does have one, a huge one! We could even see it, so that's the cause basically. Urologist advised embolization and to avoid NHS waiting times we went private, all happened quickly but it didn't work as surgeon couldn't find the right vein (happens in about 10% of men). Back to square one!

We decided to go for ICSI and do what we could to improve the sperm with life style. I'd read so many stories and clinical studies of DNA fragmentation negatively affecting IVF and shocking embryo drop off rates etc so my husband stopped drinking caffeine, alcohol, took proxeed daily, no more baths and very loose boxers. He also most importantly ejaculated every other day for the 2 to 3 months leading up to IVF, or as nearly as he could to avoid oxidisation damage to sperm. He also on advice of the ivf clinic only had 24 hour abstinence before providing the sample on fertilisation day. We knew the cause of his semen parameters so not saying this is a cure all, its just what worked for us, frequent ejaculation may not work for other issues and may make it worse.

We did a private IVF round in August, got 7 eggs from me, all fertilised. We waited to see how many would drop off as the rate of attrition is usually high but we actually got 3 top and 3 good quality blastocysts from that 7! The 7th was an early blast and they gave it an extra day but decided not to freeze it as it was slowing down. So a really successful result for us after all that worry!

Fresh transfer failed but I had the first frozen transfer in October and I'm now 12+5 weeks pregnant and have my NHS 12 week scan tomorrow. Had alot of scans already from IVF and first time mum anxiety and all well so far, kicking little fella bouncing away in there on the last one :)

Very long story there but hope it's helpful, I will say we're still waiting for IVF funding for a round (did that concurrently in case private didn't work) but that may just be our ccg being slow, we used our lockdown savings to go private.

Any other questions do let me know, happy to help where I can!

@Imisscoffee2021

Oh goodness me what a journey! Thank you so much for taking the time to get back to me. It's really helpful and a massive congratulations to you! I hope it all goes well for you both and you have a smooth pregnancy.

I think we're just trying to get our heads round the fact that we're probably at the start of a very long journey ourselves. My husband is quite upset by the whole thing and I'm trying to show a brave face and be practical.... hence all my googling and searching Mumsnet!! x

@alt22 speaking as someone 8 months down the line, it doesn't feel like it was a long journey now. There were lots of tears and frustrations with our situation, especially when the embolisation didn't work, but we've got really good at bouncing back, pulling ourselves up together. I much much preferred the 8 months of action to the 8 months TTC naturally and getting nowhere, that was such a weight and mental load, hated the unknown.

Have you gone down a urologist route to find out the cause of your husband's parameters yet or is that the next stage?

We haven't had treatment yet but we're on the list for icsi. Given his poor semen tests and I have pcos , I have 1 or 2 periods a year and don't ovulate. Was due to start first round of clomid this month . we've been trying to 17 years! I just found out I'm pregnant, naturally with no help . Unfortunately I think I'm currently losing that pregnancy really early but just the fact I've had all these positive preg tests don't give up. We were told it would be very difficult to get pregnant and I got pregnant the first regular cycle I've ever had

Now that we've got our heads round it a little bit - urologist is the next stage for us. I'm hoping they will be able to shed a bit of light on things. There must be a reason for it and I'm determined to get to the bottom of it! In the meantime, my poor husband is being given a lot of supplements!!

Hi all, thank you so much for sharing your experience!

I'm going through something similar at the moment... my partner has extreme low sperm counts after a varicocele surgery. He was lower than the normal before, but not extremely bad. So we decided to do the surgery and hoping we will be able to conceive naturally.

But very sadly, the surgery made him a lot worse than before, and very weirdly the surgery was considered successful as the varicocele had been completely removed. He did multiple SA tests (3, 6,12 & 14 months after surgery) but all the results were the same (from millions drop to tens).

We tried 1 round of ISCI around 6 months after his surgery, it was just about enough to fertilise 4 eggs. And only one embryo made it. Unfortunately the only one we had ended up with a missed miscarriage. The hospital said it's very likely due to DNA abnormalities but the NHS wouldn't test for us. The whole experience was very painful.

We are currently going into round 2. But his sperm has still not been improved, no matter how much he changed his life style and taking so much supplements in the past year!

He's seeing a private urologist now, but we are not sure if we can find a solution or if this problem can be fixed. It's been so frustrating for us! And now we are accepting the fact that we might not be able to have a healthy baby with his sperms, and considering sperm banks. And I'm 36, the clock is ticking!

Just wanted to share this and see if anyone has any more positive thoughts!