SA's show 500,000 but only 14-20 sperm found at IVF?

Airmide · 10-14-2009, 03:42 PM

I'm really confused about something. We just went for our second IVF. We've had 3 SA's done at two different places. Two before our first IVF and one in between that and the IVF we just did.

All the SA's show that we have severe male factor, but that we should have around 1/2 million sperm to work with. We have problems with motility, morphology and concentration. But the fertility specialist urologist, and the local R.E. said we should have more than enough for IVF with ICSI.

They didn't find a varicocle. His estradiol is 28, FSH 5.0, LH 4.0 and Testosterone (total I assume, since it doesn't say free) is 596. All within normal range I think, though he does have a lot of symptoms of low testosterone.

Then when we went for the first IVF our doctor had to stay all night to even find 20 sperm. 19 fertilized, 7 made it to day 3. Transferred 3, BFN and everything in the office arrested by day 5.

The doctor said there was a huge volume, no dead sperm just nothing there.

We thought maybe it was a fluke. My husband sat for a long time in a plane, and for a drive, and on a bucket fishing lol. And when we got home we did another SA and again it showed around 1/2 million.

Then we went up again (over a year after the first). My beta is tomorrow but I *really* don't think it worked.

Again the doctor had to stay all night. This time he found 6 sperm right away, then found 4 more good ones, and 4 he wasn't sure about. 13 of my 14 eggs fertilized. We had 12 by day 3 but none looked great, they all had fragmentation. We put 4 back. Again everything in the office arrested before freeze, but he said one tried to open up a little at least this time.

So I don't know what to make of this. Why could there be such a HUGE difference in numbers? Could it be something about the sperm washing? The clinic's procedures?

I'm wondering because of the low numbers and the fragmentation if it's even worth trying another IVF. Or should we look for another clinic?

Mondayschild · 10-16-2009, 09:58 PM

Hi, I take it your husband did see a urologist. Did he have any ultrasounds done to check for any abnormalities? Also, there are more test that can be done on the sperm to assess any other reasons for the failures. My DH has 2 grade 2 varicoceles which were not found by the first urologist we saw. They were found by the fertility urologist and on ultrasound. I hope everything works out for you.

Airmide · 10-17-2009, 12:24 AM

Thank you for your response! My husband did see a fertility specialist urologist. He just did an exam by hand and said he didn't find anything. Never suggested an ultrasound or anything like that.

My husband (may be TMI) is rather large, but with very small testicles. They often seem to be almost up inside him. We were wondering if this could cause any issues too.

Last year he was having a lot of testicular pain. He said it felt like tugging and twisting. But he hasn't felt that for a long time. He thinks it may be from switching the vehicle we drive to something more ergonomic.

And he recently found a pea-sized lump. So we're going to get that checked out either way.

The urologist at the time was convinced it would be low testosterone, and we were all very surprised when the results came back normal. He said other than that there were a couple of very expensive tests we could do to see if there was a DNA cause, but the treatment would still be IVF with ICSI so those were pointless. He didn't offer any other suggestions for tests or treatments.

iMama · 11-01-2009, 08:40 PM

I'm so sorry to hear about all that you've gone through.

It wasn't clear to me whether the analysis was done by the RE clinic? Another thing to consider is whether your clinic uses an andrologist/embryologist or just an RE. My clinic uses an andrologist/embryologist and he found WAAAAAY more sperm than the regular lab we used before. Maybe your RE would be willing to freeze a backup sample to have on hand prior to the IVF cycle. That's what we're doing. Of course, my RE prefers fresh, but he said due to the malefactor issue, he's going to have us do that. Another thing to consider is 1. rectal electroejaculation or 2. MESA/TESE One more thing-there's a lady on this site who had 7 eggs fertilized from 7 sperm, so try to stay positive, it only takes a few.

If it were me, I wouldn't suggest any treatments to my RE, I'd simply research what my options were, [IE] get consults from other Dr's and then have an appointment with my RE and ask him what he reccommended as the next treatment plan. If my RE didn't have any good options and other RE's did, I'd probably move on to a new RE.

GL!

10-14-2009, 03:42 PM	#1 (permalink)
Airmide 0-99 post 2 of hearts Join Date: Nov 2007 Location: pacific northwest Posts: 21	SA's show 500,000 but only 14-20 sperm found at IVF? I'm really confused about something. We just went for our second IVF. We've had 3 SA's done at two different places. Two before our first IVF and one in between that and the IVF we just did. All the SA's show that we have severe male factor, but that we should have around 1/2 million sperm to work with. We have problems with motility, morphology and concentration. But the fertility specialist urologist, and the local R.E. said we should have more than enough for IVF with ICSI. They didn't find a varicocle. His estradiol is 28, FSH 5.0, LH 4.0 and Testosterone (total I assume, since it doesn't say free) is 596. All within normal range I think, though he does have a lot of symptoms of low testosterone. Then when we went for the first IVF our doctor had to stay all night to even find 20 sperm. 19 fertilized, 7 made it to day 3. Transferred 3, BFN and everything in the office arrested by day 5. The doctor said there was a huge volume, no dead sperm just nothing there. We thought maybe it was a fluke. My husband sat for a long time in a plane, and for a drive, and on a bucket fishing lol. And when we got home we did another SA and again it showed around 1/2 million. Then we went up again (over a year after the first). My beta is tomorrow but I really don't think it worked. Again the doctor had to stay all night. This time he found 6 sperm right away, then found 4 more good ones, and 4 he wasn't sure about. 13 of my 14 eggs fertilized. We had 12 by day 3 but none looked great, they all had fragmentation. We put 4 back. Again everything in the office arrested before freeze, but he said one tried to open up a little at least this time. So I don't know what to make of this. Why could there be such a HUGE difference in numbers? Could it be something about the sperm washing? The clinic's procedures? I'm wondering because of the low numbers and the fragmentation if it's even worth trying another IVF. Or should we look for another clinic?

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10-16-2009, 09:58 PM	#2 (permalink)
Mondayschild 700-799 post 9 of hearts Join Date: Jul 2006 Location: US Posts: 790	Hi, I take it your husband did see a urologist. Did he have any ultrasounds done to check for any abnormalities? Also, there are more test that can be done on the sperm to assess any other reasons for the failures. My DH has 2 grade 2 varicoceles which were not found by the first urologist we saw. They were found by the fertility urologist and on ultrasound. I hope everything works out for you.

10-17-2009, 12:24 AM	#3 (permalink)
Airmide 0-99 post 2 of hearts Join Date: Nov 2007 Location: pacific northwest Posts: 21	Thank you for your response! My husband did see a fertility specialist urologist. He just did an exam by hand and said he didn't find anything. Never suggested an ultrasound or anything like that. My husband (may be TMI) is rather large, but with very small testicles. They often seem to be almost up inside him. We were wondering if this could cause any issues too. Last year he was having a lot of testicular pain. He said it felt like tugging and twisting. But he hasn't felt that for a long time. He thinks it may be from switching the vehicle we drive to something more ergonomic. And he recently found a pea-sized lump. So we're going to get that checked out either way. The urologist at the time was convinced it would be low testosterone, and we were all very surprised when the results came back normal. He said other than that there were a couple of very expensive tests we could do to see if there was a DNA cause, but the treatment would still be IVF with ICSI so those were pointless. He didn't offer any other suggestions for tests or treatments.

11-01-2009, 08:40 PM	#4 (permalink)
iMama 0-99 post 2 of hearts Join Date: Mar 2009 Location: Northern CA Posts: 58	I'm so sorry to hear about all that you've gone through. It wasn't clear to me whether the analysis was done by the RE clinic? Another thing to consider is whether your clinic uses an andrologist/embryologist or just an RE. My clinic uses an andrologist/embryologist and he found WAAAAAY more sperm than the regular lab we used before. Maybe your RE would be willing to freeze a backup sample to have on hand prior to the IVF cycle. That's what we're doing. Of course, my RE prefers fresh, but he said due to the malefactor issue, he's going to have us do that. Another thing to consider is 1. rectal electroejaculation or 2. MESA/TESE One more thing-there's a lady on this site who had 7 eggs fertilized from 7 sperm, so try to stay positive, it only takes a few. If it were me, I wouldn't suggest any treatments to my RE, I'd simply research what my options were, [IE] get consults from other Dr's and then have an appointment with my RE and ask him what he reccommended as the next treatment plan. If my RE didn't have any good options and other RE's did, I'd probably move on to a new RE. GL!