Poor motility and a (small?) varicocele

[thislittlebird]

Another post from me. I'm going back to basics after our second IVF cycle in November resulted in zero blasts vs 4 in our first cycle in February.

I'm looking for experiences with small varicoceles being removed/embolised and seeing an improvement in sperm parameters, especially vitality and motility. Jonathan Ramsay 'cleared' us to start ICSI in May 2021 but so far we've had no success. He thought we'd have success with ICSI and we did in terms of blasts in cycle 1, but then we didn't in cycle 2. Our grade 1 embryos stopped developing after day 3.

DH has very poor motility and vitality, despite a normal count, so little chance of natural conception. I'm thinking we need to look into having his varicocele removed as a last chance saloon thing, we can't do IVF/ICSI forever and we need better sperm to be available for it in terms of quality, DNA fragmentation (his was a bit lower than average but not that bad) and progressive motility in order to have any chance of IVF working on the male side.

He is taking a concoction of supplements, but he did have a break from them while we were doing transfers so there wasn't so much time spent on them in the lead up to the second cycle, he also had covid and a wisdom tooth infection between cycles. These might be the key factors, but we need to think about the varicocele too so any experience of embolisation would be welcome. Thanks.

Hi @thislittlebird me again! Dr Ramsay made us aware of over oxidisation of sperm if taking too many supplements so we moved to proxeed and vitamin d only. We are yet to see the outcome of this but my partners sperm was fine before he started on the multitude of supplements. Dr Ramsay said we were taking too many.

@Anonbaby see we had better results after he was taking a fair few back in the months before the first cycle in feb, and when we had the Ramsay tests in May 21. But I have no idea what the results were in our recently failed cycle, and we weren’t really taking anything then because we took it for granted we’d make embryos after our first cycle was successful in that regard. Took them briefly but not for the 3-6 months we had prior to seeing Ramsay.

It’s hard isn’t it because it could have nothing to do with it or it might! My husband has had 4 SA and only 1 has come back with anything wrong with it so I guess it fluctuates all the time naturally anyway. I’ve given up on all my supplements. Sometimes I worry about it, other times I enjoy spending money on nicer things

@Anonbaby yeah I think it does fluctuate but we definitely got our best ones after months on supplements. Still not normal though, hence the thoughts on having a varicocele embolisation.

Not that I think it will be normal after, but maybe less damaged 🤷‍♀️

@thislittlebird I think you have to go ahead with what you think is right so you don’t have any regrets x

@Anonbaby yeah, I suspect there might be a few at the end, sadly. Main one being waiting until my mid 30s to ttc and thinking it would be ok :/

@thislittlebird i don’t think you can beat yourself up about it. I think the same about waiting to TTC my third but then I can’t say for sure it would have been different if I hadn’t.
especially when they can’t pinpoint the cause and it’s unexplained infertility. Try not to be so hard on yourself. We all do what we think is right at the time x

My husband has a severe varicocele which couldn't be embolised as the consultant couldn't find the right vein, happens to 10% of men and nothing can be done except surgery which had too many risks for us. His parameters were low on all counts so in the 3 month run uo to our IVF ICSI cycle, he did what he could to improve things. He used proxeed or wellman depending what he had at the time, he wore looser boxers, stopped having baths and just had showers, and most importantly he ejaculated every other day or near enough every other day in the run up to the cycle. Hard work for the fella but we were worried about dna fragmentation/oxidisation. We got 7 eggs from me, all fertilised and all made it to day 5. One slowed down on day 5 but the other 6 were all top or good quality blasts! Fresh transfer didn't take but I'm now 8 +4 with first frozen transfer. So despite his terrible sperm parameters we didn't have much attrition, and I really think his efforts helped make sure there were fewer DNA fragmented sperm to choose from. If it had gone badly we would have looked at surgical extraction next. Hope your next cycle goes well xx