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Q: I have been trying to make my wife pregnant for over 6 months. After the initial tests she seems to be fine but my sperm count is 18 million. I did know before I sent the sample that it was not a proper orgasm as I was very tense about the test. I have never smoked or been a drinker and am a strict vegetarian. I have a thallassemia trait and take Folvite daily. I have a very high sex drive and masturbate 1-2 times a day. However before ovulation I refrain from masturbation for 3-4 days. I find a problem to ejaculate the first time after a gap of 3-4 days without masturbation. I am also unable to ejaculate inside during intercourse and need to stimulate myself and then insert myself into the vagina just before ejaculation. Though I have ejaculated inside successfully on the right days in the missionary position, we find that most of the sperm tends to dribble out after I pull out of the vagina. I do have a habit of hot showers and am stopping the same. I exercise daily and am quite healthy. Please guide me on how to improve my sperm count and if I should take zinc supplements. PHYSICAL EXAMINATION Quantity : 2.2 ccs Consistency : Viscid on collection, liquifies on standing Colour : Greyish White pH : Alkaline Test for Laevulose : Positive MICROSCOPIC EXAMINATION OF SPERMATOZOA Number per ml : 18,500,000
A: An 18 million count is low, but not that low. However, before I can make a full assessment, I would like to see your full semen report. So if you could type that in your email or MS-Word and send it an as an attachment, it would be helpful. You have provided your sperm analysis but it would be helpful to know the motility and the grading of the motility on the sperm count – preferably recorded every hour upto 2 hours. It would also be helpful to get information on agglutination, pus cells, RBCs and abnormal sperms. It is best that you get your sperm tests done at centres where CASA (computer analysis of sperm) is carried out. This is most accurate and many IVF centers have it. Keep a pillow under your wife’s buttocks and raise her bottom up to prevent semen from dribbling out. Cold showers and cold splashes on your private parts will also help improve sperm count and motility. You may also want to see a urologist or an andrologist to conduct a hormonal test and evaluate your hormones and see if medicines will help sperm count.
Q: My wife has been trying to have a baby for the last 9 months, but in vain. I observed that a large part of my semen drips out of my wife's vagina after I withdraw at the end of intercourse. Could this be a reason of failure? I would also like to mention that I started masturbating at an early age and have been doing this almost everyday (once at least) until I got married. Did I become infertile because of this?
A: There is nothing wrong with either condition. Do try to have sex during the fertile period and also find out your semen count and your wife’s hormone status.
Q: We have been trying for a baby since the last 8 months. I got my semen analysis done recently. My count is 80 million and motility is 50%. Is this the cause of infertility? Are there any medicines to improve this? My wife is very tense. However, her periods are regular. How can we find out if the egg is being released? We don’t always have intercourse when she is ovulating.
A: See a gynaecologist. She will be able to check if your wife is ovulating or not, and whether her tubes are open. She will also be able to prescribe medication after a thorough examination.
Q: I have been married for the past 2 years, but my wife is not yet pregnant. I went to the laboratory for a semen analysis. I would be grateful if you could give me the analysis of the results. Volume= approximately 2.5cc Sperm count= 24,600,000 cells/ml Motility Motile= Non Motile Immediate= 90% 10% After 30min= 80% 20% After 1hr= 70% 30% Normal= 96% Abnormal=4% Pin head=2% Big head=1% Double head=1% Pus=2-3/hpf
A: Your sperm count and motility are within normal range. You need to see a doctor to find out if there is some other reason.
Q: We are trying to have a baby. My husband has a low sperm count (15-20 ml/cc). I have been taking Clomid (10 tab from 3rd day of period) and and Dufastone since the last three months. Are there any risks or side effects associated with this medication? Can I take Centrum (multivitamin tablets) along with the above medication?
A: Don’t worry, the treatment is completely safe. Your husband could also start Clomid 25mg (one tablet at night), but only in consultation with your doctor.
Q: I have been married for the past seven years, and have no children as yet. We have made all the required analysis – the doctor said that my semen analysis shows a high percent of abnormal forms, and advised me to take some vitamins like a, e, c and zinc. What are the causes of this problem and what is the treatment.
A: You should visit a urologist to get the answers to your queries.
Q: My wife and I have been trying for a baby for 5 years now. Both of us have undergone several tests. One of the test results has indicated that I have borderline sperm count. What is the minimum sperm count a person needs to have so his partner can get pregnant?
A: Amazingly, we do not really know the answer to this question! Theoretically, you only need one sperm to fertilise the egg and start a pregnancy. However, sperm transport to the egg is quite inefficient, which is why most men have millions of sperm in their semen. We consider a normal count to be more than 20 million per ml, and of these, at least 50% of the sperm should be motile (moving forward). Why so many sperm are needed is really not clear! However, do remember that this is just an average figure – about 90% of men (considered to be normal) will have more than this number. However, all doctors are aware of men who have got their wives pregnant, even though their counts were as low as 3-5 million sperm! This is where the concept of ‘trying time’ is so important. If the count is low and a pregnancy has not resulted even after trying for 2-3 years, then treatment is called for.
Q: My husband recently underwent a sperm test where his sperm count was just 1 million and motility 12%. Do you think there is hope for me to conceive?
A: I would suggest that you repeat the semen analysis at least twice more, at 6-weekly intervals, from a reliable lab, before coming to the conclusion that your husband has a low sperm count (this is called oligoasthenospermia). If it is persistently so low, then the chance of your conceiving without medical treatment is very poor. However, with treatment, your chances are very good, since you are young!
Q: A relative of mine has been married for the past ten years, but they have no children. I believe that there is some deficiency in the husband. He is suffering from a very low sperm count.
A: A low sperm count (Oligospermia) is a difficult problem to treat, since there is no medical or surgical therapy to increase the sperm count. Since the cause of low sperm count is usually unknown, we have no effective therapy for it. The best treatment would be IVF (in-vitro fertilisation, test tube baby) or ICSI (microinjection) in consultation with your local fertility specialist.
Q: My wife has been trying to conceive for about a year now. My sperm count is medium. How do we become parents?
A: Try to have relations around the 14th day of the period – or 14 days before the next period – as that is when your wife is the most fertile. Also, take some medications to improve the sperm count if it is low. If your wife still doesn’t become pregnant, see a gynaecologist.
Q: My partner was a chain smoker but has recently cut down on smoking and hardly has one in a day. Would smoking have affected his sperm count? Do you think it would be low? If smoking has made him infertile, is there a way that we can increase fertility?
A: It is difficult to say what effect smoking has had on your partner because it differs from person to person. If you have been trying to conceive for a while and have not succeeded, then you and your partner should undergo tests that may help identify the problem. Cigarette smoking does affect sperm production and you should certainly get the values checked. Since he has cut down his smoking, sperm count should improve in 3-6 months.
Q: Is there any medicine to increase the semen count? My husband is diabetic.
A: Your husband will need to see a doctor for a personal consultation, before any medication can be prescribed.
Q: Pl prescribe a medicine which will increase sperm count, motility and vigour. My penis is 3 cm and when erect it is 8 cm. Is this sufficient for my wife to conceive?
A: Unfortunately, there is no medicine to increase sperm count or motility. I wish there was – it would make my life so much easier, because I could treat male infertility with much greater ease! However, because patients put a lot of pressure on doctors to prescribe medicines, most doctors will write a prescription, even though they know the medicine does not work! The size of your penis does not affect your fertility. After all, it's only job is to deposit the semen in the vagina - and just like the size of the tap does not affect the flow of water, the size of your penis does not affect your ability to deposit semen!
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