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Unsure what to do next

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#1 mrandmrst

  • Just Hatched
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  • Dx:Male Factor

Posted 08 May 2017 - 03:30 PM

Hello there, 


My husband and I have been trying to conceive actively for 1.5 years now. Prior to that we were doing more of a fertility timing method to keep from getting pregnant, but without any birth control or condoms for 2 years. He is 37 and I am 32. 


After about 3 months of serious trying we decided to get basic fertility testing done because my OB/GYN was surprised we hadn't gotten pregnant especially considering our previous method. 


My results were all normal - bloodwork normal, AMH good, tubes open, etc. Hubby's results showed male factor infertility and he was diagnosed with bilateral varicocele. 


His first sperm results were like 17 mil count, 85% motility, but only 5% strict morphology and 15% forward progression. He also had low testosterone results and high DNA fragmentation of 32%. Two docs recommended varicocele surgery and said we could probably only get pregnant through IVF with those results otherwise.


Hubby had the varicocele microsurgery on both sides in June of last year. The surgery doctor (urologist) said things were looking good at the 3 month post surgery mark. All he did was a basic semen analysis and bloodwork to check the testosterone level. We never got those results on paper or did any other follow ups with the surgery doctor because I got pregnant after 4 months. 


I miscarried that pregnancy at 11 weeks and ultrasound showed the baby had died unexpectedly at 8/9 weeks. We even had a totally normal ultrasound with heartbeat and good HCG/progesterone levels at 6 weeks so it was very shocking and traumatic, plus it happened right after Christmas. 


We have tried to get pregnant again for 2-3 months now but it hasn't happened so far. Hubby decided to get another detailed semen analysis last week to be on the safe side. New analysis shows count has gone up to 38 mil but forward progression decreased significantly to 6%. Morphology is the same. He is scheduled to get new blood work, new DNA fragmentation test and an ultrasound. The fertility doctor (different than the surgery doc) thinks that he still feels some varicocele veins on the left side despite the surgery. 


So basically I am very frustrated because it seems that the surgery did not really help enough to get pregnant and keep the pregnancy and there many even still be some veins left. I read that if the DNA fragmentation is still high there is a greater chance of miscarriage and birth defects even if I do get pregnant naturally. 


I am seriously considering whether we should just skip to IUI or IVF/ICSI depending on how bad the next round of results is. I don't want to keep trying to get pregnant naturally and then have another miscarriage. 


Anyone else gone through something similar?


#2 annatarz79

  • Global 100+
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  • Gender:Female
  • Dx:Unexplained

Posted 08 May 2017 - 11:31 PM

I m sorry that you had to go through this. Did you get to tested for the miscarriage?. Maybe it is not related to your husband issues. I have had many chemicals in the past and not all of them are for the same reason. High dna fragmentation can be treated with supplements. Not every pregnancy is the same and three months is not a long time for trying. Give yourself a break and try to relax. If you decide ivf try to test for gd. Please also have in mind that ivf does not guarantee a viable pregnancy.Good luck
  • nervus optimist likes this

#3 nervus optimist

nervus optimist
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Posted 10 May 2017 - 09:18 AM

I'm so sorry you are going through this. Infertility is so hard, and pregnancy loss after infertility is devastating. Sadly, even with IVF/ICSI, and even if you add PGS (genetic screen of the embryo) to the mix there are still no guarantees that you won't have a pregnancy loss. I've had 4 losses that were all following infertility treatments. The fact that you did get pregnant on your own is certainly encouraging. I would say talk to a fertility clinic, or two, or three, and ask for their input. They may all agree, or may have vastly different recommendations. You could also consider posting in the ASK the RE section of the site to get a medical perspective. The doctors here volunteer their time so it may take them a while to get back to you, and they can't give specific medical advice over the internet, but they can offer a different point of view which some people find helpful.


Thinking of you and hoping you get encouraging news soon.


  • s00n likes this

I am 38, DH - 39
Genetic - IVF&PGD to prevent Genetic Disorder
IVF #1 - Nov/08 - MC @ 6 weeks, no embryos frozen
IVF #2 - Aug/09 - bfn
IUI #1 - Feb/10 - ectopic
PRIDE - Apr/10
Homestudy - July/10
Given the gift of donor embryos - Jan/12
Donor FET Jun/12 - 9 weeks - no heartbeat... MC
Donor FET Oct/12 - we're PG biggrin.png

===> Beautiful baby boy born 2013 babyboy.gif

Donor FET Oct/16 - chemical

April 2017 - surprise PG

===> Beautiful baby girl born 2017 babygirl.gif

#4 s00n

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  • Location:Canada
  • Interests:Him- Potential SA issues Me- PCOS like crazy/anovulation/long cycles. Started TTC before 30.TTC/Secondary Infertility(2008-2015) - Adopted from public system in Ontario 2012.Freeze-All IVF after OHSS, and successful FET 2015 @ 36Yrs Old.
  • Dx:PCOS
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Posted 10 May 2017 - 11:55 AM

Our clinic was iffy on my DH's ability to get me pregnant. We got varying responses. In the end we used IVF and got pregnant (after 7 years) and then less than 2 years after the IVF we got a surprise pregnancy.


Quality/counts/morphology can be challenging. It just takes 1. BUT the lower things are the less chance of course.


N.O. gives good advice - consult multiple sources. This is a bit of a complex issue.


And infertility is hard - I do not wish it on anyone. In the scope of trying it may feel long, but investigating all your options and moving on them may help you to feel a little more in control


There has also been recent discussion on prescreening of embryos for fragmentation, and recent studies showing that fragmented embryos can result in healthy kids etc. So there's no true knowledge on whether that's a full cause of infertility either, to muddy the waters. But don't let it count you out.


Best of luck!

  • nervus optimist likes this
See my about me page for details on our IF journey including adoption and other avenues.

#5 mrandmrst

  • Just Hatched
  • 3 posts
  • Dx:Male Factor

Posted 10 May 2017 - 05:01 PM

Thank you all for your replies. I know that we haven't been trying as long or had as many failures as most of the people on this forum probably, but it is still hard for me anyway. Maybe I am just a weakling :)


We did not have any testing done on the miscarriage but the OB/GYN said it was most likely some kind of chromosomal issue. I miscarried at home after an extremely painful mini-labor. I understand that kind of miscarriage is more likely if the sperm DNA is damaged. 


I am hoping to learn more about the different types of procedures that could screen out sperm with DNA fragmentation. It seems there are several different methods and lots of acronyms. Our fertility doctor mentioned something about getting testicular sperm to avoid DNA damage but I'm also reading about some other methods to check the sperm and/or embryo. I'm unclear if IVF/ICSI or just regular IVF is better in case we want to avoid picking sperm that would have normally never made it. Prescreening of the embryo sounds promising too. 


Husband was taking Fertilaid, Count Boost and Motility Boost for most of last year. He just started it up again. He doesn't drink much and doesn't smoke. 


We live in the US, but my husband is from Europe and we are considering going there to do the procedure if it seems necessary. I would be interested to hear any recommendations for European clinics that are good with sperm DNA and motility issues.