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Trying for a baby. Semen analysis done. Can I impregnate my wife?

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General & Family Physician
Practicing since : 2008
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Question
Dear Dr. XXXXXXX
we have been trying for baby for more than 1.5 years .
In March 2011, i did my semen analysis and sperm count could not be concluded because semen was not getting liquify even after 4 hrs.Now i have moved to GERMANY permanently. I did a semen analysis here 4 month back and now semen is getting liquify and here is result :

Liquefication time : 10 min
Volume : 1.6 ml
Count : 67 Million per ml
Motility :
WHO A : 0 %
WHO B : 52 %
WHO AB : 52%
WHO C : 3 %
WHO D : 45 %
Normal form : 9 %

I did some change in my life style ( taking lots of fruits and nuts )

After this... i again get my semen analysis done in Indian on 4th April 2013.

Abstinence : 1 day
liquefaction time : 40 min
Volume : 1.5 ml
Count : 112 Million per ml
Motility :
Excellent : 0 %
Good : 30 %
poor : 20%
dead : 50 %
abnormal form : 40 %

We have gone through 2 failed IVF cycles that means for last 6 months we have not tried naturally. my DNA test were done as well DFI index is 9 % ( that means the integrity is very good )

Question :
What is % of probability that i can father a child Naturally now ? or shall we continue with IVF?
I read in your article and in wiki that total motilty more than 40 % (as per u ) and 50 % as per wiki is considered as normal ?. What can i do to shift to grade A motility ?

As i am seeing by changing my life style i have improved upon count and liquefaction problem. i just need to sove motility issue .
About my wife :
my wife age is 28 year . and her cycle is irregular ( 2.5 months ).
except irregular cycle doctor mentioned everything looks good for her.

please guide !
Posted Thu, 9 May 2013 in Infertility Problem
 
 
Answered by Dr. Raju A.T 16 minutes later
Hi XXXXXXX

Thanks for your query.

I have gone through the readings you mentioned above. Let me answer your concerns one by one.

1) What is % of probability that i can father a child Naturally now ? or shall we continue with IVF?
Based on the above parameters in the semen analysis, I can consider the chances of you having a child naturally is about 30% of normal.
I recommend you to continue with IVF for few more cycles.

2) I read in your article and in wiki that total motiilty more than 40 % (as per u ) and 50 % as per wiki is considered as normal ?. What can i do to shift to grade A motility ?

Yes, you have read right, but though fertile the chances are less than normal. Zinc and selenium supplements will help to improve the sperm motility.

There are many protein supplements available in market with zinc and selenium in ample amounts do consume one of it.

Hope I answered your query.

Please let me know if there are any other concerns.

Regards,
Above answer was peer-reviewed by
 
Follow-up: Trying for a baby. Semen analysis done. Can I impregnate my wife? 19 minutes later
Thanks for answer Dr.
I am wondering why motility is considered low in my case . As i read the WHO paper (2010) and found that 20 mil/ml count with 40 % motile ( a+b) that means 10 mil/ml motile sperm is considered ok.

Whereas in my case 112 mil/ml with 50 % motile that makes it 56 mil/ml motile (a+b) which is not ok , why ? . Why number of counts are not playing role when all the reference are in % of total counts .

looks like this website...... the online calculator is doing so and considering my SA as normal .
WWW.WWWW.WW
If you can please elaborate and compre my numbers with Reference value and point me exactly where i dont XXXXXXX the normal range would be really a great help .
The reason i am asking for more details because going for more IVF cost me lot of money and woud like to go for naturally by correcting my motility issue . Thanks for support !

 
 
Answered by Dr. Raju A.T 15 minutes later
Hi,

Thanks for writing back.

The cut off (20 mil/ml count with 40 % motile) mentioned in the literature is considered to define fertility. If anything less than this cut off will render the person infertile.

In you considering the reading you mentioned, I consider that you have the chances of having children but the chances less compared to the person with optimum 80%motility and 120 mill/ ml sperm count.

I really understand your concern about the cost involved in the IVF technique but based on the sperm analysis the natural method of conception cannot be completely relied on.

Hope I cleared your doubts.

Please feel free to ask doubts if any.

Regards,
Above answer was peer-reviewed by
 
Follow-up: Trying for a baby. Semen analysis done. Can I impregnate my wife? 32 minutes later
Hi, Thanks for quick response .


DR :::
The cut off (20 mil/ml count with 40 % motile) mentioned in the literature is considered to define fertility. If anything less than this cut off will render the person infertile.

--> So you mean that i would be considered as fertile but less chance . Right ?

1. Can i ask you what should be my motility to make it in normal range and to avoid the IVF.
Grad A %?
Grade B %?
Total A+B %?

If i read it right ,
As per WHO if Grad A >25 % OR A+B > 40 % is considered normal where Normal means the men who become father in 12 months (Men whose partners had a time-to pregnancy (TTP) of <12 months ) considering 4500 men from 14 countries. All referencing to volume of 20 mil/ml
Reference :
http://www.who.int/reproductivehealth/topics/infertility/cooper_et_al_hru.pdf

2. Please suggest me medicine name, how long i shall consume them and how many times a day . When shall i do my next SA test to see the progress .

I will proceed with 3rd IVF and in parallel will try to improve my motility issue so that we have chance naturally as well . thanks for suggestion .

Thanks a lot for answering my silly questions and sorry to be going too technical . i know you are expert i juts want to clarify my doubt.

And yes i agree that i have less chance than 120 mil/ml with 80 % motility . thanks again !


 
 
Answered by Dr. Raju A.T 2 hours later
Hi,

Yes, you will be considered as fertile but less chance.

Normal range of A+B will be around 80%.

A+B > 40% is considered minimum requirement for fertility but not the Optimum range. I have gone through the link it does mean the same. Optimum range (80%) is different and minimum requirement is different.

Any foods contain Zinc and selenium would serve the purpose. Usually protein powders available in pharmacies would be enriched with zinc and selenium. You can choose any brand available in your locality.

It does take a year or two for the minerals to show a response, a regular semen analysis every 3 months would help you to assess your status.

Wish you good health.






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