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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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    What causes fluctuations in sperm count and motility?

I'm a 42 yr old male whom over the past two years have had various fluctuations in sperm count and motility. First semen analysis showed a count of 7-8 million with normal motility. Urologist prescribed HCG to help raise count as I had a low-normal testosterone level at the time. While on the HCG for a 5 month period my sperm count actually decreased to around 2-3 million per ejaculate on 2 to 3 different test during that time frame. I then got off the HCG and 3 months later had a sperm count of 41.5 million with normal motility, these were frozen, however the fertility lab froze them all in one vial. Since only one vial had been used we wanted to get more frozen so we could try IUI before trying IVF, we instructed the lab to freeze the next sample in multiple vials to help faciliate. However the next test resulted in a sperm count of zero sperm present, did not understand this. Subsequent test showed 40 million with zero motility. Next test was again zero sperm count, these test were all being done anywhere from 1 to 3 month intervals. Several more test were done resulting in either no sperm or just a few and with no motility. Doctor said he has never seen anything like this. He put me back on HCG and the 3 to 4 test I have had since being on the HCG for the past 2-3 months have showed zero sperm and/or very little with no motility. Went to a different doctor out of state just this week, had no sperm present until sample was spun and then revealed just a few sperm with most appearing to be dead and a few just twitching. Dr. sent me for blood work to try to see what might be going on. Any ideas?
Tue, 10 Dec 2019
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Sexologist 's  Response

It can be due to
1.     History of previous surgery
2.     Psychiatric medications
3.     Genetic defect
4.     Hormonal imbalance
5.     Auto-antibodies to sperm
6.     Infections
7.     Varicocele
8.     Stress full life
9.     Radiation exposures
10.     Smoking
11.     Alcohol

The low motility can be due to:
1.     Infection due to sexually and non sexually transmitted infection
2.     Injury
3.     Inborn errors

Hope I have answered your query. Let me know if I can assist you further.

Dr. S. R. Raveendran, Sexologist
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