So many questions about semen analysis results

[Anonymous]

We're with SGF and just got the semen analysis results back, had our meeting with the Dr to discuss next steps, he recommended IVF, right off the bat, but we're a little confused as to why. We've been trying for 1.5 years, had a MMC last May and have been trying for a total of now 8 months since then (due to two cycles where I didn't ovulate).

He said that my results were all good. Slightly elevated FSH but consistent with my age, and all other numbers were good.

The semen analysis came back with 7.0 pH, normal is >=7.2 (the doctor didn't say anything about this, said it was ok, but is it actually?)
Also 2/2+ in progression/morphology where the normal is 2 to 4. He said this was slightly low but "wouldn't matter with IVF." It didn't occur to me at that time to ask if it would impact our ability to get pregnant naturally, so I've asked that question since, but wondering if anyone has an answer.

98% were abnormal, but from what I'm reading, that's kind of normal for a high % in a sample to be abnormal.

Honestly, we felt like we were given a sales pitch for IVF, none of our other questions were answered (can we be doing anything different to increase our chances naturally, like clean products, altering diet, reducing caffeine, alcohol, taking supplements, etc.). It was as if he wasn't going to talk about anything else other than IVF.

We're stuck. Has anyone else had similar experiences?

[Anonymous]

If you go to a surgeon, you end up with surgery. What else have you tried? Clomid?

[Anonymous]

Anonymous wrote:If you go to a surgeon, you end up with surgery. What else have you tried? Clomid?

OP here - you're right, surgeons love surgery. I guess we were hoping to get a little more out of that meeting than "you should go with IVF, and here's a powerpoint about it" and no answers to our other questions. We haven't tried anything else and he didn't even recommend Clomid (my missed ovulations were very directly related to two times where food intake was significantly lower due to dental procedures).

I just wish there was something else to consider first, or someone else to ask questions of since he made it seem like we didn't have any issues beyond that slightly lower progression number.

[Anonymous]

Sometimes on paper you should be fertile, but it just doesn't happen, and that is unexplained infertility. I wish I had done IVF sooner. I think your dr is recommending because it has a great chance to work for you, vs lesser chance if you continue on your own. But if you feel like you are not getting your questions answered, try another dr.

[Anonymous]

I got a similar pitch from Dominion. Ended up switching to a smaller practice and was pregnant on my first IUI. DH’s sperm wasn’t great, the doctor at the (better) clinic said those analyses can be helpful, also can be meaningless. Have gotten pregnant 3 times since then, naturally. So I’m not a big believer in the semen analysis.

[Anonymous]

Anonymous wrote:We're with SGF and just got the semen analysis results back, had our meeting with the Dr to discuss next steps, he recommended IVF, right off the bat, but we're a little confused as to why. We've been trying for 1.5 years, had a MMC last May and have been trying for a total of now 8 months since then (due to two cycles where I didn't ovulate).

He said that my results were all good. Slightly elevated FSH but consistent with my age, and all other numbers were good.

The semen analysis came back with 7.0 pH, normal is >=7.2 (the doctor didn't say anything about this, said it was ok, but is it actually?)
Also 2/2+ in progression/morphology where the normal is 2 to 4. He said this was slightly low but "wouldn't matter with IVF." It didn't occur to me at that time to ask if it would impact our ability to get pregnant naturally, so I've asked that question since, but wondering if anyone has an answer.

98% were abnormal, but from what I'm reading, that's kind of normal for a high % in a sample to be abnormal.

Honestly, we felt like we were given a sales pitch for IVF, none of our other questions were answered (can we be doing anything different to increase our chances naturally, like clean products, altering diet, reducing caffeine, alcohol, taking supplements, etc.). It was as if he wasn't going to talk about anything else other than IVF.

We're stuck. Has anyone else had similar experiences?

the data on supplements is slim- my RE said I could do them if I wanted but wasn't going to recommend them-- no evidence that changing diet will improve fertility. I avoided all alcohol while TTC, didn't do anything to increase fertility...

but if you're not ovulating consistently, seems fair to try TI or IUI first. Currently pregnant from IUI

[Anonymous]

Anonymous wrote:

Anonymous wrote:We're with SGF and just got the semen analysis results back, had our meeting with the Dr to discuss next steps, he recommended IVF, right off the bat, but we're a little confused as to why. We've been trying for 1.5 years, had a MMC last May and have been trying for a total of now 8 months since then (due to two cycles where I didn't ovulate).

He said that my results were all good. Slightly elevated FSH but consistent with my age, and all other numbers were good.

The semen analysis came back with 7.0 pH, normal is >=7.2 (the doctor didn't say anything about this, said it was ok, but is it actually?)
Also 2/2+ in progression/morphology where the normal is 2 to 4. He said this was slightly low but "wouldn't matter with IVF." It didn't occur to me at that time to ask if it would impact our ability to get pregnant naturally, so I've asked that question since, but wondering if anyone has an answer.

98% were abnormal, but from what I'm reading, that's kind of normal for a high % in a sample to be abnormal.

Honestly, we felt like we were given a sales pitch for IVF, none of our other questions were answered (can we be doing anything different to increase our chances naturally, like clean products, altering diet, reducing caffeine, alcohol, taking supplements, etc.). It was as if he wasn't going to talk about anything else other than IVF.

We're stuck. Has anyone else had similar experiences?

the data on supplements is slim- my RE said I could do them if I wanted but wasn't going to recommend them-- no evidence that changing diet will improve fertility. I avoided all alcohol while TTC, didn't do anything to increase fertility...

but if you're not ovulating consistently, seems fair to try TI or IUI first. Currently pregnant from IUI

also my clinic never did semen testing or HSG or any of the other things Shady Grove requires before getting started (semen was analyzed day of iui, but not to plan treatment). I did get my thyroid check before trying to conceive and started Synthroid though.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:We're with SGF and just got the semen analysis results back, had our meeting with the Dr to discuss next steps, he recommended IVF, right off the bat, but we're a little confused as to why. We've been trying for 1.5 years, had a MMC last May and have been trying for a total of now 8 months since then (due to two cycles where I didn't ovulate).

He said that my results were all good. Slightly elevated FSH but consistent with my age, and all other numbers were good.

The semen analysis came back with 7.0 pH, normal is >=7.2 (the doctor didn't say anything about this, said it was ok, but is it actually?)
Also 2/2+ in progression/morphology where the normal is 2 to 4. He said this was slightly low but "wouldn't matter with IVF." It didn't occur to me at that time to ask if it would impact our ability to get pregnant naturally, so I've asked that question since, but wondering if anyone has an answer.

98% were abnormal, but from what I'm reading, that's kind of normal for a high % in a sample to be abnormal.

Honestly, we felt like we were given a sales pitch for IVF, none of our other questions were answered (can we be doing anything different to increase our chances naturally, like clean products, altering diet, reducing caffeine, alcohol, taking supplements, etc.). It was as if he wasn't going to talk about anything else other than IVF.

We're stuck. Has anyone else had similar experiences?

the data on supplements is slim- my RE said I could do them if I wanted but wasn't going to recommend them-- no evidence that changing diet will improve fertility. I avoided all alcohol while TTC, didn't do anything to increase fertility...

but if you're not ovulating consistently, seems fair to try TI or IUI first. Currently pregnant from IUI

also my clinic never did semen testing or HSG or any of the other things Shady Grove requires before getting started (semen was analyzed day of iui, but not to plan treatment). I did get my thyroid check before trying to conceive and started Synthroid though.

Your clinic and RE sounds like…not a good one. Diet doesn’t affect health? Lol. Is your doctor an obese smoker trying to make himself feel better? That’s insane. OP, do not listen to this person.

[Anonymous]

Hammer/nail situation, I think. That said, I'd spend my time and money with them on figuring out IUI/IVF instead of on lifestyle/vitamins options.

[Anonymous]

Anonymous wrote:I got a similar pitch from Dominion. Ended up switching to a smaller practice and was pregnant on my first IUI. DH’s sperm wasn’t great, the doctor at the (better) clinic said those analyses can be helpful, also can be meaningless. Have gotten pregnant 3 times since then, naturally. So I’m not a big believer in the semen analysis.

That's helpful, thank you. Do you mind if I ask what smaller practice you went to?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I got a similar pitch from Dominion. Ended up switching to a smaller practice and was pregnant on my first IUI. DH’s sperm wasn’t great, the doctor at the (better) clinic said those analyses can be helpful, also can be meaningless. Have gotten pregnant 3 times since then, naturally. So I’m not a big believer in the semen analysis.

That's helpful, thank you. Do you mind if I ask what smaller practice you went to?

Yes, VCRM. Sharara also recommends the things you mentioned - diet change, supplements, etc before going into treatment mode.

[Anonymous]

My husband and I had very similar testing results (almost identical) and tried IUIs first for insurance purposes. They didn't work, and we were successful with IVF. I was 34 at the time of initial testing, and my Dr did suggest going straight to IVF if we wanted to increase our chances of having more than one child since you have the option to bank embryos with IVF. Honestly, I think that SGF just looks at all of the numbers and suggests the treatment plan that would be most successful based on all of those factors. They have a vast data set of patient outcomes and really rely on all of that experience to build statistical databases.

[Anonymous]

Let me guess, dr sagoskin?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I got a similar pitch from Dominion. Ended up switching to a smaller practice and was pregnant on my first IUI. DH’s sperm wasn’t great, the doctor at the (better) clinic said those analyses can be helpful, also can be meaningless. Have gotten pregnant 3 times since then, naturally. So I’m not a big believer in the semen analysis.

That's helpful, thank you. Do you mind if I ask what smaller practice you went to?

Yes, VCRM. Sharara also recommends the things you mentioned - diet change, supplements, etc before going into treatment mode.

Sounds like a much more wholistic approach, and better way to go. Consider also:

- second semen analysis. Particularly pay attention to detail; full hydration is important, a multivitamin can’t hurt, no alcohol and especially NO marijuana or CBDs, no biking, etc.

Make him follow the instructions exactly. Involve yourself in the process to be certain he’s following the instructions.

The 98% figure seems worrying; all the more reason to double check here. contamination is common and can give bad results (men are careless with these details).

Good luck!

[Anonymous]

Anonymous wrote:Let me guess, dr sagoskin?

Dr Sagoskin was my RE and recommended I do IUI vs IVF after being diagnosed with unexplained. He said IVF is usually fastest path to baby since much higher statistics, but it was ultimately our choice when we started.

When I mc on my 3rd IUI and was getting my blood work to confirm HCG levels, the nurse asked me who my doctor was. When i said "Sagoskin," her response was "he'll prob recommend IVF next but it's because he's focused on getting a baby in your arms the fastest."

Lo and behold, Sagoskin recommended trying IUI again and that round is my daughter.

Sagoskin may be inclined to recommend IVF first, but remember 1) he's one of the co-founders of SGF and 2) he takes multiple factors, and success rates, into consideration. He may not be the most beloved RE but he knows his stuff.