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Opinion and advice on infertility - Online Doctor Chats

Date : 21-Feb-2012
User rating for this question
Average Posted in: Infertility Problem
Answered by

General & Family Physician
Practicing since : 2005
Answered : 2408 Questions
User :   Hi Sir
Doctor :   hi
Doctor :   Dr AAAAAAA here
Doctor :   how can I help you?
User :   I am 32 Yrs Male from xxx and my wife is 23 Yrs, its been almost 1.8 Yrs after marriage
User :   still now she is not becoming pregnet
User :   Ovulation test done for her, my sperm count done, 30 million morality 48 %
User :   please advise what shall be done next
Doctor :   were examination and tests done to see if any abnormalities could be present?
Doctor :   were her hormonal level tests done?
Doctor :   like FSH, LH, prolactin levels, thyroid hormone levels?
User :   yest through Blood test - normal
Doctor :   was ultrasound scan done for her?
User :   for Ovulation ?
Doctor :   were FSH, LH, prolactin levels, thyroid hormone levels done? if yes were they normal?
User :   yes
Doctor :   please provide her height and weight.
Doctor :   please provide details of past medical illness and treatment if any in both of you.
User :   5.2 Feet of height and weight 54 Kg
User :   No past medical illness
Doctor :   ok, weight as per height is normal. has she recently put on weight within this last 2 years?
User :   Only thing she got chicken pox before 3 yrs
Doctor :   please provide your detailed semen analysis report
User :   30 Mill sperm count, Mortality : 48 %,
Doctor :   do you mean to say mobility 48%?
User :   yes
Doctor :   please provide details of volume, liquefaction time, morphology, vitality, presence or absence of pus cells, WBC or RBC.
User :   Sir dons't have report in handy, but consulted a doctor, she told normal every thing
Doctor :   the variables i asked for in your report can alter ability of sperms to fertilize the egg, if any of these are abnormal
Doctor :   since you have not had success with pregnancy in 1.8 years, I would recommend a complete Infertility work-up done for both you and your wife along with visiting a Infertility specialist
User :   next step doctor advices is for a tubel block test for her, is it necessary, and what are all the test it has
Doctor :   yes, I agree with your doctor, the test is called HSG test, it can tell if there are any blocks in tubes or if there are structural abnormalities in uterus which is not compatible with pregnancy
User :   If block rectified how much is the time frame for pregnancy ? and if no block found what is the next step
Doctor :   if no block is found, then you have to wait and watch, you should be relaxed , both of you, as stress and wories can affect hormonal levels and chances of pregnancy
Doctor :   if block is found, it depends on the nature and extent of block,
Doctor :   based on which further treatment can be planned
User :   is there a chances to improve my sperm count, or 30 mill is normal ?
Doctor :   count of 20 million or more sperm per ml is considered to be normal for fertility purposes
Doctor :   so your is fine as far as counts are concerned
User :   I heard if the egg shell is thick sperm cannot penetrate, is there any test to determine that
Doctor :   but the other variables like volume, liquefaction time, morphology, vitality, presence or absence of pus cells, WBC or RBC also need to be considered
Doctor :   no, it is not like egg shell is thick, it is actually the protien contained in sperm that dissolves this shell
Doctor :   so if that is abnormal or less, then penetration of sperm through shell is affected
User :   is that protien in sperm can be known in the test
Doctor :   this can be tested and is the last option when all other tests come back normal
User :   Thanks a lot
User :   have a nice day
Doctor :   remedy lies in doing ICSI procedure which can be done by an infertility specialist
Doctor :   thanks for consulting me. bye for now.
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