Low sperm count & motility - is this fixable?

[rickylee]

hello fellow TTC friends, my husband just received his SA results and we're absolutely devastated:

• 0.7 million/mL sperm (Severe oligospermia, normal is 20-200 million/mL)
• 2.8 million total sperm count (>= 40m is considered normal)
• WBC = "few" (normal is none or rare)
• 5% motile sperm (low)
• poor motility quality
• 9% semen viability

we have a doctor's appointment in February to speak with a doctor about this, but in the meantime, we are driving ourselves crazy trying to interpret these results and come up with a plan. we are 36 & 37 years old and want to have multiple kids, so we are sensitive on our timeline.

*I read taking CoQ10 & Vitamin C can improve Sperm count & motility. Is that even accurate and if so, how long would it take to improve? what else can we do? Looking for any advice. Thank you *

side note: my bloodwork (Day 3 FSH, estradiol, AMH, TSH, etc) has all come back normal. my cycle is 31 days like clockwork and i've tested positive on OPKs so we are assuming the sperm issue is the main reason for our infertility but we're aware it could be something else on my end too.

Edit to note: we do not smoke or drink and we eat a pescatarian diet. Husbands BMI is a healthy 19.3

 

[oanhsct]

@rickylee Instead of fixable start thinking in terms of “improveable”. Yes he can improve those numbers.

Stop drinking and smoking..those are over

Revamp your entire diet to a healthy balanced diet with lots of protein

Get in the gym and get fitter

Supplement as advised by your doctor

It’s going to take months for significant improvement but he can do it.

Edit to format better lol

 

[greatideas1144]

@oanhsct Yasss!!! I quit smoking he stopped dipping and completely overhauled out diet and exercise plan…definitely helped

 

[williams36]

@greatideas1144 Dont forget to avoid hot showers and saunas, theres been studies showing it has a huge effect on spermcount

 

[oanhsct]

@greatideas1144 Great work! Wishing y’all luck and success

 

[ealgeone]

@rickylee So sorry you are going through this. I am in a similar situation, my husband’s numbers are slightly better than the ones you posted but not that much. If they stay the same I’m pretty sure we are in IVF + ICSI territory. We are also waiting for the reproductive urologist appointment in Feb. Until then I’ve been left to my own devices on the internet.

The male infertility Reddit has a lot of info about supplements and possible treatments, which I’ve found helpful. Whether or not the numbers can be improved depends on what is the underlying cause, if they can find one, from what I’ve read a rather large percentage of MFI in unexplained. The causes can be broken down diagnostically into about four categories, I found this infographic helpful https://www.bmj.com/content/bmj/suppl/2018/10/04/bmj.k3202.DC1/walji042251.pdf

Some other factors that you didn’t include in the SA results like total volume, viscosity and quantity of white blood cells may also give you an indication of what the underlying issue might be. If you didn’t do a DNA fragmentation test this time you may want to add that on the next, since higher rates of DNA fragmentation are correlated with poor semen parameters.

If there is a hormone issue that seems to be relatively treatable, e.g. people who abuse steroids can regulate their hormones to get their counts up. In some cases varicocele surgery works, but not for everyone. Supplements, diet and exercise definitely work for some as well and there is little downside. To see changes for any type of treatment you will need to wait at least 3 months before redoing the SA. Since you mentioned being pressed for time you may want to prepare yourself for the IVF route since that is most effective option from what I’ve read.

Finally I found this paper to be helpful because it breaks down the diagnostic steps for MFI in a table https://academic.oup.com/jcem/article/92/6/1995/2623140

Again I am sorry you are going through this, it’s been really hard and definitely takes time to digest. Spending time in the male infertility sub helped me see that although the results are bad there are people in even worse situations where they find no sperm and sometimes they are able to still conceive, which gives me some hope. Lots of hugs

 

[ravenstereohearts]

@rickylee Husband had average/below average sperm in April 2023, he started eating 5walnuts, 10 almonds, 10 black raisin, 2 dried figs, everything soaked over night, and eating it on empty stomach. sunflower seeds and pumpkin seeds in the after noon. also started taking COQ10, vitamin d regularly. His November reports showed tremendous improvement in total sperm count and motility. He also tried shilajit for 2 weeks but stopped due to digestive issues. He replaced his coffee and tea with green tea. Just sharing our experience.

 

[jharrod84]

@ravenstereohearts Hey...did the shilajit help in anyway?

 

[jeanbaptized]

@ravenstereohearts Hello,

Did you guys end up conceiving?

 

[jharrod84]

@ravenstereohearts Hello...Any positive effect the shilajit had?

 

[greatideas1144]

@rickylee My husband has been on fertileAid(Amazon) Berberine (Amazon) and Clomid(prescription) his urologist has been a Godsend honestly. It’s helped so much. We got pregnant last month, unfortunately it ended in a MC. Point is, it has improved his counts and motility so much

 

[heloisebellamy]

@rickylee What was sperm morphology like? Sounds like oligoasthenoteratospermia as a result of severe oxidative stress, often caused by varicoceles.

If there is no infection, varicoceles, low hormones (just to name a few) you will need to seriously consider ICSI.

I would try to get ahead of the curve, and get an appointment to see a urologist who mainly specialises in fertility issues asap.

P.S. Yes you can improve those numbers with diet but it definitely won't be enough to avoid IVF.

 

[rickylee]

@heloisebellamy Thank you for your comment. There were too few sperm to evaluate the morphology…. probably not a great sign

 

[heloisebellamy]

@rickylee I'm a glass half full person. Like I said it, my gut feeling is it's something that's reversible unlike those who just have only poor motility or morphology.

In saying that, even if it is reversible, it is unlikely to turn around as much as you need to avoid IVF, but you never really know until they do all the tests required, and follow through with treatment.

Don't be too down on yourself, there are men that need sperm extracted from the testicles to father a child, so you are by no means out of luck.

 

[victoryforever]

@rickylee My husband also had pretty devastating results. There are lifestyle changes that he could make (which tbh I’m not sure he can make completely. I know he’s trying, though) but at the end of the day his numbers are pretty bad so I’m looking forward to our appt with the RE in 2 weeks. I’ll let you know if I learn anything helpful. I’m hoping we can just get IUI or IVF going.

 

[l4ur3n]

@rickylee Yesterday I heard an interview in the podcast "The fertility podcast" with a man who leads a page of information and community for male factor infertility called "Knackered Knackers".
I found it really informative

 

[walterroger]

@rickylee Very similar situation - we're also 36/37 and hoping for more than 1 kiddo. Husband has different numbers but low morphology. I have low AMH but otherwise standard numbers.

We're looking into acupuncture (we found a place focused on reproductive health) and he started the coq10, vitamin c, vitamin e, and ashwagandha last week. We're doing this in parallel to exploring IVF

A big big hug to you you're not alone in this!

 

[walterroger]

Also! We are pescatarian. I've read so many reports on the magic of walnuts and Brazil nuts for male fertility so we're giving that a go too because why not

 

[inquirer17]

@rickylee Only throwing this out there in case it applies - my husband’s SA came back with low motility after one a few years earlier had been normal. He had been on a low fat diet for a few weeks during this second SA and apparently a diet restrictive in fat/calories can reduce quality/quantity. Maybe partially why eating nuts seems to help some people? You said your husbands BMI is 19 which is on the low end of normal, so just thought I’d mention this as another factor.

 

[maymcflurry]

@rickylee My husband’s first SA showed low motility and slightly low sperm count. Doctor told him to drink green tea every morning, recommended a bunch of supplements (I can’t remember exactly which ones), and limit smoking and drinking. He got retested a couple months later and his numbers improved. His motility is still below average but it’s better than his first test. We’re hoping by the time we try IUI next month that it will be even better. It’s worth a shot to ask your doctor what changes they recommend to improve his numbers.