r/SaveTheSperm

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.