Male Factor Infertility

One more question. Last time we went for his appt he didn't mention anything about us trying to conceive with the urologist. So that was in 2009 and I am wondering if there are other test they could do like testosterone and things to make sure it's mainly just the varicocele that is causing the trouble. We conceived my son in Oct. 2009 and hubby had normal counts and motility then but since then he's been borderline for motility. I guess best thing is to ask his urologist all of this at the end of the month when we have his appt.

A varicocele often worsens with time and likely way causing problems now and not with first child. Does this mean that you will not conceive unless the varicocele is corrected? Hard to say but make sure to discuss with his urologist. The fact that you had some complications also plays into the equation. His working conditions would also be a big factor to lowering motility. With the approaching season change and cooler temperatures maybe a small improvement will be seen in motility.

Other options include seeing if his sperm is good enough for intrauterine inseminations or putting him on Clomid to boost production trying to increase overall numbers.

Amy Perkins, MS
Laboratory Supervisor
Arizona Androlgoy Laboratory & Cryobank

thank you for your reply. He is going to his appt end of september and realizes it could be both of us. I know it could have just gotten worse in time. It's been 2 years since he's had it checked so it's time to recheck it with urologist. If he thinks we will get same result with another IUI we will go that route again. Also I am going to ask about clomid for him, i have taken it for me and knew they gave it to some men but wonder if it will be appropriate for him and our situation. Maybe so, but he needs to go see a urologist cause the fertility dr only helps me not hubby so they won't help him with issues he has other than the IUI we already had that failed. His sperm is borderline for IUI it was 5.02 million for the insemination so maybe this will be enough next time to make it work.

I am thinking one more IUI and if that fails I really think it's on to surgery for him next. I did my part now it's his turn. They did say I will be much more fertile now as I had scar tissue all over and endometriosis on ovaries too so I am hopeful it will happen soon. Thanks again for responses.

He needs to have 2 separate semen analyses, 6 weeks apart. A single result is not considered smart for predicting anything as his levels will fluctuate dramatically from hour to hour, day to day. If he wants to get the varicocele fixed right, he needs to seek out a top-notch experienced microsurgical expert. Sure, any urologist can do a varicocele repair but to get the best chances for success and the easiest recovery, it should be done micro-surgically by a an expert. I have seen amazing results- though be aware it can take many months for the fresh, healthy sperm to get through after the repair.

Thank you so much for your response. This means so much to me. I have been debating on whether we should even really consider the surgery or not with this doctor. We live near Huntsville, AL.and best place would be Birmingham, AL for a good specialist. I was wondering if you know of anywhere that would be a great place to consider anywhere closer to us? Even Nashville is only about 2 hours away. I hate for him to waste his time going and then us not using this doctor for the surgery. II am also torn on whether to just do another IUI and not do surgery at all because if IUI will give us the same results there is no need for the surgery as he has no pain or discomfort from this.

Also his first Semen Analysis was March 24, 2011 and all they told me was that he had a borderline motility issue for us to try to conceive one more month on our own and then if nothing we could do Clomid, IUI and ovidrel trigger shot to make me ovulate. So we did that the next month and he had to leave another SA on July 18th, 2011. He had 30 million total sperm count(which is low to right?) but only 5.02 million were usable for the IUI. They told me 5 million is a good number for a successful IUI(and that nothing above that increased our chances even tho they like it to be much higher) so we did what we did and still not pregnant. We have now been trying 16 months with 4 of those months on clomid and one month with IUI and still nothing. I have had lots of pain so I finally had laparoscopy done last month and ended up having severe scar tissue from C-section. My bladder and uterus were attached and my uterus was attached to my abdomen so he had to remove all of this very carefully. I also had endometriosis on my ovaries and they removed my appendix because it was swollen and red. I have Interstitial Cystitis as well that can be helped with diet and meds later, along with Pelvic Congestion syndrome. So I feel after all of this and my husband having a varicocele maybe now we will get pregnant soon. Thank you again for all your help. I am now going to take another step back and pray about what to do next. I don't guess there is anything he can take to help with this since it's a varicocele problem and are there different levels of varicocele's? Like could his not be that bad, i know they say they look like a bag of worms but his looks more like just a few veins you can see on the outside and not as bad as they used to look to me. A year or so ago it did remind me of a bag of worms. Why would it look different now? Any more advice would be great Doctor Sheldon Marks. Thank you again!