Very Low Sperm Count - can anyone interpret results or share their stories/advice?

[GryffinGirl]

DH and I have been TTC for about 15 months, after some nagging he went to the doctor and has had a sperm test. He had a follow up appointment today and got a copy of his results which don't look good at all . Has anyone had experience of this and would you share your stories (positive or negative) and any words of advice or comment?

DH's results look something like this:

Volume = 2ml (I think it should be 4-6ml for "normal"?)
Number of sperm per ml = 2 million/ml (I think it should be at least 20 million/ml to be "normal"?)
Motility = 40% (which I apparently not bad for what's there?)
Viscosity = normal
Acidity (pH?) = 8.2
Morphology = "unsuitable for morphology due to low count"
Comment = "severely low sperm count. suggest repeat"

DH has retreated into his cave again and doesn't want to talk , but has an appointment for another test. How likely is it that the results will differ from now?

thanks in advance.

p.s. the doctor basically said to DH "I have no idea how to interpret these results" , hence my appealing to you ladies

No idea how to respond just wanted to bump. Sounds to me that the doctor is not that good and you need to get referred to a specialist.

Hello

Sorry you are going through this.

My dh was diagnosed with a low sperm count in August 2006. He was told that his count was about 25% of what it should be, and the count was 5 million in 4 ml of fluid. The gp said at the time that although he wasn?t infertile, he had ?limited fertility?.

There are things that can affect sperm count, long-hall travel, tight underwear, cafeen, alcohol, but actually sperm is one of the lesser understood parts of fertility.

If your dh has had his repeat count, then I would ask for a referral to a urologist, but it has to be something your dh wants to do, men find it very difficult to accept that it?s them with the problem, so he may take some persuading. My dh is still very bitter about his low sperm count, and blames himself for the fact we have been unable to conceive again.

On a positive note though, we do have one 5 yo ds, but have been ttc no 2 for the past three years.

thanks wannabe - my DH is also very bitter and does not want to talk to me about it at the moment. I think he was looking forward to speaking to the doctor i.e. a professional rather than me with my googled information, but the GP wasn't a lot of use . DH does fly long haul quite a lot and probably drinks more than he should.

was you DH refered to a urologist?

hi gg, mens sperm counts do fluctuate wildly and a re a result of lifestyle. my dh had very low sperm count but we did everything suggested and it did rise so we could have a few goes at ivf, no baby from ivf though.
drinking affects it so does diet and heat. he had to blast his balls every day with cold water. he also took selenium.

hello hifi and thank you for the information about selenium and the cold water. The doctor has suggested nothing to DH, but from googling I have a fair idea

I hope you don't mind, but did your DH have to reach a certain level to make IVF worthwhile? Did it take long to get to the stage of opting for IVF. Good luck with your IVF in the furture

no gg he was never referred because he never went back .

He's been taking some vitamins which are supposed to increase sperm count but I haven't fallen pregnant and they've now run out and as it says not to take them for prolonged periods that's it for us really.

I always hold out hope that it will happen one day - we do have a ds after all and it only takes one sperm but dh won't talk about it and gets very snappy whenever I suggest that I could be pg.

I did have a friend who had had icci after having had a vasectomy which couldn't be reversed and they had twins, although sadly one of them was stillborn .

but there are ways of extracting just a couple of sperm if necessary.

wannabe - it sounds like you have had a tough time. Fingers crossed for you.

We do not have any DC's, so i would want us to take things further with a specialist if necessary, but we haven't yet had that conversation. At the moment DH doesn't want to talk to me about it, although he is going for a follow up test tomorrow so he is taking things forward himself.

bump

GG

This is precisely whey GPs should not do semen analysis testing because they cannot interpret the results properly.

Did you both attend this initial appointment when the result was given to your DH?. (I would have advised you both to attend). I would advise that you both attend such future appointments.

I would tell your husband that one poor semen analysis is not fully indicative of there being any male factor problems. Such tests should be repeated and done under the supervision of a specialist, not your GP.

Sperms are complicated things and there is much about them that is not understood. Simple remedies like taking vitamins do not actually show benefit. He needs a proper medical exam by a urologist to see whether there are any varicocele present for instance.

Men can become very unptight re sperm counts because many of them see a connection between sperm and their virility/potency as a male. Actually there is no such connection.

I would hope that your GP now sees sense and refers you both to a subfertility specialist at a unit.

thanks Attila for responding. I had hoped you would see this

No, I didn't go to DH's GP appointment - it was this morning. I offered to go with him and wanted to, but DH was insistent on going on his own. He's not ready to discuss things with me and wants "facts", so was absolutely floored when the GP could't offer any advice or guidance on the test results. He really got nothing out of the appointment other than a referal for another sperm test and the promise of a further referal to a "fertility specialist" (not specifically a urologist) if the results were the same. If it wasn't for google and the advice of MN-ers, we'd be in the dark .

I'm goign to make an appointment myself (different GP thank goodness) and ask for a referal. I have no apparent problems (clockwork regular cycle, aged 32, no history to speak of) but will need to be checked out if we are to take this further

thank you for all your help

Agree with the advice that your DH needs to see a urologist.
Just a word of encouragement that if there is no success in raising the count/conceiving naturally, ICSI is the assisted conception treatment to go for. This is IVF where they inject single sperm into the egg. Count sounds similar to DH's and ICSI worked for us
Best of luck.

sorry to hear about your experience gg.
for what it's worth, my dh was diagnosed with a low sperm count every time he had his sperm tested (can't remember the exact results, but your dh's motility seems to be better than his).
The GP referred us to a urologist who explained that having a low sperm count doesn't mean infertility. Sperm is made every three months (exactly when in the 3 month cycle nobody knows), and if your dh happened to have a cold or something like that while his body was making his 3 month's supply of sperm, then that would dictate a low sperm count for the next three months (hope that makes sense).
Secondly, it depends on the specimen they take for analysis (when your dh last ejaculated before providing specimen, etc.)
Also, the generic sperm testing is not a great indicator of fertility. When my dh's sperm test came back as abnormal my gp questioned it and told us that every time he sent a patient's specimen for testing it came back abnormal, which was one reason he referred us immediately.
The other factor, is, as you know, alcohol - no idea whether it had anything to do with it, but my dh was a very heavy drinker, but cut back drastically before we eventually conceived! He also spent a lot of time sitting down at work (nature of his job), and we made very effort to relax and take lots of long walks.

hth and good luck!

hi gg, they didnt specify a certain level but you do want quality sperm to give you the best chance possible. our 2nd go his sperm count the week before was fine then on the day it was really low again.the last time we did icsi, they ballsed up as i had loads of eggs and should have done half icsi and half ivf but they didnt. we gave ourselves a 3 ivf limit. we now have a fabulous dd, thru adoption. good luck.

bump

Bump

hope it went better today GG - good luck

thanks tickle - Dh is going for the follow up tomorrow not today (referal clinic wasn;t open today )

Hi there,

My DH also has low sperm count and also low motility. He was asemi professional cyclist and that was seen as a contributory factor. So poor DH no more cycling, boxer shorts for underwear, baggy trousers, selenium, pycnogenol, and acupuncture has all helped to improve count.

Most importantly, DON'T get tested by GP again... only because quality of sperm is severely compromised if left lying around beyond half an hour. Unlikely that testing was done at the surgery so chances are it was dispatched to somewhere at some later time and dealt wiht when someone was available to do it. If you go to a specialist, then they will test there and then. Also dont forget you should abstain from BD for 2-4 days before DH produces sample, no longer than 4 days because it compromises quality and no less than 2 days because the concentration wont be high enough. 3 days is the ideal.

DH first analysis was horrendous and we were really worried and upset, but next one was much much better, so there is plenty of hope, besides which, if you are candidate for IVF route, ICSI is the procedure they would most likely recommend which means they only need 1 sperm, per egg as they do the fertilisiation manually, and he has 2 million of them! Good luck!
WM

Dh has to go friday for a sperm count, which is isn't too impressed about but since we have been ttc for 18 months he has agreed to.
How long did it take for the results to be with the doctor as it is impossible to get an oppointment and i am desperate to know the results.

tegan, sorry to hear you are also experiencing this.

In our case, we were told that the results take two to three weeks to get back to the GP. The test is done at the andrology department of a local hospital and the results sent to the GP. Considering they have to test 30 minutes after the sample is produced, I can't quite work out why the results take 2-3 weeks to filter through to the GP! My DH went this morning for his second test, so another 2+ weeks to wait until we find out if the results are as poor again.

worrymerchant - thanks for sharing all your knowledge and I'm sorry to hear your DH had to give up his cycling (but for a very good cause ). DH was tested at an andrology clinic attached to Hammersmith hospital in London, so the GP didn't perform the test, only handed over the results (which he couldn't interpret ). If the results are similiar again, he'll refer us to a specialist. Can I ask, did you go down the route of having ICSI?

tea71 - it's good to hear that even with a low sperm count people conceivee. I've told DH that he'll should cut right down on alcohol, so let's hope it helps.

thanks to everyone for your wise words

Hi GG, yes we did do ICSI - unfortunately in our case we weren't successful, various contrubutory factors to that.

You might find it useful to check out a book called Fertility and Conception by Zita West from your local library. It's pretty good at explaining everything, even how to interpret sperm analysis. It makes good suggestions on what can be done to improve things and tells you what options are open to you.

THe most important thing s to try and get Your yourselves both as nutritionally, emotionally and physically fit as possible.

I am still not convinced your DH sperm is being tested immediately. If it is for a GP report, it may well still be left lying around. it is expensive to arrange a private test, but if you get referred to an IVF clininc then they should test and get the results back to you all during your first consultation!

DH seems to have quite good motility though, so don't forget to carry on trying naturally!! HAve you read Taking Charge of Your Fertility ? A very interesting read which might be very helpful in determining optimum timing etc.

WM

PS I think the motility thing is a big advantage to you because even though the count might be low, the motility - which is the foward progression - is quite crucial as this means they are good at propelling their way forward and so have a better chance of penetrating the egg. So that is why I suggest that if you get your BD timing right you can really optimise your chances. In a nutshell, there might not be many sperm, but they are good swimmers and so have the potential to get where the're going if you can get them to the door at precisely the right time! IYSWIM!

hi WM - thank you again for answering my questions and sharing your experiences. I am sorry the ICSI was not successful for you. You may be right that they are not testing quickly enough. The results suggested a 60 minute timeframe from erm, deposit, to testing. I think 30 minutes is best. I am comforted by the fact there is 40% motility. I have clockwork cycles and have been charting, so hopefully we are giving ourselves the best possible chance of a natural conception. We should eat better, drink less though.

I have ordered the Zita West book from Amazon

I would like us to go private if the results are poor again, if I can persuade DH. We are lucky, we could afford it. DH is 36, I am 32, and i don't want to waste time being added to waiting lists or playing a postcode lottery.