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What Does My Semen Analysis Test Report Indicate?

Posted on Mon, 10 Aug 2015

Question: Hi iam xxxx 26 years of age, my wife 24 years of age married for one and half years... My wife is suffering with pcod since one year gynecologist made her cycles regular by using birth control pills after that we tried for children my wife was treated with two clomid cycles both the cycles failed. We are currently on third clomid cycle plus hmg injections for my wife and we are planning for iui this time as advised by my gynecologist. I had done my semen analysis which says my sperm count is 22millions /ml, motility 40%,morphology normal 65%.i had also done doppler scrotum test which says i had bilateral vericocele of grade 1 and grade2 respectively in my left and right testes and also bilateral undersized testes. Doctor advised me go to vericocele surgery which would improve my sperm count is surgery required in my case? Will my wife able to conceive without vericocele surgery for me? Is my sperm count normal? Pls help me. Will undersized testes affect sperm count or will they cause male infertility? Is vericocele curable by medicine?

Answered by Dr. Mahesh Koregol (42 minutes later)

Brief Answer:
Dont go for surgery

Detailed Answer:
Hi,

I understand your concerns about Varicocele.

Following is my reply:

1. Varicocele surgery does not help in improving sperm count. Don't go for surgery. Varicocele cannot be treated with medicines.

2. Your sperm count is normal. You don't need treatment for it.

3. Continue with IUI cycle. You can conceive with your report.

Let me know if you need any more help.

Regards,
Dr. Mahesh Koregol.
IVF & Infertility Specialist

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (1 hour later)

But i have seen many discussions on net that vericocele surgery will improve sperm count?my wife is also ovulating normally after she had underwent treatment for pcod....is it possible to conceive naturally with 22millions sperm count or will i have to go ahead with iui... There is no problem from my wife's side at present... If i won't go for surgery will my vericocele increase after some years pls help me

Answered by Dr. Mahesh Koregol (3 hours later)

Brief Answer:
HSG for wife needed

Detailed Answer:
Hi,

I agree with what you have read online. That was the belief few years back. Recent scientific evidence does not support this claim and are not in favour of operating varicoceles that too grade 1 & 2.

Varicocele is unlikely to increase suddenly. I think you should not think much about it.

It is better to go ahead with IUI as you were unable to get pregnant naturally for so long.

Your wife needs to get HSG ( Hysterosalpingogram) test done to confirm tubal patency.

I dont think you should worry about varicocele anymore

Let me know if you need anymore clarification.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Mahesh Koregol (2 days later)

Hi doctor, as you said varicocele surgery will not improve sperm count then what are the ways to improve sperm count.my doctor suggested me to use oligocare forte tablets for improving my sperm count. Is 22millions sperm count with 40%motility and 65%normal morphology normal for natural intercourse or IUI required .we are trying only from 4 months for children.... Does leaking of some semen from vagina normal after intercourse.my wife is using clomid will it affect her endometrial thickness... How to improve the thickness of endometrium... What is the normal endometrial thickness required for implantation... Will hsg test for my wife can be done without doctos prescription? Pls clear my doubts pls help me

Answered by Dr. Mahesh Koregol (3 hours later)

Brief Answer:
Your sperm count is normal.

Detailed Answer:
Hi,

I dont think you need any medicines to improve your sperm count as it is normal. You can take the oligocare tablets as prescribed by your doctor but are not really necessary.

Leaking of semen is normal after intrcourse.

Endometrium thickness is not affected in every woman by clomid. It needs to be treated only if thickness is less than 7 mm.

HSG test can be done in any good laboratory in XXXXXXX It is recommended to have doctor's prescription.

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Mahesh Koregol (2 days later)

Hi doctor, as advised by my gynecologist we had our first IUI on cycle day 14 and cycle day 16. The follicular study for my wife on day 14 confirmed rupture of follicle. Her follicle size was 21mm and 24mm, left and right respectively.The egg got released from her left follicle.
What is the success rate of IUI
Is IUI required in my case taking into account my sperm count of 22millions with 65%normal morphology and 40%motility with liquification time of 25 minutes
My biggest doubt is what is the minimum sperm count required for IUI to be successful
Hsg test done for my wife and there are no tubal blocks for her
Is natural pregnancy possible for me or will i have to try with IUI techniques
For how many cycles IUI can be done
Will i have to go to ICSI if IUI fails pls clarify my doubts

Answered by Dr. Mahesh Koregol (2 hours later)

Brief Answer:
IUI has around 20% success rate

Detailed Answer:
Hi,

Success rate of IUI is around 20 percent in any cycle.

Your sperm parameters seem to be normal. Minimum sperm count for successful IUI is around 15 million per ml.

I dont think you should try naturally anymore.

IUI can be done 3 times at the maximum. If does not succeed , go for ICSI.

Regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar