What can I expect?

[KristenEMcBride]

Good morning. I am very new to this site and have just recently heard about Inciid the Heart. My husband and I have been trying to conceive for a few years but as he is out of town for months at a time we had not been directed to an infertility doctor until recently. We are going to make an appointment sometime in November as he'll be home for the holidays.

I was initially prescribe Clomid. When that didn't work I went in for an HSG test and my results were perfect. All my ovulation tests were fine as well. My husband had one normal seaman analysis when we got married 5 years ago and after my tests they had him go in for another which came back with low morphology and low motility. My doctor said the levels we're terrible but did suggest seeing an infertility doctor and due to my insurance not paying for this we have put it off until we know he'll be in town for a couple months. What can we expect with the initial visit? What could cause his recent seaman analysis to have these lower counts?

[Scott Roseff MD]

Hi,

Welcome!

As an aside, if a woman has regular menstrual cycles, and if she ovulates normally all by herself, then taking Clomid can potentially prevent her from conceiving or cause the pregnancy to fail....

I can't speak for other specialists, but as far as what to expect at my office:

At the first visit, I would have already reviewed all of the new patient's prior records and test results. I take an extensive medical history, and then I perform a complete physical examination. Then, we sit down again and I give my preliminary diagnosis or diagnoses and we talk about updating any outdated tests or getting tests scheduled that have not been done to date. Following that testing, we "regroup" for me to tell the patient/couple what fertility problem(s) I think exist and what we need to do to achieve a timely pregnancy in the simplest fashion, in the shortest period of time, and for the least financial investment.

Sperm can change with exposure to toxins (environmental, heat, alcohol/smoking) and/or with age. Also, what one lab calls "normal" may not be considered normal to the next lab. Illnesses can affect sperm - There are so many possibilities....

Hope this helps,
Dr. Roseff in Florida

[KristenEMcBride]

General Infertility (cont.)

Thank you so much for the quick reply! My tests have come back fine so my concern is my husband. He's the lead singer of a band that is touring constantly. Being on the road isn't conducive to a "healthy" lifestyle. Do you have any suggestions that I can ask him to do while away to help? Coming from a Doctor it will go over MUCH BETTER than a "nagging" wife.

Also, in regards to infertility, if the woman is healthy and the sperm counts are low in morphology/motility, what are the next steps?

Thanks again for the timely response. I greatly appreciate it.

Kristen

[Scott Roseff MD]

Hi,

Smoking (anything) can have an adverse effect on sperm, as can more than 3 glasses of alcohol per week and/or illicit drugs.

If the sperm is poor, the options depend on several factors, like:
a) how bad the sperm really is;
b) if the sperm DNA structure and function are OK (special tests we do);
c) how old the woman is;
d) what the day 3 FSH, estradiol, AMH, and antral follicle counts are;
e) how long they have been TTC.

Hope this helps!
Dr. Roseff