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Thread: So many questions

  1. #1

    Default So many questions

    The short story... I have PCOS. We realised pretty early on once we started TTC that there was a problem, I've been on metformin since March and I'm now about to start clomid (just waiting for AF to show her face). In all that time I've ovulated for sure once and had a luteal phase of 8 days, so problems galore! When my gynecologist gave the prescription for clomid, he insisted that DH have a semen analysis. We never honestly believed that there would be a problem, but turns out there is. DH has a low count (about 5 million) and poor motility (15%), we weren't given a morphology figure. So turns out we are battling infertility from both sides and now need to find a way to deal with it... I'm repeating the barrage of questions from the buddies thread here in the hope of maybe finding some more answers.


    Firstly... what sort of specialist would deal with male infertility? My gyn apparently mentioned to DH the possibility of a testicular varicocele which could be causing the problem and can be corrected surgically. But what sort of doctor would fix that?

    Is there a type of specialist that could deal with both his problem and mine? I mean, obviously the gynecologist can do nothing for DH, and someone specialising in problems of the male reproductive system (urologist?) wouldn't be able to do anything for me, but is there someone who can deal with us both, short of going the IVF route?

    To do with intercourse timing... I know they say that every second day is best for TTC, but why? With a bad sperm count should we be BDing more often or less often? I thought it would be more often, but when I mentioned this to DH he said it made no sense... that if a male with good sperm needed two days to recharge, then a bloke with bad sperm would need even longer. I thought it may have something to do with getting a decent number of sperm inside... that if a normal healthy male will deposit over 20 million each time, then we need to BD 4 times to get that as many as another couple would get once... If that makes sense? Does anyone know which of us is correct?

    How many clomid cycles will someone generally be allowed to do? I'm not ovulating without the clomid, if clomid works and I ovulate, great... but with DH's SA and the news that it will take us longer... will I be allowed to have enough clomid cycles to have "longer"?

    I'm wondering whether it would be worth us trying to continue with natural conception (as natural as clomid, acupuncture and everything else can leave it), or just go the whole IUI/IVF thing straight off... really tough decisions to make and I don't know the first place to look for the answers!


    I'm really quite sure we need to find a new specialist, but the thought of what type, let alone which one is really quite daunting.



    BW

  2. #2

    Join Date
    Feb 2004
    Location
    Melbourne
    Posts
    11,171

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    I can answer some for you.....

    What sort of specialist would deal with male infertility? My gyn apparently mentioned to DH the possibility of a testicular varicocele which could be causing the problem and can be corrected surgically. But what sort of doctor would fix that?

    He'd probably need to go & see a reproductive endocrinologist.

    Is there a type of specialist that could deal with both his problem and mine? I mean, obviously the gynecologist can do nothing for DH, and someone specialising in problems of the male reproductive system (urologist?) wouldn't be able to do anything for me, but is there someone who can deal with us both, short of going the IVF route?

    As far as I'm aware an RE can deal with both of you....

    To do with intercourse timing... I know they say that every second day is best for TTC, but why? With a bad sperm count should we be BDing more often or less often? I thought it would be more often, but when I mentioned this to DH he said it made no sense... that if a male with good sperm needed two days to recharge, then a bloke with bad sperm would need even longer. I thought it may have something to do with getting a decent number of sperm inside... that if a normal healthy male will deposit over 20 million each time, then we need to BD 4 times to get that as many as another couple would get once... If that makes sense? Does anyone know which of us is correct?

    The RE told us that it was better for us to BD every day (Aaron's count is 5million as well). What he said was that with a low count if you leave it for 24hrs the count would be back up to 5million, if you leave it 36hrs it's not going to get any higher, same as if you leave it 48hrs etc etc. He said the reason people DTD every second day is to get back up to the high count, so if you're never going to get there what's the point in waiting? So the point is if you DTD Mon, Tue, Wed you'd have had 15million in there potentially, compared with DTD Mon & Wed where you'd have only 10million. Make sense?

    I'm wondering whether it would be worth us trying to continue with natural conception (as natural as clomid, acupuncture and everything else can leave it), or just go the whole IUI/IVF thing straight off... really tough decisions to make and I don't know the first place to look for the answers!

    This is a toughy & really only you can decide what to do.... Having said that we tried for 2yrs before fially biting the bullet & saying we'd do IVF. How long do you want to wait? Do you need to save money? Is this something that is burning so badly you just have to do it now? It's a tough one...

  3. #3
    Sammi Jane Guest

    Default

    Hi butterfly warrior,

    My DH has had a varicocele 'fixed' so I'll try to answer some of your questions for you.

    Firstly... what sort of specialist would deal with male infertility? My gyn apparently mentioned to DH the possibility of a testicular varicocele which could be causing the problem and can be corrected surgically. But what sort of doctor would fix that?

    My DH had to see a urologist & have an x-ray (it's not actually an x-ray but similar) to confirm that he had the varicocele. Then we went to a radiologist who did the embolisation. You can have surgery to fix it too and the urologist would perform that.

    Is there a type of specialist that could deal with both his problem and mine? I mean, obviously the gynecologist can do nothing for DH, and someone specialising in problems of the male reproductive system (urologist?) wouldn't be able to do anything for me, but is there someone who can deal with us both, short of going the IVF route?

    We saw Ric Porter at IVF Australia who is fantastic! I highly recommend him. He can send you to different people for your different issues, but then advise you on what to do with the results.

    To do with intercourse timing... I know they say that every second day is best for TTC, but why? With a bad sperm count should we be BDing more often or less often? I thought it would be more often, but when I mentioned this to DH he said it made no sense... that if a male with good sperm needed two days to recharge, then a bloke with bad sperm would need even longer. I thought it may have something to do with getting a decent number of sperm inside... that if a normal healthy male will deposit over 20 million each time, then we need to BD 4 times to get that as many as another couple would get once... If that makes sense? Does anyone know which of us is correct?

    I was told with our triple defect SA results to BD every 2nd day. In fact even with improved results Dr Porter said every 2nd day is enough. I'm not sure on what's right, as everyone seems to have a different opinion...

    How many clomid cycles will someone generally be allowed to do? I'm not ovulating without the clomid, if clomid works and I ovulate, great... but with DH's SA and the news that it will take us longer... will I be allowed to have enough clomid cycles to have "longer"?

    Not sure, sorry.

    I'm wondering whether it would be worth us trying to continue with natural conception (as natural as clomid, acupuncture and everything else can leave it), or just go the whole IUI/IVF thing straight off... really tough decisions to make and I don't know the first place to look for the answers!

    Dr Porter could help you with that - he is very good! He didn't push us into IVF straight away - he recommended we have the embolisation done and the results are so good that he's now recommended we try naturally for a while... I'm very impressed with him! He's in Sydney too.

    I hope some of that helps... GL with it all.

  4. #4

    Join Date
    Jan 2006
    Location
    Brisbane
    Posts
    488

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    Hi BW. I am so sorry to hear that you are having problems from both sides. I am very new to this so can't help with many of the questions but I am currently on my 4th cycle of Clomid and I was starting to get worried about the number of cycles my Dr would leave me on it for. She told me that she would only leave me on it for 6 cycles. Every Dr probably has a different opinion but that is what she told me.

    Good luck

  5. #5

    Default

    Samrus, where abouts is Dr Porter located? We are in the extreme west of Sydney, and some places are just too damn difficult to get to (says she who drives into the city every week for acupuncture! )

    Feeling a little better about things after talking to my acupuncturist... She thinks we need to start with getting a SA from a semenologist rather than the local pathology place... lots more information, I'm a little overloaded at the moment, but smiling for the first time in a few weeks.

    BW

  6. #6
    Sammi Jane Guest

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    Hi Butterfly Warrior,

    Dr Porter is in Chatswood so probably a bit far for you. He is at IVF Australia though, and I'm pretty sure they have a clinic out west somewhere... maybe check out their website. I'm sure all of their doctors are good. They will probably do a SA for you with very good doctors doing it. Definitely your acupuncturist is right - the local pathology places are not experts with SA's and apparently they are quite a difficult test to do.

    GL with it all.

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