Patient: My wife and myself have been married for one year seven months and we started regular coitus about 8 months ago(2-3 times per week).Her cycle occurs every month but ranges between 26-29 days/month…we have been unable to conceive….her hormonal profile and Pelvic USS is normal…based on my attached seminal fluid analysis what is your analysis and what suggestions can you make concerning the low motility..should we be thinking IUI/ICSI or try conservation treatment first.I am a General pratitional by profession.
Doctor: HelloThanks for the query doctor.We do not consider a couple infertile if they have not yet completed one year of tr ying to conceive without any medications or support. We see that the time for trial is only 8months in your case.Since your wife has no issues and her scan is normal with regular cycles, there is a very positive hope that everything is going well.We have reviewed your semen analysis. It is fairly normal except for the fact that the motility is 30percent, when compared to the normal being 32 percent as per the .WHO guidelines which is not a big issue. MoreOver, we need at least 2 semen analysis reports done at least a couple of weeks apart to decide on the sperm issues Rest of the parameters are normal.Hence we advice you to try for conservative treatment for another 3 cycles and then switch to IUI for next 6 cycles. In case of no pregnancy, later opt for ICSI. If you are eager to conceive very soon, directly opt for IUI now for 3 cycles and then if fails, plan for ICSI.All the best for a fast conceptionRegards
Comments / Follow Ups
Patient: Thanks for your prompt reply.What conservative treatment do you recommend for the next three cycles?
Patient: Does the high pus cells point towards infection?
Pus cells of 10 to 12 suggest moderate infection. You can take a course of broad spectrum antibiotic. Conservative management includes multivitamins, quit smoking and alcohol in case you do, try to conceive with monitoring the cycle with follicular scans and times intercourse only. If needed a hcg trigger can be given at follicle size of 18to 20 mm