Male Factor Infertility
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I would give adequate time for improvements in sperm quality and natural conception before moving onto IUI's. Figure out your own timeline of trying naturally, say the next 3-6 months, and after that if no pregnancies move onto IUI for 3-5 months and if needed the next step would be IVF.
It can become overwhelming so just try to set a timeline of what you are comfortable doing and the pace you want to move. Also remember correcting that sperm quality can take some time so giving natural conception the next 3-6 months is realistic if you want to give the changes made time to improve the sperm quality.
I agree if after that sperm quality has time to improve and still no pregnancy the next step should be IUI.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread



1. No heat to the scrotum and groin areas. Heat causes damage to the sperm cells so stay away from hot tubs, saunas, Jacuzzis or soaking in baths above body temperature.
2. Stay well hydrated. Drink plenty of fluids. Caffeine is okay in moderation.
3. Eat a well balanced diet with plenty of fresh fruits and vegetables. Red meat and fish should be consumed regularly.
4. Regular ejaculations, every 24-48 hours, to keep the system revved up.
5. Avoid testosterone replacements and all male hormone/androgen supplements. These can drastically reduce or even zero-out sperm counts.
6. Absolutely no tobacco in any form. Tobacco use causes DNA damage to sperm cells that leads to lower pregnancy rates, increased incidence of miscarriage and birth defects. This holds true for marijuana and other recreational drugs.
7. Alcohol in moderation. Excess drinking is associated with significant sperm toxicity.
8. Maintain a healthy BMI level. Excess fat tissue results in increased estrogen and lowered testosterone.
9. Avoid cells phones in pants pockets or belt clip attachments. Do not place laptop, tablets or other computer devices directly on lap.
When it comes to supplements more does not always equal better so please follow the dosages below. If you are not a fan of taking all these individually we would recommend purchasing a male fertility blend vitamin such as FertilAid for Men, Fertility Blend for Men, Conception XR or other blended multivitamins containing a majority of these ingredients such as GNC's B-Complex 75 Complete (as low as $9.59/month) with the addition of the missing items. Fertility Boost for Men can also be added to help improve sperm motility and forward progression.
Always consult your primary care provider before starting any supplements.
Vitamin/Anti-oxidant Dosage Benefits
B Complex Once daily DNA
Vitamin C 500 mg daily Count, motility and morphology
Vitamin D 400 IU daily Improves sperm quality
Vitamin E 400 IU daily Motility, viability and morphology
Coenzyme Q10 200 mg daily Motility and forward progression
Folic Acid 1 mg daily Count and DNA
Acetyl L-carnitine 1 g daily Motility and forward progression
L-carnitine 1 g daily Motility and forward progression
Lycopene 10 mg daily Count and motility
Selenium 200 3BCg daily Motility, viability and morphology
Zinc 50 mg daily Count and DNA
Fish oil capsules 2-3 daily Count, motility and morphology
View Thread

A number of things can cause low motility and heat is one you mentioned. See the sperm healthy lifestyle guidelines below.
Making lifestyle changes and starting the FertilAid and Motility Boost is the best place to start. Give it 2-3 months and retest to see if that motility is improving. Always important to test 2-3 times for an accurate analysis of your fertility.
During collection use only a sperm safe lubricant called Pre-Seed and make sure to avoid getting much into the sample because even though it's marketed as safe it can alter that motility slightly.
I think the good news is you have normal sperm production so some minor changes are likely to help boost that sperm quality.
There is also a chance that the sample sat too long before the lab tested or other handling error of the sample. Recommend using a fertility lab for testing over hospital lab or general labs that process blood and urine samples a majority of the time.
Please keep us posted on your next test.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread

The diet and lifestyle improvements should improve your fertility so I do recommend making those changes but you must get that possible infection treated. Infections was weaken and damage your sperm cells.
If you have been actively having unprotected intercourse for 1 year you need to have both the male and female evaluated for infertility. If you've only been trying for the past few months keep trying at at that 9-12 month mark start those fertility workups to see why after 12 months conception has not happened. It can take time to achieve pregnancy and this is why most fertility experts like you to actively try for 12 consecutive months before becoming concerned with fertility.
Make sure not only do you need to make these lifestyle changes but your wife as well. A number of factors like age, weight, regularity of cycle, stress levels, smoking, drinking can have huge impacts of female fertility.
Regular intercourse, every other day, after your wife stops her period or using an ovulation calendar to know the time of the month your wife is ovulating or most fertile will help improve your timing for intercourse and chances for conception.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread

The elevated round cells count or PUS cells/WBC is concerning and you may need a round of antibiotics. WBC = white blood cells, elevation of these cells can indicate infection or inflammation within the male reproductive tract. You should talked to your doctor about epididymitis or prostatitis. These are both very treatable and usually a round of antibiotics will take care of things. Retest a semen analysis following completion of the treatment to see in WBC count is back down.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread

1. No heat to the scrotum and groin areas. Heat causes damage to the sperm cells so stay away from hot tubs, saunas, Jacuzzis or soaking in baths above body temperature.
2. Stay well hydrated. Drink plenty of fluids. Caffeine is okay in moderation.
3. Eat a well balanced diet with plenty of fresh fruits and vegetables. Red meat and fish should be consumed regularly.
4. Regular ejaculations, every 24-48 hours, to keep the system revved up.
5. Avoid testosterone replacements and all male hormone/androgen supplements. These can drastically reduce or even zero-out sperm counts.
6. Absolutely no tobacco in any form. Tobacco use causes DNA damage to sperm cells that leads to lower pregnancy rates, increased incidence of miscarriage and birth defects. This holds true for marijuana and other recreational drugs.
7. Alcohol in moderation. Excess drinking is associated with significant sperm toxicity.
8. Maintain a healthy BMI level. Excess fat tissue results in increased estrogen and lowered testosterone.
9. Avoid cells phones in pants pockets or belt clip attachments. Do not place laptop, tablets or other computer devices directly on lap.
When it comes to supplements more does not always equal better so please follow the dosages below. If you are not a fan of taking all these individually we would recommend purchasing a male fertility blend vitamin such as FertilAid for Men, Fertility Blend for Men, Conception XR or other blended multivitamins containing a majority of these ingredients such as GNC's B-Complex 75 Complete (as low as $9.59/month) with the addition of the missing items. Fertility Boost for Men can also be added to help improve sperm motility and forward progression.
Always consult your primary care provider before starting any supplements.
Vitamin/Anti-oxidant Dosage Benefits
B Complex Once daily DNA
Vitamin C 500 mg daily Count, motility and morphology
Vitamin D 400 IU daily Improves sperm quality
Vitamin E 400 IU daily Motility, viability and morphology
Coenzyme Q10 200 mg daily Motility and forward progression
Folic Acid 1 mg daily Count and DNA
Acetyl L-carnitine 1 g daily Motility and forward progression
L-carnitine 1 g daily Motility and forward progression
Lycopene 10 mg daily Count and motility
Selenium 200 3BCg daily Motility, viability and morphology
Zinc 50 mg daily Count and DNA
Fish oil capsules 2-3 daily Count, motility and morphology
View Thread

Day-to-day life and other environmental factors can impact on sperm quality. Please follow the sperm healthy lifestyle guidelines below. Retest in 2 months to see if quality is improving.
Even with a couple parameters low it is possible to for your wife to conceive. I would focus on improving you parameters before moving onto IUI.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread

Try a fertility supplement like FertilAid for Men to help improve that morphology.
Keep us posted on how this pregnancy goes.
Miscarriages are part of nature's survival of the fittest and needed to ensure the birth of healthy babies.
Amy Perkins, MS, TS (ABB)
Laboratory Supervisor
Arizona Andrology Laboratory & Cryobank
International Center for Vasectomy ReversalView Thread
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