Low sperm count? Consider IVF to improve chances of conception

If you and your partner are facing fertility challenges trying to conceive, you may have a one in three chance that the problem stems from sperm. Don’t wait to check out whether this is a cause of infertility. Even as you and your partner try to figure out whether sperm is an issue, you may also be experiencing declining fertility, as your ovaries continue to age.

Let’s explore some expert advice if sperm is the fertility issue.


Do

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  • see a fertility specialist & get a semen analysis
  • consider intrauterine insemination
  • consider in vitro fertilization
  • consider intracytoplasmic sperm injection (ICSI)
  • take a personalized IVF prediction test
Don't

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  • wear tight pants, or use a hot tub regularly
  • use certain medications
  • take anabolic steroids or supplemental testosterone
  • rely on herbal or dietary supplements

Mylene Yao, M.D‘s recommendation to ExpertBeacon readers: Do

Do see a fertility specialist & get a semen analysis

See a fertility specialist to confirm whether “male factor” is a cause of your infertility. Your doctor will examine a fresh semen sample dropped off at the laboratory or taken at the clinic from your male partner to evaluate semen quality and help you decide whether intercourse, insemination, or IVF would be most likely to succeed. The information from the semen analysis will usually include sperm count (the number of sperm), sperm motility (the percentage of sperm that are swimming), sperm progression (how well the sperm swim), and sperm morphology (the shape of the sperm).

Do consider intrauterine insemination

If your partner’s semen sample is sufficient in count and quality, your fertility doctor may suggest intrauterine insemination (IUI). With this procedure, your doctor will deliver selected and washed sperm from your partner directly into your uterus with a sterile catheter when you are ovulating. Because IUI puts sperm directly into the uterus, even weaker swimming sperm have a better chance of reaching the fallopian tube, where an egg may be awaiting fertilization. Your doctor can time the IUI with natural ovulation or medication-induced ovulation.

Do consider in vitro fertilization

With in vitro fertilization (IVF), your fertility doctor will give you medications to help you produce eggs and then retrieves those eggs to combine with your male partner’s sperm in a laboratory dish. Tens of millions of sperm with strong swimming ability are needed with IUI to give at least one to a good chance to fertilize the egg. In contrast, fewer sperm with less stellar swimming ability are needed for IVF, because they are placed in close proximity to the egg in the same dish.

Do consider intracytoplasmic sperm injection (ICSI)

In a procedure called intracytoplasmic sperm injection (ICSI), a fertility lab technician injects a single, selected sperm from your male partner into a single egg. With ICSI, even sperm that swim weakly, or not at all, are able to fertilize an egg.

Do take a personalized IVF prediction test

Univfy has created personalized IVF prediction tests to give couples highly accurate predictions of their chances of having a baby with a first IVF or subsequent IVF treatments. Univfy PreIVF, a test to predict IVF success with a first IVF cycle, and Univfy PredictIVF, a test to predict success with subsequent cycles, analyze multiple health factors from your medical data – not just your age— to give highly personalized and accurate readings. Using advanced science developed originally at Stanford University and with leading fertility clinics around the world, Univfy IVF Prediction Tests allow you to make more confident and better informed decisions about your fertility treatment.


Mylene Yao, M.D‘s professional advice to ExpertBeacon readers: Don't

Do not wear tight pants, or use a hot tub regularly

Cooler temperatures help sperm production and quality. Testicles are kept outside in the scrotal sac the body to keep them cooler than the body’s internal temperature. Since the birth of the first in vitro fertilization (IVF) baby in 1978, treatment for infertility using IVF has improved dramatically. Patients today have more success with IVF than with simpler treatments, because it bypasses multiple fertility issues (follicle development, ovulation, fallopian tube obstruction, and poor sperm quality) all at the same time. With the advent of intracytoplasmic sperm injection (ICSI), a procedure used with IVF in which a single sperm is manually injected into a single egg, even men with sperm quality issues can conceive a child.

Do not use certain medications

Some antibiotics and medications for high blood pressure, depression, epilepsy, and chemotherapy can reduce sperm quality. Consult your doctor for alternative medications or other solutions. For instance, although most classes of antibiotics do not harm sperm production, Sulfasalazine, used to treat ulcerative colitis, has been shown to affect sperm production temporarily. Patients can use an alternative antibiotic, 5-aminosalicylic acid, which does not affect semen.

In addition, high blood pressure medications – called calcium-channel blockers – reduce the fertilizing ability of sperm, and some depression drugs can also affect sperm quality. One side-effect of many antidepressants is an increase in the hormone prolactin, which suppresses sperm production but the effect is reversible. Epilepsy medications, such as valproate, oxcarbazepine, and carbamazepine, can also disturb the normal hormonal balance.

Chemotherapy agents used to treat cancers generally have a negative effect on sperm. Before treatment begins, chemo patients can bank semen samples for future use.

Do not take anabolic steroids or supplemental testosterone

Taking anabolic steroids or supplemental testosterone can reduce sperm count to zero, a condition called azoospermia. You should see a fertility specialist before taking testosterone.

Do not rely on herbal or dietary supplements

Natural, alternative supplements may be neither safe, nor effective. Compared to FDA-approved prescription medications, very little research to prove effectiveness and safety for supplements is available. And supplements do have the potential for side effects and drug interactions. So, discuss the use of any alternative supplements with your doctor.

IUI with or without ovarian medications to stimulate egg production and IUI are common first steps in fertility treatment. True, they are technically simpler and less expensive than IVF. But in some cases, it may even be counterproductive to delay the use of IVF in favor of multiple rounds of less effective treatments. It’s important to discuss these tradeoffs with your doctor.
Sometimes, when treating infertility, it makes sense to make a beeline for the most effective treatments to save time, money, and emotional frustration. Even with IVF success rates exceeding 60% per cycle for the top US clinics, IVF is currently used by as few as 2-5% of patients. Remember, taking six to nine months to do a less effective treatment before seeking IVF can mean wasting precious time, especially for older women whose natural fertility declines with every month.


Summary

If you and your partner are having trouble conceiving, it may be that the male is experiencing sperm problems either with their sperm count, motility, progression, or morphology. Because of the great advancements in this medical field, there are many things you can do to help urge the process forward so that you and your partner can have the baby you have always wanted. Be sure to follow this advice and consult with a fertility specialist for specific instructions and options.

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