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Amy - May 3rd, 2005 11:28 AM

my husband and i just went through our 6th iui. my husband has been diagnosed with mild motility problems due to previous semen analysis done. after our first 4 iui's though an obgyn we moved on to an infertility specialist.

anyway my question today is what are considered good values on the semen analysis after they have been washed and preped for an iui. before the prep his volume was low 1ml and motility was also low at 17 but they said the count was good at i believe it was 34 million. after the prep the motility was 50 and the count was one of our lowest 1.8 million. i was a little concerned but the doctor told me that they don't worry until the count is around 500,000.


Dr Smith - May 3rd, 2005 7:11 PM

The scientific literature (see references below) suggests that IUI is ineffective when fewer than 2 million motile sperm are inseminated (important: this is the [i]total[/i] number of sperm inseminated, not the [i]concentration[/i] in millions/ml). When morphology is poor, the minimum number required increases to 5 million motile sperm.




Wainer R (2004) Influence of the number of motile spermatozoa inseminated and of their morphology on the success of intrauterine insemination. Hum Reprod. 19(9):2060-5.

Miller DC (2002) Processed total motile sperm count correlates with pregnancy outcome after intrauterine insemination. Urology. 2002 60(3):497-501.

Amy - May 4th, 2005 9:28 AM

thanks Dr Smith for your quick response. my husband has been diagnosed with a small varicocele on one side. our insurance doesn't cover anything with our infertility so would it be worth it for him to have the varicocele fixed? or what other things can we do to help improve his motility? or are we going to have to start considering ivf?
he's cut back on how much caffeine he drinks, wore boxer shorts this month, he takes a mens multi vitamin a day. i have found that our better semen counts have been waiting around the 4 days but the doctor told us that having sex on the day of the hcg shot improves our chances because they are young sperm with better motility but these have been some of our lowest counts that we have had? what else do we have control over to help improve my husbands sperm counts?
thanks for all your comments. amy

Dr Smith - May 5th, 2005 11:53 AM

Varicocele repair only improves semen parameters about half the time and can take up to 18 months before any improvement is observed. Save your money.

I think you need to consider IVF as the most efficient way for you to get pregnant.

I am not aware of any scietific study that showed having sex on the day of the hCG improves the chance of pregnancy. In cases of male factor infertility (such as your own), it will decrease the number of motile sperm avaialble for the insemination that's timed to coincide with ovulation.

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