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Trying to conceive with no results. Reports show less volume of semen. What should I do?

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Infertility Specialist
Practicing since : 2002
Answered : 673 Questions
Hi, This is XXXXX. I have been trying to concieve since 1 year and this has not been possible. I have been meeting the doctor and i have no problem as such. But, my husband has less volume of semen. I have underwent IUI thrice with no results. I am in a dilema whether to change the doctor or not. If i have to change, can you suggest a good doctor?
Posted Tue, 31 Dec 2013 in Infertility Problem
Answered by Dr. Dattaprasad 2 hours later
Brief Answer: Details necessary. Detailed Answer: Hi XXXXXXX Welcome to XXXXXXX If you can provide few details, it will help in guiding further treatment. 1. Husband's baseline semen analysis report: Volume, count, motility & progressive motility. 2. Pre wash & postwash count & motility during IUI. 3. What treatment you received for ovarian stimulation during IUI. Awaiting reply. Regards.
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Follow-up: Trying to conceive with no results. Reports show less volume of semen. What should I do? 14 hours later
I was given fertigyn 5000 i.u ans HCG 500 i.u injections and progestron 400mg tabs.. Only once we had the report of pre wash and post wash. Volume of semen was 0.5, 0.8 and last time when it was 2ml. He was taking a tablet to increase the volume. Will provide the exact report in the evening, when i go back home. As i have not carried the reports. volume: 0.8ml, count: 85.6million, motility: 66%, progressive 58% Pre wash count: 77mil/ml motility: 59% post was: 39mil/ml motility: 96% For ovarian stimulation GMH-HP 75 iu
Answered by Dr. Dattaprasad 21 hours later
Brief Answer: Can try one more IUI. Detailed Answer: Hi XXXXXXX Welcome back. Sorry for the delay as I was awaiting full information before giving any advice. Coming to your query; Further treatment depends on how many follicles you made during past IUI cycles. If you had made two or more follicles of >16-18mm on the day of hCG/IUI (you can have a look at previous follicular studies), its considered as superovulation (ovulation with more than one follicle). Upto 4 cycles of superovulation with IUI can give decent pregnancy chances. After fourth cycle chance of pregnancy goes on decreasing. If in all of your previous cycles you had made two or more follicles, you can try one more cycle of superovulation with IUI. If in any cycle you had just made single follicle, you may try more than one cycle (may be two). In any case, whether single follicle or multifollicular ovulation, please don't do more than 6 cycles of IUI. Here are few practical tips to increase chance of pregnancy during IUI cycle: 1. You can start having intercourse daily or alternate days when follicle size reaches more than 1.2cm. By doing this, you are not relying solely on IUI for pregnancy & it will increase chance of pregnancy. (Your husband must be able to give semen sample on the day of IUI. If your husband is not comfortable in giving sample after 3-4 days of intercourse, don't try this). 2. Regarding low volume; the count & motility both before & after wash appear to be sufficient, so no need to worry for that. There is one more trick; If your husband can give 2 samples (15-30 minutes apart) on the day of IUI, the doctor can mix those two samples & process for IUI to further increase sperm count. 3. Regarding change of doctor; if you are satisfied with the treatment you are getting, no need to change doctor. If you are not at all satisfied, you can have a look at your follicular study. If not a single cycle was with multifollicular ovulation, you may consider to change the doctor. As I don't know whom you are consulting, I am not suggesting any doctor right now. Broadly speaking, you can consult any doctor with expertise in handling IVF cases, as generally these doctors can handle superovulation well. Hope this helps you. Let me know if you have other concerns. If not, you can close the discussion & rate the answer. Wish you good health. Regards.
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