How bad is this count ...

[FlyOnTheWall89]

How bad is 8 mill / ml concentration? 39 total sperm count. It says high volume, low concentration, borderline TSC.

IVF or try for longer?

The total count per ml should be above 20ml (technically higher but they have dropped the lower value in line with what is now considered "normal" as SA results decline) as yours is significantly lower than this I would move on to IVF asap. I'm this process time is so important and I would be concerned I looked back wishing I had started earlier. I was hesitant to go with IVF and although it isn't easy it also isn't as bad as I built up in my head.

There is also the emotional cost of continuing to try and then it not happening every month to consider. I feel that continuing to try for longer before IVF would have had an even bigger negative impact on my mental health.

How long have you been trying? Have you had any tests done? What was his motility and morphology were those all normal?

Thanks @Hoping4baby21. We have out IVF funding and we are technically ready to go, but my OH wants to try for a bit longer with all the supplements he is taking and the lifestyle changes like now only 1 coffee a day etc. Motility normal / above average and morphology now 9% after only 7 weeks on the supplements.

I agree, it totally takes it toll on our relationship and our mental health. I am 33 and have a AMH of 10.7 so on the low side too.

I have read so many stories of people avoiding IVF with these numbers, but it is so hard to make the call. I have done so much research and reading. I think I can totally handle IVF and whilst I understand it will be really hard, so is continuously trying. We have been TTC for just over a year which I appreciate isn't that long in the grand scheme of things.

I agree with @Hoping4baby21 we were told with low count that chances of natural conception were v low so proceed to IVF. I do have friends who conceived naturally after a failed round of IVF and then had low sperm count however they had also gotten pregnant naturally several times and unfortunately had miscarriages. So if you’ve been trying for a year and nothing then it’s likely you’re more like myself and DH.

That said, a while longer delay shouldn’t cause an issue but I would use the time productively. Your DH should have a DNA fragmentation test to check for DNA damage to the sperm and if high see a urologist to make sure there is no infection or varicoele that can be fixed as this would greatly improve your chances of success at IVF. I would also review his supplements - should be on ubiqunol, high dose omega 3 (such as Mor dha not EPA) along with an all in vitamin such as proceive or proxeed.

Hi OP,

I wouldn't wait either. Those sperm results are not good and likely will need ICSI or even PICSI. Please don't take it lightly, sometimes IVF is not a quick solution unfortunately, and takes more tgan expected. Moreover if you mention that your AMH is low.

My husband had 100,000 total in a sample, and most were abnormal. So utterly atrocious. We conceived naturally whilst in the early stages of IVF, our consultant said it was a miracle! So it's not impossible but you have to be practical. If I were you I'd proceed with IVF. We needed IVF to have our second child, we never had that 2nd miracle.

@FlyOnTheWall89 oh good I'm glad it is all in place. Ok In your situation I understand the desire to wait a little longer for the changes to kick in and make a difference. They say 3 months for the differences to kick in, it is great that you have seen drastic improvements in 7 weeks, I would wait the additional weeks to bring it to 12 and then get a cycle started. It wouldn't be waiting to try naturally (although of course you can totally do that in the mean time.

I wish you the best of luck and it seems like you are approaching things with a great mindset. I second what another poster said about DNA Frag as that means that even with a good SA ICSI might still be best. Our NHS consultant didn't seem to take this seriously and said if on the day the analysis was good they would just do IVF. So you might want to ask that question.

Thanks all, so helpful. It's such an unspoken about this and my OH is just so so wanting a natural conception.

We have an appointment with the top London / UK urologist coming up in April and I have a HSG booked which they said I should probably do before we do IVF. They have said ICSI would be the current route, but they can literally decide on the day depending on the sample produced.

Thanks @Dochas12111 - he is on ubiquol, DHA, Proxeed, pycnogenol, Vit D and Floradix (which he's always taken).... so I think we have supplements covered. I think the urologist will suggest a DNA frag test and a scan to check for varicocele.

Yes @Cherry35 I guess if you have to freeze the embryos then wait a bit, the months can drag on.

@Scottishgirl85 , wow a miracle little baby.

I think we will have to have a big conversation after we have seen the urologist.

@FlyOnTheWall89 I tnink some men like to bury their head in the sand as infertility is often perceived wrongly to be a female issue so a natural conception would mean he can tell himself all is fine. However you also both need to be realistic and think about what is more important - natural conception or a pregnancy. Nobody wants to do IVF but it could be better to face up to it being the best thing for you.

IVF is also not a guarantee. I was 31 with an AMH of 27 when we started it due to male factor and it took 5 years and 6 rounds of IVF for us to get pregnant. I’m 23 weeks now and just turned 36! Not now I thought it would go!

Good luck!

Another vote for getting started ASAP. Our initial tests showed severe male factor and all ok on my side (AMH low end of normal but OK). 11 months later we had our first round of IVF / ICSI and I responded poorly so I had my AMH retested and it had fallen dramatically. I don’t mean to scare you, my consultant said such a decrease is unusual but it’s so much harder with problems on both sides so the sooner you get started, the more time you will give yourselves. Good luck.

What was your AMH @4F99S1 ? Mine is 10.7 but I've only had one test and I've seen so many people with second tests being really different to the first test. Have you managed to have a baby yet or are you still going through all of this?

Blimey @Dochas12111 that is one hell of a long time - you have just built some really serious resilience over the years because it's so tough. How exciting to finally have the success you hoped for. Hugs. X

Hi @FlyOnTheWall89, I can’t remember the exact figure of my first test but it was the low end of the normal range for my age. (Say the normal range was 15-30, mine was about 16 or 17 so lower than I’d have liked but at the time - perhaps naively! - didn’t think it would be a problem) When I got it retested it was 3.6. Given the difference between the two results, I considered retesting but my response to the first IVF cycle was far more in-keeping with the lower level so either it dropped very quickly or the first result was inaccurate but I was fairly confident the second result was accurate. Since that first cycle (which we abandoned due to poor response) I’ve had two more, neither of which was successful. The last was worse than the one before which could be bad luck or could be a sign that things have declined further. I haven’t retested because it wouldn’t change anything. I’m already on max dose stims and now started DHEA to hopefully improve egg quality/quantity so there’s not really a more aggressive route we could take if we found it had dropped further. This will be our last shot at conventional IVF and if it doesn’t work we’ll look to a clinic like Create which specialises in low AMH for a final throw of the dice. As I said in my first post, my consultant did say how unusual such a drop is, so please don’t think the same will happen to you.

@4F99S1 thank you. The doctor at my fertility clinic said for my age, it should be more around 13 + so I guess I'm similar to you.

I really hope it works for you. That is a lot of injections and turmoil and waiting. Best of luck and please post back in here to let me know how it goes x

Just an update for this thread. We are moving ahead with IVF w ICSI and I've been recommended long protocol which I have no reason to believe isn't the right one.