IVF/Low Sperm Count

[Aisling81]

Hi,

I was just wondering if someone could help me with a few questions I have about IVF etc.

We have had our second sperm analysis today with slower count than our original analysis (3.8 3 months ago- now 0.4). There are no problem with the other parameters of the analysis. We are obviously a bit shocked. We had made some lifestyle changes and were taking Chinese medication which is supposed to be very effective.

Anyway - our next step is to go get some help and some formal tests. I was wondering if I need a referral for the IVF clinics or I can just call up and make an appointment myself. Will they allow us 'self refer'? Reading a bit about our situation I am thinking that ICSi would be our only choice if we can not improve the sperm count. We have technically only been trying for 8 months and went for the analysis by chance. Will this effect the clinics offering us IVF?

Any thoughts would be greatly appreciated

Thanks Aisling

[freelancescientist]

You can self refer if you are going privately. If you are eligible for nhs funding then this needs a GP referral. As you say with those counts then only ICSI should be offered. Your length of time 'trying' shouldn't come into consideration as there looks to be a definite male factor, but if you are asking for nhs funding then sometimes that is one of the criteria, it depends on your funding body (CCG).
There is no harm in trying to improved the count but in my clinic with previous results like those, even if you can get the count any higher we would still perform ICSI as we find that even if the numbers get better, fertilisation results with conventional IVF were much poorer than expected.

[Lauren83]

Hello

Like pp said you need to a GP referral if you are nhs, some ccgs say 6 months (if you have known issues) some say 3 years

We had low count and had icsi, the SA can vary wildly, be careful with Chinese meds its always good to find out what your clinic supports, ours had in the literature to avoid Chinese meds, they did recommend menevit for male factor though

I'm at Care Manchester a private clinic

[Aisling81]

Thanks for all your info girls. I am going to fill out the form for agrc and go see what our options are. I feel like if we go straight to clinicwe will have to pay everything private but since we haven't been in NHS 'radar' about this we haven't had any bloods etc done. Oh well- what's another few hundred when we'll be bankrupt anyhow!

I forgot to say I had 2 mmc last year..I think something dramatic may have happened my husbands spermatozoa since then. It's so confusing.

I feel like a bit of a phoney as so many people gave been trying years- feels like I'm being dramatic talking ivf so soon.. But I can't really see abt other option.

Anyway.. Time to try get some answers.. Thanks so much for your help

[Rumplestrumpet]

Hi Aisling,

I wouldn't be too depressed by one sperm test (there could be a range of reasons why this one was so low, eg mild infection, insufficient abstinence), but you are of course right to get it checked out. I'm not clear if you're planning to go private, but I would definitely advise you to get onto the NHS system as soon as you can - you can do this in parallel with private consultants if you want.

As others have said, the general rule a GP will follow is to wait until you've been trying for 2 years first before they refer you on to specialists, but this is only because they know that even those who may have minor fertility issues on paper will often fall pregnant naturally, and medicalising it too soon only complicates things. But, that said, you've got good reason for concern with your DH's latest results, so you should push for a referral.

As Lauren says, I'd beware of alternative therapies - many of which are not proven and can in fact have the opposite effect. You can ask your GP GP what they recommend, they often encourage men to take Wellman.

As for IF vs ICSI, there's very little difference in terms of tests and treatment - at least initially - but I'm sure you can talk this through with specialists if it comes to that.

Best of luck!

[Heels99]

We had same situation but at that point Icsi wasn't available on nhs so we had 4 private cycles over 5 years. First 3 cycles at one clinic then transferred to a different one for 4th successful cycle, twin girls now age 6. Long haul. It is frustrating that with all the advances in fertility treatment there have been very few advances in male factor treatment over the years.


Op I don't think there are any clinical trials that prove Chinese herbs help unfortunately. Our clinic advised against it and wouldn't treat people taking the herbs as can interfere with the treatment

Good luck to all