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Trying to conceive. Done semen analysis. What would be the next step?

my husband and I have been trying to conceive for 20 months (both currently 30y) without luck. I have been tested for progesterone , and have charted for ~12 cycles (25d). He has since had a semen analysis . His numbers for count were well above average but his motility was listed as 11% with the reference range of 12%. My OBGYN has told us to be patient but 20 months seems a very long time for people our age. What would be the next step. We do have a Urology apt set for him but im unsure what to expect or ask.
Asked On : Tue, 25 Dec 2012
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General & Family Physician 's  Response
Hi, thanks for using healthcare magic

Normally after a year of persistent intercourse, a diagnosis of infertility is made if conception does not occur.

Motility of 11% is a little low, it is thought that at least 50% of the sperm should be progressively motile. This can sometimes be caused by exposure of the testes to extreme temperatures or delayed analysis of the semen by the lab.It is important to remember, however, that some men with normal semen analysis may have problems conceiving whereas, some with abnormal results have no problem. It only provides a general idea of fertility.
You should mention the semen analysis results to the urologist and ask him what areas would be affecting fertility and ways that they can possibly be improved.

In the female fertility is affected by cervical, uterine, tubal and ovarian factors.
Cervical factors can include- obstruction of the cervix
Uterine factors include-any abnormality in the structure of the uterus and adjacent structures- this is evaluated with a test called HSG
Tubal factors include any blockage along the fallopian tubes
Ovarian factors- any issues with ovulation

In 10% of couples the exact cause of the problem is never discovered, this would not necessary influence treatment as your doctor may proceed in a step wise fashion.

Hope this helps and wish you the best
Answered: Tue, 25 Dec 2012
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