High count low motility?

[thislittlebird]

Does anyone have experience of this? I’m wondering how this will be treated when we attend our infertility referral. Will it be treated the same as low count because the motility is very low?

Sorry and by “treated” I suppose I mean handled, don’t expect them to do anything really.

Hey lovely! DH had very high sperm count but low morphology and motility, our GP told us that because the count was high there should overall be enough good quality sperm but when we saw the fertility clinic they said straight away we needed isci (if you don't know already this is a form of IVF recommended with low numbers of good quality sperm)
If there is anything lifestyle wise diet weight smoking which could be contributing it may help improve things xx

@Roo45 Thanks for replying, sounds similar. That's interesting because his initial result was classed as normal by our GP (until we looked at the breakdown) and then we saw a fertility consultant after I had an AFC scan and she flagged it as a potential problem. He has since had another SA and that result was worse than the first.

Unfortunately there's not much. He doesn't smoke, barely drinks, isn't a cyclist, he's pescatarian, maybe slightly overweight in BMI terms but really not much. So the only thing he can do (along with me) is be a little more serious about healthy eating and exercise in the coming months, but I suppose I can't see it helping much. Did your DH see any improvement with lifestyle changes?

I was really hoping we wouldn't need ICSI because of the additional cost but I am resigned to it really, prepared that they'll say we will need it.

Hi @thislittlebird

I think your DH should have more testing done. Specifically hormones and maybe genetic testing.

No point starting ICSI till you know there is nothing else wrong with his sperm as you'll most likely miscarriage if there is... (even after successful ICSI fertilization)

There is things they can prescribe or recommend (supps) but that depends on the results of further testing.

Please keep us updated.

@Iszzy thanks for replying. I had thought about this briefly but I’ve never heard of men having hormones tested. We haven’t been referred to a urologist only a gynaecologist for me, so I assume we’d have to go private for anything like this. Do you have any experience of what tests they do? I have only heard of dna fragmentation testing.

I guess it makes sense since we have a good few months. He has been on impryl but only for six weeks by the time we got his second test and his results had got worse (from 14% down to 9% motility and this time with below average morphology too, whereas previously it was normal).

@thislittlebird

A urologist would be beneficial. Testosterone and estrogen as a start. Have a read of this, although it's not specific to Azoospermia.

www.ncbi.nlm.nih.gov/pmc/articles/PMC8039603/

Curiously was sperm analysis done 3 months apart?

@Iszzy thanks I’ll check it out. His first was done last July (as were my tests) and we were both incorrectly told our test results were fine. His second was done in the last 6 weeks.

Or maybe last August actually, but yeah...some time ago.

@thislittlebird

Ok. 3 months apart is the best way to compare tests back to back correctly, as spermatogensis takes 90 days, causing a peak in results every 3 months, followed by a gradual drop. So if you test 3 months apart, you are at least testing (approx) during the same period within spermatogensis.

@Iszzy yeah, so we should push for another test 3 months from his one a few weeks ago? I guess that makes sense, I’m not sure if they’ll ask him for another when we go for our referral in May.

@thislittlebird

Yes, do another one in 7 weeks time to get an idea if the supps and diet is helping.

Can you post the full results from 7 weeks ago? I can look up something later tonight and give some more tailored advice.

@Iszzy sure, thank you. I’ve attached them here. I asked him if his abstinence was really 2 days and he said he couldn’t remember, was either 2 or 3 days. I’m confused by the morphology listing on here because it says normal and then below that (at bottom of sheet) it says below range. His previous morphology was ok.

Yeah he’s on a few supplements but can change those or try something else I suppose once the three months is done.

And this was his previous one in case that’s useful at all for reference

@thislittlebird we are in a similar boat DH could use a little more veg in his diet but otherwise not too much lifestyle we can change. Our results also seemed to get worse after supplements! We just took a general preconception make vitamin but after doing some research DH has now been taking co Q10 for last few weeks and hopefully this will help? Poor sperm can sometimes just be one of those things, in our case DH had some some surgery near the testes as a child which they think may have affected the sperm but there is no way to know for sure!

We've had 2 failed cycles and our consultant has recommended further blood tests for both of us- I'll try and find the letter and add them.
Yes usually a urologists would advise on further investigations apart from blood tests which may be worth considering- I've heard of cases of varicoceles which can't be felt but diagnosed by urologists and treating that improves the sperm count. Xx

*male vitamin sorry, we researched different ones and they all seemed to have similar ingredients so we just went for one that wasn't too expensive. I've also added walnuts and Brazil nuts to DH diet but he's not great at taking them

@thislittlebird

'Sperm morphology (normal)' basically means "% of normal sperm"

The positive thing I see in the results is that everything else is actually good, meaning it may be something minor.

I'll send you a PM

Thank you! @Iszzy

@Roo45 honestly I find it such an inaccessible subject because I’m dealing with understanding my own issues (low progesterone maybe no ovulation) and now I’m having to understand his issues as well. It’s nice to find people on here with similar problems tbh.

Why are they getting worse for our husbands after the supplements????? It’s such a nightmare, I can’t get my head round it all. At least his surgery might make some sense.

The only things my husband has had was chlamydia from his ex as a teen (which he got seen to as soon as he found out) and he did have Peyronie’s disease onset just before we first met.

Would be handy to know what blood tests they suggest, I’m hoping we can work some of this out before we start it all. He saw a urologist in 2012/13 for his peyronie’s but I assume they wouldn’t look for a varicocele at the same time so it might be worth getting him to see one again now.

@thislittlebird I know I found it hard to deal with too, if your DH is anything like mine he doesn't want to talk about it. I'll find the letter and post in the next day or so.
@Iszzy would you be happy to give some advice for my DH SA too?xx

Thanks! @roo45

Mine sort of talks about it but I know he finds it hard. I think men take these things harder than we do too. I was really hoping to see improvement this time, I guess I’ll have to hope to see it next time instead because I think it would help him feel better to see it improving.

@thislittlebird

I think for men, they don't realize how common it is.....

I just noticed you mentioned your DH has Peyronie’s disease onset.. it would be interesting to see if his hormones are still ok and if inflammation is nil or elevated. I assume he is no longer taking any medication for this?

@Roo45

I've sent you a PM

@Iszzy I have wondered if the peyronie’s could have caused this. When he saw a urologist before (when it had just happened) there wasn’t much they could do but they mentioned surgery which he was really not keen on. He was in pain but the pain subsided over time and use and all they gave him was painkillers (ibuprofen, I think). So over time it has become a non issue but I can’t help but think about it causing this issue in some way.

Thanks for the DM, I’ll read it properly and reply to it later!

@thislittlebird so sorry for the delay, LH FSH testosterone thyroid function test and prolactin