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Dr. Andrew Rynne

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Semen analysis showed sperm morphology 70%, sperm motility 5% and agglutination niL. Any advice?

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Dr. Rajiv goel

Urologist

Practicing since :1998

Answered : 577 Questions

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Posted on Wed, 19 Dec 2012 in Men's Health
Question: Doctor My semen analysis report reads as follows
(1) Sperm Count - 29 million
(2) Sperm Morphology - 70%
(3) Sperm Motility - 5%
(4) Agglutination - NiL
(5) Liquefaction - Delayed - Partly Liquefied after 2 Hours
(6) Semen Culture - NiL
(7) Observation - ASTHENOSPERMIA with LIQUEFACTION PROBLEM

I consulted a urologist. I was checked for varicoceles and the doctor said I did not have any. After examination, he said I was clinically alright. I also consulted a infertility specialist. I was given a elementary course of antibiotics (Clindamycin) for 5 days. I retested again but there was not much difference.

Please tell me

(1) With my semen parameters will I be able to father a child?
(2) There is liquefaction problem. After treatment with antibiotics also it is not resolved. What is the solution for this delayed liquefaction?
(3) What can be the cause of poor sperm motility? Can low testosterone / harmonal problems be the cause of this poor sperm motility?
(4) Is Liquefaction the MAIN cause of poor sperm motility? If the liquefaction problem is resolved will my motility improve?
(5) What is the next step I should take? I am lost. PLEASE help me.
doctor
Answered by Dr. Rajiv goel 10 hours later
Dear XXXXXXX,

Thanks for the query.

I have gone through the details submitted. I am concerned more about the poor motility of sperms rather than delayed liquefaction. My comments are as follows:

The poor motility of the sperms is certainly a matter of concern. With this motility it shall be very difficult for you to father a child. I am not hugely concerned about the delayed liquefaction; but still shall like to know what your prostate was like on examination.
Although your examination has been normal, I shall still like you to get ultrasound Doppler study of the scrotum to rule out varicocele.

Meanwhile I am suggesting some generalized measures for daily life.

1. Wear loose cotton underwears; boxers
2. Discard jeans
3. No underwear while sleeping
4. No smoking
5. Plenty of fresh fruits and vegetables (Especially carrots, papaya, mango)
6. Laptop to be kept only on table; not to be kept in lap
7. Mobile phone to be kept in shirt trouser; not to be kept in trouser pocket
8. Take either cold water or lukewarm water bath

In addition, I shall like you to start yourself on T. Lycored 2 tablets thrice daily and T. Carnitor one tablet thrice daily for 4 weeks. Repeat your semen analysis after 4 weeks and get back to me. If the liquefaction time of your semen does not improve then I may consider starting yourself on some antibiotics.

Good luck.

Sincerely

Rajiv Goel

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Rajiv goel 13 hours later
Dear Doctor,

Thanks for your reply. As you have advised, I am scheduled to get a scrotal ultrasound doppler. I have not yet got a prostate examination. But I was prescribed the anti-biotic CLINDAMYCIN for 5 days. But no improvement seen

I have also decided to get my harmonal pattern evaluated - Thyroid, FSH, LH, Testosterone (Free & Total) & prolactin. This is just in case if anything is out of place, it will be evaluated in the beginning itself. I will upload the reports tomorrow. Is there any other test I have to take?

Doctor One thing I would like to make sure is whether this delayed liquefaction is causing the poor sperm motility? If the motility is assessed after complete liquefaction. i.e after 3 hours or so will there not be poor motility of sperm?

Also If the liquefaction problem is corrected, will the sperm motility improve. Thanks

doctor
Answered by Dr. Rajiv goel 10 hours later
Dear XXXXXXX,
Thanks for writing back.
The poor motility of the sperms is not because of delayed liquefaction. With the treatment i have suggested most (95%) of the patients shall experience better motility and hence greater chance of conception. your partner can conceive even now but with better motility the chances shall be better.

You really don't need the hormonal evaluation but you can get it done nevertheless. You don't need to get the prostate examination done at this point of time but we shall get it examined at a later date if required. 5 days of clindamycin is not good enough for prostate infection.

Hoping to hear from you soon with scrotal doppler and other hormonal evaluation.

Sincerely

Rajiv Goel
Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Rajiv goel 15 hours later
Dear Doctor,

Thanks once again for your response. I couldnt get the Doppler done 'coz there was a lady doctor at the Scan centre. I have rescheduled the scan for tomorrow.

Meanwhile I have received my harmone test report. I have uploaded it. I think the testosterone is on the low side. Doctor Please tell me the dosage strength of Lycored. I am going to start on the medications tomorrow.

Lycored - 2 tablets in the morning afternoon & night and
Carnitor - 1 tablet in the morning afternoon & night

Is that right Doctor? Should I take it with food or before food or after food ?

Thank you Once again Doctor.
doctor
Answered by Dr. Rajiv goel 54 minutes later
Dear XXXXXXX,

I have reviewed the reports and serum testosterone is within normal limits and nothing needs to be done on this front.

Lycored softgel (2000 ug)comes in only one strength and you have to take both the medications after food.

Sincerely

Rajiv Goel


Above answer was peer-reviewed by : Dr. Aparna Kohli
doctor
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Follow up: Dr. Rajiv goel 22 hours later
Dear Doctor,

I have done the scrotal doppler as suggested by you and I have attached the report. Though I have no varicocele, it seems there is a cyst in the right epididymis. To date I have not had any pain and never even noticed it.

I am totally devastated by the news of the cyst. What effect will it have on my fertility? Will my right testicle lose function altogether? What should I do to get it gone? Please advice at the earliest.

What should I do now? Thanks for your time.
doctor
Answered by Dr. Rajiv goel 32 minutes later
Dear XXXXXXX,

Stop worrying about the cyst. Its presence shall not affect your fertility and a large population shall have them without causing any problems.

Sincerely

Rajiv Goel

Above answer was peer-reviewed by : Dr. Prasad
doctor
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