Need advice

Hi,

I am 29 year old working lady and married for 5 years. My hubby is 34 yrs
old.
We have been trying for baby for last 1 and half years but no success.
My gynecologist has asked for sperm analysis test for my hubby and
hormonal tests for me.
My reports came positive. For my hubby the sperm mobility came 51% and was
reported with asthenospermia. But the gyno tells tells this is ok as it is
more than 50%.The report of my hubby was as follows:
Sperm Conc: 60mill/ml
Motility(%) :    1 hour  2 hour 4 hour 24 hour
Excellant progression (%) Grade IV: 14% 10% 02% 00%
Rapid progression (%) Grade III   : 21% 18% 09% 00%
Slow progression (%) Grade II     : 16% 15% 11% 00%
Non-progressive (%) Grade I       : 04% 05% 03% 00%
Immotile (%) Grade 0              : 45% 52% 75% 100%

Morphology :  
Head defects: 39%
Mid-piece defects and neck :18%
Tail defects:10%
Defects in head mid-piece and neck :07%
Multiple defects:04%

Now from last 2 months the doc is giving me medicines for ovulation(Siphene 50 MG) and
taking injections for the same so that we can try for the fertile period.
The sonologist checked me and confirmed that I have ovulated both the
times.But I dint get pregnant. I am very frustrated as why this is
happening even after I am ovulating and the gyno has confirmed that 51 %
sperm mobility is ok.

Can you pls advise me on this.Is this happenening bcoz of low sperm
mobility of my hubby or there can be any other issue.Do I need to go
through HSG test and post-coital test?

[Elaine Brown, MD]

Hi!
Infertility can be very frustrating!  Most of the large clinics have counseling built into their protocols because often there are no answers and it all seems to be based upon luck!
Here is an interesting site to check out for information about the semen analysis.
http://www.ivf-infertility.com/infertility/investigations/male/semen.php

It sounds like motility is really a minor player, but I can't imagine that a trial of Intrauterine Insemination could hurt anything.

Personally, I like to have couples go through the post coital test.  Most of the time it s completely fine, but occassionally I find some very useful information.  The HSG is a must.  You can spend lots of money and time doing infertility treatments but none will work if there is tubal factor.  Do that one soon, so you can save your money for IVF if your tubes are blocked.  If not, I would encourage you to consider IUI!

Good luck!
Dr B