TTC - PCOS and Low Motility

[Lils93]

Hi all,

I'm new here! I'm not really sure where to start and feel like I'm about to off-load my life story, so my apologies in advance!

Myself and my partner (both nearly 30yo) have been TTC now for 9 months now (which I appreciate isn't the end of the world given people try for much longer). However, we have the following hurdles and are currently in the process of a referral to see a fertility specialist:

PCOS:
Diagnosed 10 years ago through blood tests and pelvic scans, I've been on Metformin ever since
I use the Clearblue digital OPKs which do show a spike each month/suggesting that I am ovulating (I also get egg white CM)
Most recent blood tests were all normal - I think the Metformin has been working! (tested LH/FSH/E2)

Suspected Endometriosis:
Ongoing pains in my pelvis, specifically on the left side
Pelvic scan suggested that the left ovary is 'stuck' to the lining of my womb (pelvic adhesions)
I was referred to a gynaecologist who advised against having surgery to cut the adhesions as they'd most likely grow back by forming scar tissue and will interrupt TTC

Semen Analysis:
My partner's sample showed that the amount of sperm is normal but the motility is low at 36%
The results also showed that some of the sperm is misshapen

Frenulum tear:
2 months ago, my partner experienced a frenulum tear during my fertile period (worst possible timing)
He's now experiencing pain during intercourse, adding more pressure and making this feel like an impossible mission (we took a break for a while, but he's determined to carry on)

Has anyone else experienced a combination of the above issues and been able to conceive naturally? I'm beginning to feel like IVF may be the solution we will be given.

Also, slight tangent, but we're discussing holding off starting IVF until we get married (nothing set, but if we're told IVF is our only hope, we'd have something a bit 'shot gun' within the next 6 months). Does this just seem like a waste of time/would it be best to just concentrate on have a baby first given our age etc.?

I feel a bit conflicted but also don't want to 'rush' into the IVF as it almost seems like the last resort....

Any thoughts/advise welcome. Thank you! 🙂

At 30 years old your not old. Fertility does dwindle with age and it increases more after 35 but its gradual
. Its not a cliff. At 30 a reproductive doctor would consider you a spring chicken.

I'm 37 and I have pcos and now they are saying they suspect endometriosis. My partner has low morphology .
Where nhs will go really depends.
They might suggest you try a few months on ovulation induction to increase your chances. Itll boost your egg production and hopefully produce a better quality egg. Thats what they made me do.
Were starting ivf at the end of the year but were told as I have pcos it'll be a longer process and require a few months between egg collection and transfer because your at risk of ohss with pcos.
Unfortunately I don't have a success story to share but we did manage to get pregnant in december ( loss) which in itself was a miracle as we've been trying for many, many years however there's also women with pcos and endo who get pregnant without issue or just needing a little help. It really just depends on the individual couple.
I wouldn't rush into ivf if your not ready. There's you've a good few years yet before you need to panic .
We've been talked through the process and it's a big deal, and to be honest I'm scared but as I'll be 38 now and considering how many years it's been , I feel ivf is probably the next step for us as we've tried everything else at this point

Thank you so much for your reply and insight!

I'll see how it goes at the referral, and I'll definitely ask about the ovulation induction as I didn't realise this was an option. Were you given any information on your partner's morphology at all? I agree that IVF is a big decision and so will take your advise re not rushing into it.

I'm very sorry to hear about your loss. Wishing you all the best on your IVF journey later this year, really hoping it all works out for you!

Hi - I know this is an older thread but wondering how you got on??
We are in a similar boat: 35, TTC for 6-months. I have PCOS but ovulate (positive clear blue OPK and mucus) with possible endometriosis (awaiting repeat scan).
Husband also has borderline motility.

Thanks and would be good to hear how you are getting on.

Hi @Englishrose35, thanks for you message.

Unfortunately I don't have much news, we are now on month 15 TTC.

My partner has a repeat semen analysis test in two weeks, once we have the results for this we will be referred to the assisted conception unit to discuss our options.

I'm continuing to take Metformin the PCOS and still seem to ovulate each month (positive OPKs and mucus too). The only option I was given re the endometriosis was to have surgery on the adhesions, but we decided against this as it may not drastically improve our chances of conceiving naturally and will disrupt TTC.

Thanks and wishing you the best!

@Englishrose35 I have PCOS and my partner has a low count and low morphology, if you haven't already I'd get the ball rolling with the doctors as the wait times can be horrendous! We're 2 years in and just about to start our first round of IVF in the upcoming weeks. We were advised due more the male factor side IVF. This may not be the case for yourself but I would definitely get speaking to your GP x

Hi @waitingforourmiracle may I ask how long it took from the initial referral to IVF start date? I suppose the waiting lists depend on whereabouts you are etc. I just want to manage my expectations, we started the referral process with the GP back in July (first tests etc). We're now with the gynaecology unit waiting for the second semen analysis results before they will refer us to assisted conception. Thanks!

@Lils93
Thanks for responding. Wishing you the best too and hopefully the assisted conception unit can offer a plan after the repeat semen analysis.

My endo isn't confirmed - and I might need a laparoscopy following my repeat scan. All very stressful as causing a lot of delays and feels like there are a lot of obstacles. Wishing you the best!

I have PCOS and my DH had low morphology (but no endo in our case). We both lost 10% of our body weight together (i had already been taking metformin for several years), he started taking specific vitamins for male fertility, switched to non-alcoholic beer and just before he went back for his repeat semen analysis last summer, we found out we had conceived naturally (first ever natural conception in 5 years of TTC - our DD1 was conceived using letrozole for ovulation induction in 2021). I def recommend ovulation induction before moving to IVF, just in case it works. It doesnt delay things by much time as you can only do so many cycles but is much less invasive than IVF. Agree with PP on getting in the system though. We were able to do all our weight loss etc after being referred and whilst waiting for our appt, so it didnt feel like time wasted.

Sorry to those of you who are having troubles conceiving - its so awful and i hope you are all able to look after your wellbeing

Thank you for the helpful info. It's so horrid having issues on both sides isn't it ☹️
I paid to see a gynaecology consultant privately who also has an interest in fertility. I'm probably going to ask for GP to refer to NHS fertility clinic now (has been 6-months) but we are prepared to pay privately if needed depending on waiting lists.

Do you mind me asking what your partners count and motility were? Ours are borderline and we've been told "natural conception is still possible"
First SA had low volume and borderline count and motility, second SA had Normal count but low motility and slightly low morphology. DH has previous torsion.

My worry is that we have 3 things against us already

We're 2 years in and just about to start our first round of IVF in the upcoming weeks. We were advised due more the male factor side IVF. This may not be the case for yourself but I would definitely get speaking to your GP x

@Lils93 The wait from the GP to the gynae was the longest part for us, the wait for that was about 8 months (should of been longer but they messed up my referral so it was pushed through in the end) we had our first appointment at the hospital in the July, same has you had to have a repeat SA done and couldn't get another appointment with the gynae until the October that's when they confirmed we would be going straight for IVF, the referral then was really quick, funding was accepted within about 10 days, my GP then had to then do the referral which was lost in translation abit but was done in November and I had my initial consultation beginning of December, I would of started treatment that month if it wasn't for the Christmas closure. I hope that helps! X

@waitingforourmiracle that's really helpful, thank you! Fingers crossed our referral from gyane is as quick and the funding etc. goes through smoothly. Wishing you all the best for the IVF! xx

@Englishrose35 I can't remember what they said for morphology but I know it was "poor" his count was 2million both times. Since then he has been taking zinc which we were advised and he has cut down a lot on his drinking, he did had a few over christmas but we're both t-total now till after the treatment x

@Lils93 we're greater Manchester based and our referral was done to CREATE instead of an NHS hospital, may be worth looking into private clinics that accept NHS patients as things seem to move quicker x

@waitingforourmiracle great, thank you. I'll definitely have a look into that x

@CrispAppleStrudels so glad you were able to conceive naturally, always reassuring to read! Can I ask if you were ovulating naturally before starting on the letrozole? I do seem to be ovulating each month so I wonder if I will be offered the induction before IVF x

@Englishrose35 no problem at all! Thanks, I shall write an update once we have the results and know what the plan is. I completely understand, it's so stressful and so many hoops to jump through! :( x

I was showing as ovulating on OPKs but i had no EWCM and blood tests showed that i wasnt actually ovulating. I did one cycle that didnt result in ovulation, then the dosage was increased and i did two more cycles which did result in ovulation and ultimately a BFP.

Pcos here and endo. 38 years old.
Male low count and morphology.
I'm currently 3 months pregnant from ivf.
We actually got pregnant naturally a year ago after a hsg dye but it sadly ended in a chemical. The hsg gave my ovaries some sort of boost as I began ovulating on my own. We tried clomid on top but didn't get pregnant so went forward with ivf .

Thank you for sharing and congratulations on your pregnancy.

Can I ask: how long were you TTC for before they offered clomid? And then total time TTC until IVF?

And do you know if the count was very low or more borderline? Thanks

@Lils93 hello!

Sorry I'm late to the post, I'm exactly in the same position as yourself! PCOS suspected Edno and my partners sperm was low on morphology and motility.

We found all of this out late last year and I fought for a fertility specialist referral which I finally got in January.

My other half has been taking proxceed supplements as directed by the fertility specialist and I'm on Infolic Alpha supplements alongside merformin and folic acid.

Partner had another semen analysis recently and came back above average so the supplements have definitely done what they say on the tin!

We've been TTC for 2 years now. I paid for a private consultation about my Endo but we opted out for the surgery with everything else still going on. We're eligible for IVF come September but have some hope since our chances to naturally conceive have increased after my partners semen result.

Don't give up hope. I'm in the two week wait window at the moment so my mind keeps thinking about being faced with another negative result, but feel assured knowing we have other options to explore.
The most annoying thing about PCOS whilst TTC is the symptoms are the same as pregnancy!

How are you getting on?

@lolli96 Hello, thanks for your message!

My partner recently received his second sperm analysis results, unfortunately still the same (with only 2% morphology). The gynaecologist has therefore pushed our referral ahead to the Assisted Conception unit and we were advised of a 30-33 week waiting list to start treatment (somewhere in October it's looking like). Currently waiting for our initial appointment at the hospital to see if IUI or IVF would be best.

Great news about the improvement in your partners results! Can I please ask specifically which supplements he's been taking? We will give these a go in the meantime.

Fingers crossed you've been able to conceive naturally, hope the two week wait goes quickly and you get your positive result!

@Lils93

Oh sorry to hear that! So my partner was in Proxeed supplements you can get them on Amazon for the better deal, but they are quite costly.

We received a positive test last week so hope baby dust comes your way!!

@lolli96 Oh wow, massive congratulations to you! Thanks, we will give the Proxeed a go x

@Lils93 thank you!

If it helps I'm selling a brand new box and a few left over from the last one vinted for £35. On Amazon one box is £60!! It's extortionate!

@Lils93 ignore me it's not allowed!