Subfertility

[milwife]

Hi,
Trying since Nov 2024.
Two chemical pregnancies (mid February and early May 2025).
Husband has 4.4mm varicocele and below normal sperm count, concentration and 1% morphology.
We feel stuck in a limbo.
Not sure what we should be advocating for.
My initial bloods seem fine.
We are desperate to have a child.
Thanks,
G

Sorry for your journey - I'm right here with you! 2 years TTC - (& 3 miscarriages between 6-10 weeks). Any kind of loss or delay in TTC is so bloody hard! I've been in your position trying to do anything to get a better result.

* Firstly try and get the varicocele sorted - this will help with his sperm count and takes 3-6 months to get back to normal. Also look into "it starts with the egg" book, she also has a chapter about sperm results - one further test your husband can look into is DNA fragmentation (common with men with low sperm count / morphology).

* Get both of you on good supplements - I take ovum, they have higher amounts of folic and coq10.
Most of the men supplements with stronger ingredients are available via the doc (ie. Impryl).

* Get your full bloods done, thyroid, AMH etc.

I have also gone to see the CRP clinic in Epsom to test for my NK cells to see if it's my body naturally fighting them.

If you get referred to the infertility clinic for IVF, be aware that you need to have been trying from the end of the most recent loss to count for the "trying for 1 year" criteria. I wish I hadn't mentioned my most recent loss and we would have qualified (wasn't on their system).

Thanks so much for your reply. Which doctor would fund the impryl? Can a GP do the AMH blood test? Anything I need to say to help me get that from them? Should I get thyroid antibodies looked at as the other thyroid ones were ok? Lastly, do you need to have been trying for a year since your last lost, so for us that would be May next year? Thank you!

And so sorry to hear about your losses and TTC journey - I hope you're staying a bit positive however you can. Sending lots of love!

Thank you! It's absolutely rubbish to be in this position isn't it 😞 doing ok though thanks, had some therapy recently and that also really helped me to process my journey.

Impryl - I got them from our recurrent miscarriage clinic, so thought it was prescription but just searched and they're available from a site called fertility family.co.uk

He could go and see a urologist via his GP, probably already in touch with one if he's done a sperm test already. This is how he'd get the varicocele embolization done.

Yes GP can do the AMH test and hormone bloods - they usually do a round of "day 3" tests which you take on day 2-4 of your cycle. Or something like a hertility test which you put in the post. You could speak with your doc and say that you're struggling TTC and you want to have some diagnostics to understand if you have any underlying fertility or hormonal issues that you can look into. At least when you have your amh you'll have a bit of an understanding of how much time you have (mine is very low @ 32) so time is running out for me! Also they usually do "day 21" progesterone tests too to see what your luteal phase is like.

In terms of the trying for a year - I literally just got off the phone to my NHS consultant who was planning my IVF application earlier this year and she said my most recent loss puts me back to applying in June next year, which is a real bummer. I've heard of people not disclosing the chemicals - if you wanted to try to move that timeline a bit...

Sending love back! We've got this 💪

Yeah, hoping to get on 1 year waiting list for varicocele embolisation. Waiting for urologist to send their report to my husband's GP. Do you mind telling me what the AMH finds? Is it the number of months you've got left to conceive based on the number of eggs you have left? Oh that's horrible, I'm so sorry, so they won't let you get IVF until 1 year post most recent loss?

Good that he's on the list - obviously I don't know about your financial situation but consider if you can get it sorted privately to get it sped up a bit. A year is such a long time!! Can't believe that! And then there's 3-6 months of sperm going back to normal afterwards..
Male factor is obviously 50% of fertility issues, so don't let anyone make you think that if you make all the changes on your end it'll be fine..

AMH is showing a hormone level that's directly connected to the number of eggs you have left (we're born with all the eggs we'll ever have) - when your egg level gets to 0 then you menopause. The internet / it starts with the egg will probably do a much better job than me at explaining that! 😅 Mine is around 2, so not very good for someone of my age - but also younger age = better quality. Would highly recommend reading or audiobooking it starts with the egg!

Yes isn't that mad!! Depends on your local hospital regulation though, some say 1 year some reduce it if you have female or male issues.

It’s good that you’re already in the system and have both had some initial tests. Have you been referred for an ultrasound yet? When I had all these bloods done a decade ago I was diagnosed with hypothyroidism and put on Levothyroxine. My DH’s sperm analysis came back as pretty terrible too. We had just had our first fertility appt (I’d been referred for a hycosy and DH had been referred for a scan) and I fell pregnant - 10 cycles/16 months into the TTC journey. DD2 took 12 months too even though my TSH levels were stable and I was having regular periods. I’m currently 14 weeks pregnant after trying for 3 years for number 3. Often TTC is a horribly long journey but I’m sure you’ll get there.

Thank you so much - with the grade 2 varicocele and poor sperm with 1% morphology as well I'm so not helpful anymore. Don't want to rush IVF if we even get offered. But hard to know how long to wait. And to not panic! Body is tense! Thanks for your words and congrats on your children x

I can’t remember the details of DH’s sperm analysis, except the count was so low they couldn’t do a proper measurement of motility/shape etc. I thought it was a dead cert we’d need ICSI, but in the end we’ve managed to successfully conceive three times naturally (plus 2 CPs and 2 early miscarriages), even if it has taken an absolute age each time. Although, saying that, my current pregnancy was only 3 cycles after my last miscarriage. Don’t lose hope!

Thank you, not sure the length of time it's normal to conceive a pregnancy that ends in live birth with our circumstances. Enjoy! x