u/Shot_Type_7925

Hi Doctor Brian.

I’m interested in what the cause is for sperm parameters that are constantly subpar but not extreme. Where do you go to seek improvement when all else has failed? Or do you assume there is a genetic ceiling?

My wife and I have one child through ICSI, but have never conceived naturally.

I’m 38M, don’t drink or smoke. Healthy weight, run 20 miles per week, eat a healthy vegetarian diet and take no drugs. I was on an SSRI but have come off that successfully. Work a corporate job and live in a place with clean air and low pollution etc etc

For the last five years, my sperm analysis has always been within the same range. The count sits between 5-15m/ml, the motility between 20-50%, and the morphology mostly fine. I’ve had about five different analyses done, and they’ve always come back in this range.

I have had genetic testing done, with zero issues. Physical examination of my testes shows good volume, no varicocele, nor any other physical issues. Hormones have always been completely mid-range. Most recent testosterone was 17.9nmol/L, with FSH 6 and LH 2. No other notable findings, and all blood work was perfect.

I have tried all sorts of supplements to improve my count but nothing has ever made a difference. As I’m already active with a good diet and weight and no vices as such, I can’t really optimise much further there. I do have some work related stress from time to time, but nothing that is different to everyone else.

My general question is, what is there left to explore? Based on my analyses over the years, the average sample for me is likely around 10m/ml with a motility of 30% - which just makes natural conception much, much harder. Not impossible, but harder. With my wife being 37, time is ticking and chances get lower over time. In these scenarios, do you just accept that this is perhaps my normal genetic parameters? My father also had similar struggles, but did end up with two children conceived naturally - so I do suspect a genetic component.

Thanks in advance.

I work in climate science - more on the data and client side, not the one actually doing the research. In short, big companies pay us for climate data so they can make projections or develop strategy or whatever.

I’ve been heavily exposed to climate data for many years, so I’ve been across the developments for a long time. Something about the last few months has broken me.

I spent December and January in an area that’s famous for snow, and saw none. Watching this El Niño develop has been terrifying. The UN admission that we’ll blow past 1.5C was the clincher for me. In my field, the UN was basically always considered the final organisation that had to show at least some optimism. Seeing that gone is now the final death blow. They know it’s over.

It has really broken something in me. To know that this organisation who was almost comically optimistic about collaboration and limiting warming has completely conceded defeat. It is a big deal.

I don’t really care about anything anymore. I’m not motivated to work, because I can’t plan for a good future. I have to almost disassociate while working, because my whole day is about climate data in one way or another.

I think the worst part has been my withdrawal from society. When you spend your whole life loving the environment and aligning your life with its protection, you end up truly hating humanity. You see us for what we are - a complete parasite who is destroying the world.

Has anyone else found that they’ve gone this way? My grief over collapse was always something I could somewhat compartmentalise. But now, it’s changed my entire life.

Always interested in the changes people have made, either to protocols, diets, supplements, or other health-related changes that have resulted in positive impacts for your egg retrievals?

And conversely, what didn’t work at all for you? No matter what we’ve tried, we’ve basically always gotten between 2-3 mature eggs per cycle.

We’re at the stage now where getting even 1-2 extra eggs per cycle makes a massive difference to our cumulative odds, so I’m always interested to hear anecdotal experiences.

Hi everyone.

We’re trying to work out if we had a successful cycle. E.g. do we just stick with this protocol or do we try something different?

My wife (37) has always had low AMH, I think it’s around 0.4. We’ve done four cycles of IVF, always collecting 3-4 eggs maximum.

Our first cycle we got four eggs and zero blasts. Our second cycle we got three eggs, one blast, and were lucky enough to have our son from that. I think this was very lucky and not expected based on that cycle’s overall performance. Our third cycle was three eggs and zero blasts.

We’ve just finished our fourth cycle, which was our first time doing a Clomid antagonist cycle. We got 4 mature eggs, 3 fertilized, and 2 blasts. One of those blasts was transferred and unfortunately ended in a chemical pregnancy. The other blast is frozen but was not the best quality.

Is this kind of result that means you should stick with this protocol? This is the only time we’ve ever got 2 blasts from a cycle. Or have people been able to jump up to get more?

It never really leaves, no matter what happens.

My wife and I are lucky enough to have a 2-year-old son, who was conceived through IVF ICSI.

We started our journey to try for a second child through IVF a few months ago. Nothing but failure. We thought we were pregnant this time, but was a chemical pregnancy. My wife has to inject herself and go through surgeries, all because of me. Her life could’ve been better if she chose someone else.

They think my parameters are genetic more than anything. I don’t drink or smoke, I’m in great health, I am very fit, and I’ve tried every supplement and investigation. Nothing has ever showed up in any scans and tests, and I’ve done them all. No matter what happens, my count always sits between 5-10 million and my motility between 20-50%.

I feel defective. I will always live with the fact that biology said someone like me shouldn’t reproduce, and then hard-coded that judgement into me.

We got our first beta back today at 55. It was technically about 4-6 hours before the start of 10dp5dt when bloods were drawn, as our transfer happened late in the day.

We had our first very faint positive on a FRER at 7dp5dt, so we think perhaps it’s implanted late? Since then, the line has progressed a little bit each day.

Feels like a bit of a coin toss for us. We have a toddler who conceived through IVF, and the beta for that at a similar time was 80 and it worked out fine.

Please share your success stories! Based on everything I’ve read from studies on betas, it does indeed seem like we have 50/50 odds on how this will turn out.

Would love to hear them!

We got four mature eggs and were hoping for better fertilisation rates, but only got two in the end.

Thanks a lot, and good luck to everyone out there doing the same thing.