Urology Appt. Update

[KaraOrNot]

H recently had his 3rd SA, so we met w/ the urologist today to review things.  He said that he does not think we will have any issue achieving pregnancy naturally or w/ IUI, at most.  He also gave H the option of discontinuing Clomid (he initially said that it would be 6-12 months to get the full effect; H has been on it for 4 months). So if anyone is keeping track, this is what we have been told so far:

1st Doctor (Fertility Specialist - Not an RE) - No significant issues; Clomid for me, to regulate my cycle and lengthen my LP.  No sperm issues, but may need IUI.

2nd Doctor (RE) - Diagnosed w/ MFI; Only options for children are 1) IVF, 2) Sperm Donation, or 3) Adoption.

3rd Doctor (Urologist recommended by RE) -  Can achieve pregnancy naturally or w/ IUI.


The fuck?  I am more confused now that I have ever been.  I have no clue who to listen to or what information is correct.  It seems like every doctor we see is giving us different information.  The only thing I know is that we have been trying for 18 months and are in the exact same place when we started.  

I called the RE to go over the results w/ them and get their opinion on next steps.  Unfortunately, the RE I initially met w/ left the practice, so I have to start over w/ someone else. 

[Deleted]

Gah, that is confusing. Did the urologist give you any stats on the SA? Has he been showing improvement?

[KaraOrNot]

Right? It makes no sense. H is super excited, but I am fearful, because I agree that the urologist is not a fertility expert. The doctor was pleased w/ the increase in motility, but my RE said that they really are only concerned about total motile normal, which is still low.

These are the numbers. The more I look at them, the less I understand them. If anyone has any insight, I am all ears!

SAs done in 6/12, 9/12, and 1/13:

PH (average is 7.2 to 8.0): 8.4, 7.6, 7.2
Motility (average is >49%): 17%, 30%, 36%
Concentration (average is >20 M/ML): 27.2 M/ML, 57.2 M/ML, 50.2 M/ML
Total Count (average is >40 M): 81.6 M, 154.4 M, 100.4 M
Total Motile (average is >20 M): 13.9 M, 46.3 M, 36.1 M
Normal Forms (average is >14 %): 3%, 2%, 2%
Total Motile Normal (normal forms - 5-14% is borderline, 0-4% is considered subfertile): .4%, .9%, .7%

[discogranny]

How frustrating! I know the last thing you want to do is involve another specialist but is there a urologist near you the actually specializes in MFI?

Hopefully meeting with someone new at the RE's office will end up getting you some answers.

[changedname]

That's so weird and from the numbers you posted. I don't see where they are getting the mfi from anyway?

Did the urologist think the clomid improved things that much for him that now you don't need ivf etc?

I hope you can meet someone else that can clear it all up.

[KaraOrNot]

Yeah, the numbers don't make sense to me either. My old RE said that he really only looks at the total motile normal number, as those are the ones that will get you pregnant, lol. Less than 1% of H's sperm are in that category. The official diagnosis is: Hypogonadism (doesn't produce enough testosterone), Teratospermia (abnormal morphology), and Asthenozoospermia (reduced sperm motility).

The urologist was surprised that IVF was ever mentioned.

I am still waiting to hear back from the new RE, but hopefully the he can give use a better picture of what is going on and what we need to do.

[changedname]

Feb 1, 2013 13:28:40 GMT -5 KaraOrNot said:

Yeah, the numbers don't make sense to me either. My old RE said that he really only looks at the total motile normal number, as those are the ones that will get you pregnant, lol. Less than 1% of H's sperm are in that category. The official diagnosis is: Hypogonadism (doesn't produce enough testosterone), Teratospermia (abnormal morphology), and Asthenozoospermia (reduced sperm motility).

The urologist was surprised that IVF was ever mentioned.

I am still waiting to hear back from the new RE, but hopefully the he can give use a better picture of what is going on and what we need to do.

Fingers crossed for you that they can give you some kind of plan that doesn't include ivf. I can't remember, have you done any IUIs? don't they sometimes prescribe them for low sperm count?

[KaraOrNot]

Feb 1, 2013 15:35:16 GMT -5 changedname said:

Feb 1, 2013 13:28:40 GMT -5 KaraOrNot said:

Yeah, the numbers don't make sense to me either. My old RE said that he really only looks at the total motile normal number, as those are the ones that will get you pregnant, lol. Less than 1% of H's sperm are in that category. The official diagnosis is: Hypogonadism (doesn't produce enough testosterone), Teratospermia (abnormal morphology), and Asthenozoospermia (reduced sperm motility).

The urologist was surprised that IVF was ever mentioned.

I am still waiting to hear back from the new RE, but hopefully the he can give use a better picture of what is going on and what we need to do.

Fingers crossed for you that they can give you some kind of plan that doesn't include ivf. I can't remember, have you done any IUIs? don't they sometimes prescribe them for low sperm count?

We have not done IUI.  The first doctor we saw suggested it, but he was an idiot (said that clomid doesn't need to be monitored because monitoring is expensive and doens't help you get pregnant).  We then went to the RE, who said IVF or sperm donation. He didn't think there was enough normal sperm to do IUI.

[changedname]

ah ok. My RE wants 5m motile (post wash?) for IUI. Anyway you guys know my feelings on IUI - not worth the $$ if they are going to cost you a ton.

I'm sorry you are in such a confusing situation, I wonder if you are going to end up being unexplained - because if there was nothing wrong with his s/a then you should have got pg by now kwim?

[Cheesecake]

What a confusing situation! Do you have any idea of what you would want to do now. Give IUI a try or no? How weird that they give such extremely different advice. I can see opinions differing a little between docs, but this is too much...