Semen analysis
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CaliDreaming
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I'm sorry but your hubby's results are not good. If you've been struggling to conceive then his sperm is probably a big part of the reason why. Just about all of his numbers are low. In the fertility world, most doctors do not spend a lot of time on male fertility. I can't tell you how many women have been told their men's sperm was "fine" only to find out after years of trying that the sperm was not capable of fertilizing the egg.
The good news is that sperm problems are usually an easy fix. A lot of the time it comes down to lifestyle factors like quitting smoking and drinking, improving diet and taking supplements, not wearing tight boxers, etc. Other men may have to take clomid or hormones, but it's not nearly as invasive or expensive as female fertility issues. Your hubby does not have sperm antibodies so that is very encouraging as usually that problem is not fixable.
It's best not to think about SAs in terms of pass/fail but in terms of letter grades. At 23 million/mL, your hubby's sperm concentration (which is different than total sperm) is barely passing. They determine what is normal on a bell curve compared to other men, and he is on the extreme low end of the curve. 95% of men have higher sperm counts. To put it in perspective, an average sperm concentration for a fertile man is probably around 75 million/mL and some superstars have up 300 mill/mL
For reliable conception you would want to see those numbers much higher or you would want his other parameters to be stellar, which your hubby's unfortunately are not. Motility, the total % of sperm moving, should at a bare minimum be at 40%. A typical fertile man's motility may be 75% or more.
The morphology is also very, very low. The morphology refers to how the sperm are shaped. This significance of this parameter is debatable as many men, depending on the type of defects in their sperm, are able to get their partners even with morphology this low. Sperm with severe defects in the head will not be able to fertilize the egg and sperm with severe defects in tails can't swim properly. Since your hubby has very low motility, it seems more likely that the poor morphology is significant.
We've all heard the saying that it only takes one sperm, which is technically true, but very misleading. The path sperm must take to the egg is very treacherous and the vast majority of them are not going to make it. It's like a war and although it's theoretically possible to win it with a single shot, it's not likely. The more bullets and soldiers you have, the better your chances of victory. More than half are going to be killed trying to get through the cervix. Half of the ones that make it are going to go up the wrong fallopian tube. Large numbers of them are not going to be fast enough to make it to the egg before they die or the egg disintegrates. When all is said and done, only about 50 or so sperm out of millions are going to make it all the way to the egg.
So for pregnancy to happen, you have to have many millions of them that can swim fast and straight to make it. I think I remember that you need at least about 15 million or so strong ones out of the total sperm count to have a realistic shot or you'd have to be extremely lucky. Looking at your hubby's count and doing the math, he's going to have less than a million and that's not nearly enough. Some men can be fertile with 20 mil/ML concentration, but they usually have great motility and morphology to go along with it that makes up for the lower than average concentration.
It's good that your doctor recognizes that there's a problem because a lot of times they don't even do anything for the man at all.
The good news is that sperm problems are usually an easy fix. A lot of the time it comes down to lifestyle factors like quitting smoking and drinking, improving diet and taking supplements, not wearing tight boxers, etc. Other men may have to take clomid or hormones, but it's not nearly as invasive or expensive as female fertility issues. Your hubby does not have sperm antibodies so that is very encouraging as usually that problem is not fixable.
It's best not to think about SAs in terms of pass/fail but in terms of letter grades. At 23 million/mL, your hubby's sperm concentration (which is different than total sperm) is barely passing. They determine what is normal on a bell curve compared to other men, and he is on the extreme low end of the curve. 95% of men have higher sperm counts. To put it in perspective, an average sperm concentration for a fertile man is probably around 75 million/mL and some superstars have up 300 mill/mL
For reliable conception you would want to see those numbers much higher or you would want his other parameters to be stellar, which your hubby's unfortunately are not. Motility, the total % of sperm moving, should at a bare minimum be at 40%. A typical fertile man's motility may be 75% or more.
The morphology is also very, very low. The morphology refers to how the sperm are shaped. This significance of this parameter is debatable as many men, depending on the type of defects in their sperm, are able to get their partners even with morphology this low. Sperm with severe defects in the head will not be able to fertilize the egg and sperm with severe defects in tails can't swim properly. Since your hubby has very low motility, it seems more likely that the poor morphology is significant.
We've all heard the saying that it only takes one sperm, which is technically true, but very misleading. The path sperm must take to the egg is very treacherous and the vast majority of them are not going to make it. It's like a war and although it's theoretically possible to win it with a single shot, it's not likely. The more bullets and soldiers you have, the better your chances of victory. More than half are going to be killed trying to get through the cervix. Half of the ones that make it are going to go up the wrong fallopian tube. Large numbers of them are not going to be fast enough to make it to the egg before they die or the egg disintegrates. When all is said and done, only about 50 or so sperm out of millions are going to make it all the way to the egg.
So for pregnancy to happen, you have to have many millions of them that can swim fast and straight to make it. I think I remember that you need at least about 15 million or so strong ones out of the total sperm count to have a realistic shot or you'd have to be extremely lucky. Looking at your hubby's count and doing the math, he's going to have less than a million and that's not nearly enough. Some men can be fertile with 20 mil/ML concentration, but they usually have great motility and morphology to go along with it that makes up for the lower than average concentration.
It's good that your doctor recognizes that there's a problem because a lot of times they don't even do anything for the man at all.
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