Sperm results not great - looking for context

[Plantsandcoffee]

Hi everyone,

New on here and just had some news about our fertility. Looking for advice and information from others who have had a similar situation to us on their journey.

I don’t know anyone whose had fertility issues. Everyone I know seems to have gotten pregnant in a heartbeat, even my own mum. So I’m feeling really alone in this.

Been trying just over a year, had the initial tests I’ve checked out all well (I’m 32) but my husband (36) had a sperm sample back which was relatively high in volume but morphology , vitality and mobility were all below the average. Listed below:

morphology 1.5% - below 3-4% average
Vitality 34% - below 55-63% average
Motility 27% - 31 -34% average
No of sperm 59 mill - above average

This has kind of frighten me/us and I feel really like I don’t know what to do. We’ve been referred to Guys St Thomas but have no context apart from comparing with the averages from the GP. We don’t know anything else, such as what are chances of natural conception? or how long we’ll have to wait for a first appointment? or any treatment? Or is there any treatment before ivf possible for us? Are there hormones or medications that can be taken to improve these results?

Any advice from someone who has had a similar test result and experience would be so helpful.

Thanks everyone

Hi @Plantsandcoffee, our situ isn’t too different and we’ve been referred to Guys too. My husband’s percentages were 2.5% morph, 9% motility in March and he’s managed to get it up to 8% morphology and 26% motility by May with the help of supplements and regular ejaculation. His count is normal/average and ranged from 47-74 mil per ml.

It’s been a long process to get that referral for us, and we’re likely looking at starting IVF with ICSI with them in the next three months.

You can definitely still conceive naturally, it just lowers your chances when there’s a lack of motile sperm. There’s a lot worse SA results around, and a lot better, I would refer to it as suboptimal. We saw a private urologist and he said you need 20 mil motile sperm really, and we have less than that so despite the improvements in his parameters it’s still off to IVF/ICSI for us. I would imagine you’ll also be recommended ICSI.

We were referred by our GP (after much drama) in late June, we heard from them early this month to say we have been approved for funding and an appointment was scheduled Aug 31. I don’t know if these timings have taken my age (38) into consideration or the delays we’d experienced due to cockups prior, but it hasn’t been too long. I’m not sure if that helps, but hopefully you’ll have a similar experience.

I would get him on Impryl or Proxeed (the main two that you’ll hear about), and maybe a couple of others. My DH has been taking Impryl for months (and you will need three months) and has seen an improvement. Maybe also some ubiquinol, there’s lots of resources online with suggestions for improving sperm quality.

I don’t have any friends who have gone through this either, mine all ~just conceived~ after a few months in their mid/late thirties.

Feel free to ask any questions if you have any!

Honestly try not to panic too much. Sperm tests are a snapshot in time and can vary a lot and be affected by simply having had a cold a few weeks before. I did 5 rounds of ivf in 18 months and DH gave 6 sperm samples in that time ranging from 1% all the way up to 6% x

Hi @thislittlebird,

Thank you so much for your response. It’s been so helpful and insightful it’s also been a real comfort. So glad to hear an appointment has been scheduled for end of August for you.

Its really interesting to hear about the supplements as I had no idea these even existed. The improvements for your DH are impressive. I wouldn’t have thought this could be achieved with supplements. My partner takes Wellman supplements but I have a feeling they don’t do much at all. Do Impryl or Proxeed need a prescription?

If you don’t mind me asking, once your GP finally did refer you, did Guys St Thomas only get in touch once they had funding or is there an initial consultation where they confirm which treatment you would need? Or did your private urologist confirm the treatment and your GP then refer you ?

Thank you again for sharing! It’s really helped!

Thanks @twinningatlife - that’s really good to know. We’re arranging another SA I hope this is the case x

@Plantsandcoffee

No worries.

Yeah, supplements can help, depending on the issue. As can lifestyle, things like stopping smoking and reducing alcohol intake etc. The upside of your and my own DH's results is that the sperm count is pretty normal. As @twinningatlife said, it can also vary a lot. My DH's was very consistent until his better result in May though so I think the supplements + ejaculation have helped in our case. Daily ejaculation (or often as possible) is suggested for men with normal count but poor quality as it refreshes the sperm and, if I'm remembering correctly, it reduces oxidative stress.

Obviously we might go in September/October and his results are down again but he's trying. How long has he been on Wellman? Impryl and Proxeed are essentially cocktails of fertility-specific supplements so you can buy them online and they can be annoyingly pricey, but a couple of doctors had recommended Impryl and we decided we'd give it a go back in February.

Ours has been a slightly weird route to Guys, I think if you haven't had the odd experience we've had then you would have another appointment in between, possibly virtual, where they run through your history etc and apply for funding as of that appointment, or in some cases advise if you don't qualify (issues like very low AMH, age etc).

We'd had 6 months delay thanks to incorrect results dished out by our old GP and then we saw a Gynaecologist 3 months later who told us to go away and completely ignored my progesterone/ovulation issues and said my husband's problem wasn't "enough" and we were "unexplained" (we were not), which was stressful. So we went to see both a private gynaecologist and a urologist and they wrote letters in support of us and our problems and did some tests, which my GP then referred us to Guys on the back of. I am guessing we didn't have that middle appointment pre-funding approval because of all this, and because the private doctor letters laid out a case for us based on our history.

You'll get sent a questionnaire a few weeks after the referral, once you get that it's a bit of a relief to know the ball is rolling.

Hi everyone, can I join in too? I've felt so lost with this. DH has 0% morphology which was repeated on both SA's. He has just been told to take a multi vit which hasn't made a difference (he did all the normal lifestyle changes too but that didn't work).

I'm on clomid to try and boost things my side but I keep thinking what's the point? Our next step is ICSI after 6 rounds.

Did anyone manage to get a referral to a urologist? If so how did you manage it?

Thanks @thislittlebird

We’ve ordered Impryl and will try daily ejaculation. He’s been on Wellman for a couple of months but he hasn’t been taking it religiously. So we couldn’t really give a fair review… I think he’ll continue to take the WellMan alongside Impyryl since he’s got a fair few left. He’s obviously now more committed to taking them… I think we both thought the Wellman supplements were a nice to have, not a necessity, so this information on supplements has been so illuminating.

It’s sounds like you’ve had a few unhelpful experiences along the way. Hopefully if we have been referred it will be straightforward. You’ve clearly had to persist at this and it’s paid off.

We’re going to call the GP surgery tomorrow to see if we can get confirmation that we have been referred and chase up on getting his second SA booked in. DH made an appointment to chat with GP to see if he can get any further information from them, but I suspect unless they specialise we might not get a deeper insight until Guys St Thomas get in touch.

The information you’ve shared has been so helpful. Thank you. Would be great to hear how you get on if you’re up for sharing.

Hi @seathistle

I understand the lost feeling completely, you’re not alone in that. thislittlebird has shared the most helpful information here.

The vitamins seem to take a couple of months to take effect and frequent ejaculation helps refresh the sperm.

We’ve only just been referred on Thursday so I couldn’t help with your question about referral to a urologist. I’m a bit new to all this.

Hoping this thread will help give you further answers. Il continue to share as we go along. x

Hey @Plantsandcoffee I just wrapped up my first cycle which unfortunately went very poorly due to issues on my end, but we did manage to make some significant improvements to sperm beforehand. My DP had really bad morphology and we saw a good improvement from Proxeed Plus, still below the threshold but much better. We bought it on Amazon. His motility was also poor after getting covid but a member here recommended to me the zinc supplement from Wild Nutrition and we were absolutely blown away by the results in only a couple of weeks. And yep I know exactly how you feel, it feels like everyone I know got pregnant 5 mins after deciding to and now I have to break it to my close friends that I couldn't even get one embryo from 17 eggs. Stay strong ❤❤

@seathistle you may also find these helpful ! And on my first appointment they referred me to a urologist in the hospital and he saw me pretty quickly.

@Plantsandcoffee fingers crossed you see some improvement but do give it three months. We tested a couple of months in and it was worse, then a month or two later it had definitely improved. Men refresh their sperm every three months, and I think women’s eggs are similar.

Sometimes there is more going on and like @seathistle mentions it can be worth seeing a urologist. We saw a private urologist because we were having no luck getting help. If you want an nhs referral I would ask for one from your GP, they don’t seem keen on offering them and tend to send people straight to ICSI. Our urologist ran in-depth tests, did a physical exam and gave us the all clear for ICSI. But if my DH had had worse results he would have advised we do xyz and then start in a few more months.

@Vparisi I didn’t realise you had MF too. did they tell you it’s eggs and not a fertilisation issue?

*I should clarify, obviously women aren’t refreshing their egg supply in three months, but it takes three months to see any improvements, as far as I’m aware.

@seathistle also, there could be more going on like a hormone issue (not sure what his count was) or a varicocele so do see a urologist if you can.

It’s super lonely. I’ve found today very hard and it’s a long and usually lonely journey but there is some support on here, even if not always in our lives.

I would second getting a second SA booked in - if the next one is also abnormal then you will probably be referred to IVF. Vitamins, lifestyle changes and frequent ejaculation can help with morphology/motility/numbers to an extent (some guys see a great increase in numbers) - but be aware that SAs only really tell part of the story. DNA fragmentation tests aren't routinely done in the UK and there are some even rarer problems that can't be picked up in standard tests - in my example, we didn't realise until we went through a round of standard IVF that my husband's sperm were unable to recognise and swim towards or penetrate my eggs, which is something to do with a missing protein (?). If you have male factor though, you are most likely to be referred to have ICSI. Good luck!

Hi everyone,
I honestly feel like I could have written a lot of these posts myself. We have been ttc for a long time (around 4 years but with breaks for various things like working away). I was just wondering how everyone is doing now? We have our first fertility appointment in a couple of weeks at Kings and I’m wondering what to expect.

We’ve already had so many setbacks and it feels like we are still very early on in our journey.

Hi @pcosSOS

We got confirmation yesterday that we have an appointment at Guys St Thomas next Thursday. Funding is approve thankfully. I’m not entirely sure what the next step will be. It would be great to hear how you get on. Il update this post after our appointment
X

@Plantsandcoffee Best of luck with your appointment! Our whole process was almost alarmingly quick with kings in the end. We had our first appointment end of Nov where they redid all our tests (bloods, internal scan and sperm analysis) then our consultation first week of December. We are a very straight forward case of male factor as it turns out that in spite of being told for years to the contrary, I don't have PCOS. I think our results and the fact we have been trying for 4 years meant that they just put us forward for IVF with ICSI and I am now on day 5 of stims. Once we had a diagnosis everything was so quick, we had the medication delivered mid December and I just had to wait for my period before starting.

Your process might be different and they may want to do more tests or try IUI first. I find the hardest thing in this whole thing is the not knowing but unfortunately it's just because everyone is so different and they are trying to work out the best plan for you.

Have you got your consultation appointment booked in for after your first appointment?

@Plantsandcoffee ... we were intially referred for IVF due to my DPs poor SA (teratozoospermia, normal but low count, some motility issues) and I have low AMH. We have successfully had two IVF miracles using ICSI ... HOWEVER ... we have been trying/prepping for a third cycle and due to us being 42, I have researched and put us on a number of supplements. To our surprise in only a couple of months of supplements my DPs SA was PERFECT. His count per ml had doubled (15 million to 28 million), his morphology is normal and motility normal high range. Its the first time in 6 years his SA has been normal.
The supplements he takes as follows; proceive for men, CoQ10, alpha lipoic acid, omega 3, NAC and L carnitine.
I hope this helps x

Hi all,

Can I join in the conversation.
Me and DH have been trying for years now. Was referred to Guys and St Thomas’ in January this year (2022). Still waiting for first meeting with the assisted conception unit.

Not sure what the expect.

Hi @Trying22

Sorry for the slow reply I've been not checking MN so regularly.

I'm at Guys too so happy to help with any question if I can.

I'm due to start treatment in May.

Not quite sure where you are on the journey but at our first appointment at Guys there was a lot of paperwork, blood tests (for both) and an scan (for me) The Dr also advised the treatment so ICSI in our case.

@Plantsandcoffee

Thanks for this. Received a call yesterday from the unit and they said we should get an appointment around May/June.

I need to loose weight before this appointment as I heard I will be weighed to confirm if I am eligible :(

Thanks for this.

@Trying22

No problem, that's great news it's great to have a rough time line.

Ah pain about the weigh in but you can do it!

@firefly37 hey, could you kindly tell me the brands of the male supplements that you used? Thanks x