Hi I m a 30 year old female and my husband is 42...we ve been married for 1 year and 9 months and didn t conceieve.. my hormonal profile and HSG were all normal.. My husband however was diagnosed with asthenozoospermia.. Following are the two semen analysis results 11/5/2014 GROSS EXAM. Volume 1 ml Colour Gray Viscosity +++ pH Alkaline Mucous + Agglutination ++ MICROSCOPIC EXAM. Concentration 43 million/ml Total sperm count 43 million MOTILITY DATA Motility 45% Grade a 10% Grade b 15% Grade c 20% MORPHOLOGY DATA Normal sperm 5% Abnormal sperm 95% Leukocytes 3-5 Immature germ cells 3-5 30/8/2014 GROSS EXAM. Colour Normal Reaction Alkaline Volume 1.3 ml Viscosity Normal MICROSCOPIC EXAM. Sperm count 32 million Pus cells 0-1 RBCs 0-1 Epithelial cells 0-1 MOTILITY STATUS Active: 35% after 20 mins, 30% after 60 mins, 30% after 120 mins Sluggish: 5% after 20 mins, 5% after 60 mins, 5% after 120 mins Non motile: 60% after 20 mins, 65% after 60 mins, 65% after 120 mins MORPHOLOGY 40% abnormal shape He has been taking vitamin supplements (MFS PLUS & Coenzyme Q 10) for about 2 and a half months now..still no pregnancy My question: Is a spontaneous conception possible if he continues taking the vitamin supplements, or should we go directly for ICSI?? P.S. I m an OB/GYN second year resident..feel free to answer in medical terminology Thank you