Male factor infertility

[secondtimelucky87]

Hi,

Just looking for a bit of support/advice please. Very fortunate to have one child, who is 2 years and 8 months, conceived naturally during lockdown after trying for 3 long years. I breastfed her for 2.5 years so it took a while to get my periods back but started TTC as soon as they did, at 25 months. I've had my LH, FSH and oestradiol tested and they were normal. My cycles are generally regular (although this month I got my period at 10dpo) and I'm getting positive OPKs etc.

Finally convinced my husband to go for private sperm analysis after being fobbed off by GP for months despite having been trying over 6 months and our ages (he's 47 and I'm 36). It showed low motility and low count so I'm glad we got that checked out. He had a follow up consultation and was told chances of us conceiving atm are very slim so in the first instance it's 3 months of lifestyle changes until a repeat analysis.

Unfortunately he works from home which is bad news for sperm as lots of sitting down but he's trying to go to the gym more. Bought a bag to avoid phone in pocket. On the following vitamins daily:

Wellman
Magnesium and zinc
Vitamin c
Vitamin d

He's still been having 2 (small) glasses of wine a night since the sperm analysis. I'm right in thinking this is still too much from a fertility perspective isn't it? I've asked him to cut down to one.

Is there any other advice anyone can give us? I know I'm incredibly blessed to have my daughter but feel like time isn't on our side and I'm worried. We both really want to give her a sibling.

Thanks so much for reading if you got this far.

Hi OP,

We are about to start our third round of IVF for extreme male factor infertility. Our new consultant has got DH taking Lycopene (tomato extract) - if you look it up it seems it does impact sperm.

He was also asked to take a male fertility supplement either welman or Proxceed and vitamin C.

Our case is a bit different to yours as my DH needs his sperm surgically extracted due to a blockage.

Also told no warm baths so DH has totally stopped those. Nothing like cycling either. And limited caffeine.

Thanks so much for your reply. Really appreciate it. I'll buy my husband some Lycopene today and cook lots of tomato-based food from now on.

Yes we're going to repeat the analysis in February and if still no improvement I think next step will be to check for varicocele. Really hoping lifestyle changes will be enough though. First time around the dramatic reduction in work stress for both of us seemed to help a lot but we can't really recreate those conditions and we're both a few years older too.

Wish you all the very best with your journey too. 💗

My husband had normal results from the basic semen analysis but was found to have quite a high level of sperm DNA fragmentation.

We saw Jonathon Ramsay who is a leading andrologist and he checked him for a varicocele and also for infections which can affect sperm quality.

He also advised that my husband consulted a nutritionist and made lifestyle changes to protect his sperm quality (cotton boxers, reduce cycling, reduce sitting, eliminate alcohol & caffeine). The nutritionist put him on a few different supplements and basically recommended a Mediterranean diet - loads of colourful veg, lean protein, grains and healthy oils. This included tomato purée for the lycopene as suggested above, as well as a big bowl of nuts every night (almonds, walnuts, hazelnuts, Brazil nuts).

These changes seemed drastic but they made a massive difference to his sperm quality, when we re-tested the DNA fragmentation after 3 months.

It might be worth seeing an andrologist so they can check for everything (including varicocele) that could be affecting sperm quality in one go. If you’re in or near London Jonathon Ramsay is great. I can also share the details of the nutritionist he recommended if you’re interested.

Wishing you all the best.

Also try taking 600mg daily of coenzyme q10. We had low concentration and conceived naturally after taking all the supplements you already mentioned and q10. I took DHEA. Our first was conceived via ivf, failed FET for second, did another full ivf cycle for second and that failed, then conceived naturally.

Thanks so much for sharing - so helpful. We are indeed in London. The sperm analysis was done somewhere in Harley St - not sure which clinic. Am I right in assuming even a thorough sperm analysis wouldn't include checking the DNA fragmentation? This has to be done separately? I think in first instance we'll see what the next analysis in Feb brings up. I did ask him to pester GP for a referral to check for varicocele but he hasn't yet. He has never been contacted for sperm analysis on NHS though despite asking in October so I imagine that'll be something else we'd need to do privately.

Unfortunately there's no way my OH would give up booze I dont think. It really annoys me tbh. I asked him to cut down to 1 small glass of wine and yesterday afternoon while we were out he had a bloody mary, then a small glass of wine with dinner and later (admittedly a tiny one) a small shot of Bailey's. I know in the grand scheme of things it's not a huge amount but I'd hoped he'd take things more seriously after spending £200 to get those poor results. He still drinks 2 coffees a day too and wouldn't touch nuts with a bargepole! I've suggested smoothies or doing what I do every morning (overnight oats with yoghurt, seeds, fruit and ground nuts) to no avail. It does feel like hitting my head against a brick wall sometimes. It's a tough one though as I think part of what helped us finally conceive after 3 years the first time was having much less stress in our life so I'm wary of being a constant nag. He's also an absolutely amazing dad. We eat very healthy dinners every day and love Mediterranean diet (my family are Italian!) but his breakfasts/lunches aren't great.

I'll keep trying to suggest he make some changes. Tbh even though I know to some breastfeeding 2.5 years is a ridiculously long time, I really wasn't ready to stop and only did because of my fertility worries. So i want him to take things as seriously as me.

Amazing about conceiving naturally the second time. The same thing happened to my best friend. Thank you - I'll try to convince him to take the COQ10 and get myself the DHEA. I spent £15 on Lycopene yesterday after seeing it recommended here and he seemed annoyed he had to take more supplements so I'm not holding my breath 🙄

Yes, basic sperm analysis looks at count, motility and morphology. DNA fragmentation is checked via a separate test called COMET, which cost about £800, I think. It might not be necessary if you already know you have some issues with sperm quality. We were only advised to have it checked since my husband had got normal results in the basic sperm analysis but we had recurrent miscarriages.

They check for a varicocele via ultrasound and though my husband didn’t have one, the tubes in his testicles were apparently quite narrow which was causing heat stress and damaging the sperm. It wasn’t quite enough to warrant surgery but the diet and lifestyle changes helped to offset the oxidative stress it was causing to his sperm.

They also check for infections in the sperm, which can be fixed with antibiotics. The tests were done at The Doctors Laboratory on Harley Street but i think you might need a doctor to make the referral and interpret the results.

It’s really hard trying to convince your partner to make these lifestyle changes. TBH my husband was quite sceptical at first and thought I was being neurotic, but hearing it from a doctor made him take it seriously, and we kind of treated it like a fun (!) challenge in the end. Like you say, you don’t want to cause more stress or give up everything you enjoy x

Thanks so much for this @sweetpea2000

Unfortunately I found out that, due to work stress, my husband has been vaping a bit recently. I kept smelling it in the house and he kept denying it so when i found out it really upset me. It caused a big argument which probably doesn't help the stress I know but it just feels like an uphill battle atm. Especially when it took 3 years to conceive first time around. I really don't know what to do anymore. He is looking into therapy to manage the stress in a healthier way. It's my fertile week and I've no desire to try now.

Hi sweetpea2000, we’re suffering male factor infertility. Struggling to get my partner on board, and think hearing it from a professional would help. Please can you share the details of the nutritionist you saw? I’ve been looking online but most seem to focus on the female. TIA.

@TTCBristol90 it was Melanie Brown Nutrition. Melanie herself had a bit of a long lead time so I saw her colleague Anna Firth who was great.

Wishing you all the best.

How did it go @secondtimelucky87 ?

I’m in the similar situation now. I’m 39, and DH 47 and found this thread.