Infertility due to low sperm count- ICSI and more!

[Stace2015]

Hi All, last week we found out that my dh has a low sperm count so have been referred to a fertility clinic, currently awaiting the referral letter. At the bottom of his letter it says: Eligible for ICIS ONLY... Next to IVF it says N/A.. did anyone else have this or any insight as to why we would only be eligible for ICIS?!

We are both in our late 20s and have been trying for 2 years. My dh has now been on vitamins and trying to eat more healthy so that we can either conceive naturally or prepare for whats next.. any advice?! x

You're only eligible for ICSI because that is what will give you your best chance of conceiving.
IVF is where the eggs are collected and then mixed with sperm in a dish to see if they will fertilise. ICSI is the same, but the sperm are injected straight into the egg.
You've been offered the ICSI 'upgrade' because the low count means there probably aren't enough healthy sperm to fertilise the eggs if they were left to their own devices.

You could ask for a referral to a urologist to see if they can improve his count, and you could also both try 3 months of no booze, healthy eating, vitamins etc to see if that would help. But it takes 3 months for a difference in sperm, and you would have to ask the clinic to re-test you, which might mean you drop off the waiting list for IVF. Probably best that you book a follow up appointment with them to discuss some options, because you eligibility will depend on your area.

Hi Sparechange thanks for that bit of info!

Correct me if im wrong.. So IVF is when both the sperm and egg are removed and put into a dish to their own devices, but ICSI is when they are put into a dish for the sperm to be injected into the egg itself then put back inside of me?! Sorry but only just looking into infertility, IVF, ICSI very recently! Still learning.

My dh only had one SA done at the hospital so im assuming it will prob be another 3 months until we get our fertility appointment and they will try to test him again. My husband has a very bad diet and a very sweet tooth so its difficult trying to change this but i have got him wellman conceive and zinc vits and have asked him to cut down on sweets, chocolate etc. Hopefully when we get our referral appointment things will have changed!

No... IVF is the standard treatment - you take the drugs, they remove the eggs, the eggs are fertilised, the embryo goes back.
ICSI just means that instead of the sperm and eggs being left in a dish to see if they fertilise, they use a microscrope to select the best sperm, then inject it into the egg, and repeat for each egg they collect.
It is just one small alteration to the standard IVF process.

He really does need to sort his diet out, because all the vitamins in the world won't help if he is eating crap all the time! And there are probably a few lifestyle improvements he can make - lose underwear, not resting laptops on laps, taking more exercise etc
There are lots of books on it - would he potentially read one of those?

Hi stace2015 sorry to jump on your post but if you don't mind me asking, what was your husbands sperm count? I ask because my husbands latest count was 3 million but our hospital don't seem fussed. They told me today that they will only investigate it further if it drops below 1 million!? My DH is 30, a healthy weight, has hardly drunk a drop in the 2 years we have been ttc, never smoked, has been taking fertility vitamins for the last 4 months and exercises regularly.

Just wondering if this is standard practice or if you/anyone has been referred a similar count?!

Thanks sparechange, I was totally baffled but you have cleared that up for me!

Knowing my husband, no, he won't be willing to read any books! I've tried to softly suggest things but it seems whenever I bring up him changing his diet etc, I'm 'nagging'. Hoping once he hears it from the hospital, it will give him a kick up the ass!

Hi Closephine85, I'm afraid I don't know the exact count! I have the test results paper here but can't quiet seem to work it out! Our gp told my husband over the phone and basically said 'your count is lower than we'd like..' Which was pretty in helpful!

stace Be gentle with him. It is a massive kick in the guts to find out you have fertility issues, and men seem to take it worse than women.
Maybe you could read the books and point him in the direction of any useful bits?
And ask if there are any fertility counsellors that you could both go and see, who might be able to help you make sense of some of the emotions that come with getting news like this.

There are some great support threads here, which can answer lots of questions you have about any terms you don't understand so ask away if you need to

Aw thanks so much sparechange, you've been fab! I am actually going to order a few books, do you have any suggestions?!

I'm going to be patient and wait for this fertility appointment and then we know where we stand. Thanks a again

Happy to help!
The Zita West and Robert Winston books are good, but both more focused on female infertility than male factor issues.
Might be worth asking on a couple of the other threads if they have any suggestions, and I'll do the same and report back

Will do! Thanks again luv x

I highly recommend having a referral to urology, please push for that. It's lazy to just refer you for fertility treatment without knowing why the count is low. It is possible that the count could be low due to a simple infection or blockage which would be easily fixed without needing icsi.

My husband has very low count of 0.1 million, we've not been to referred to fertility at all just to urology who have been absolutely fantastic. It's likely we will need icsi but I am so glad that he's been thoroughly investigated by experts in male fertility.

It takes a while to sink in for men, my husband couldn't really accept it for a long time but he has now it just took him much longer than I thought. Just be patient and don't expect him to cope in the same way that you do.

As the GP didn't order a repeat sperm test that implies his count isn't that low. The guidelines state if it's considerably lower than normal the sperm test should be repeated ASAP to confirm but if it's just slightly low to wait 3 months.

Hi Lugo40

Thanks for that bit of info! Very helpful! Yes it is quiet difficult to try and talk to him about it without coming across as moaning or nagging him!

Yes the Gp did say to him that it was 'lower than she'd like' so I'm assuming it wasn't REALLY low.. Hoping that this is a positive and can be easily corrected x

Diet and weight loss may have a huge impact on sperm quality.

Monica