Sperm count

Dear Doctor,

I am 39 and my wire is 33. we have been trying our best to have a child meeting several doctors and visiting several hospitals for the past 5 years. Recently my wife had Histolap post which the doctor gave her some medicines to bring down her Serum Insulin level which has worked. The doctor asked me to go for a Semen anlysis to check if they can go ahead with IUI. My results are as follows : Total Sperm Concentration : 22.5 Million ; Progressive Motility - 8.4%; Non Progressive Motility - 11.2%; Immotivel sperms 80.4%; Morphology 3.3% ; Progressive motile sperm concentration - 1.9 Mill/ml; Functional Sperm Concentration 0.2 Mill/ml; Sperm Velocity - 4 Mocron/sec; Sperm Motility index- 22; Total Sperm number- 67.5 Million; Total Motile Sperms- 13.2 Million; Total Functional Sperm- 0.6 Million; WBC - Pus cells(+).  Remarks- Asthenospermia with mild infection.

Please let me know if we can go for IUI or what medicines should I take to improve my sperm quality so that we can go for IUI. Also suggest the best way for us to have child at the eariest.

[John Kim, M.D.]

Your semen analysis remarks-- asthenospermia with mild infection--may suggest an infection. I would recommend that you see your doctor to get treated with antibiotics and then repeat the semen analysis. If after antibiotics, there is still asthenospermia ie low motility and low morphology, you can try IUI but if the total motile count is less than 5million then success rates are low. If after antibiotics and the repeat semen analysis is still abnormal, I suggest checking FSH, LH , TSH, Prolactin and testosterone level (blood tests) and seeing a Urologist. The repeat semen analysis should be done at least 70 days after the initial one because it takes that long for you to get a whole new batch of sperm. If you check it earlier than that, you are checking old sperm that may still be affected by whatever condition you have now like infection. So you have to check a repeat semen analysis at least 70 days after taking antibiotics.