Treatments Questions

Advice- Keeping trying naturally or will we need ICSI???

We saw our GP yesterday to discuss my husbands sperm analysis. 1st = 0% morphology, 2nd- 1.5%. I have also had blood tests which have all come back normal. The doctor has printed out all of our results for all fertility tests and suggests we see a consultant to discuss our chances of falling pregnant naturally (ideal scenario) or if we will need some medical help eg. ICSI. What do you think the chances of falling pregnant naturally?

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Hello and thank you for getting in touch with us. It would be helpful if you could please provide some more details, such as your and your partners age, and the duration you have been trying to conceive. The investigations done at your family GP will also help us to understand your reproductive hormone balance to make a decision.

Just in case this is of any further use to you, we are taking part in an event to help people conceive but who may be struggling. Our lead fertility doctor will be attending amongst other IVF specialists so it may be worth you and your partner looking at this, you can find out more here: www.manchesterfertility.com/about/events/talk-fertility-event-stuggling-conceive/

31 low AMH

I'm in a female same sex couple. Had a previous AMH result of 3.4. I have regular periods and no other health problems. I know IUI wouldn't be recommended in my case but what are my chances of a successful IVF cycle? And would you recommend I do a Natural IVF cycle?

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Unfortunately your AMH is unusually low when compared to your age. It is important to test your fertility in different ways: ultrasound scan (antral follicle count) and another blood test (FSH, oestradiol on cycle day 2 to 4).

I would argue why IUI is not recommended. You have reasonable chances to conceive naturally via IUI. On the other hand, a low AMH predicts a low IVF response. IVF is better controlled and gives higher chance of pregnancy than IUI. If your FSH is not high (<12 IU/L) and your antral follicle count is not low (>4), I would recommend IVF.

I would not recommend natural IVF as success rate is not higher than IUI but can be expensive and invasive.

Three unsuccessful cycles.

Hi, myself and my husband have just discovered that our third round of ICSI has resulted in a negative PDT and we are wondering what to do next, we are considering changing clinics.

I’m 36 and husband 34. We had a spontaneous pregnancy 6 months after getting married and then unfortunately had an early miscarriage. Following that we’re unable to conceive. Regular menstrual cycle/ AMH 12.75, FSH 8.9. Sperm sample has moderately reduced count and motility. Advised for ICSI

Cycle 1 - 300 units merional/ cetrotide/ Gonasi trigger 5000 units.
11 eggs/ 10 mature/ 8 fertilised with ICSI
1 blastocyst ET on day (3BC)
Nothing good enough to freeze (2 x 4CC)
Negative pregnancy test

Cycle 2
Endometrial scratch. Merional 300 units
9 eggs, all mature
8 fertilised with IMSI
2 x CM on day 5 implanted
Nothing to freeze

Cycle 3
DHEA 25mg TDS for three months
Testosterone gel 5mg for two months
Endometrial scratch
Gonal-F 300 units/ Cetrotide/ Gonasi trigger
10 eggs, 7 mature, 6 fertilised
1 x 3bc and a expanding morula/ almost blastocyst.
2 x embryos transferred
Cyclogest and SC progesterone
Negative PDT
Nothing to freeze.

Many thanks

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

We are sorry to hear about your situation. We would highly recommend that you see a fertility docotr for a consutlation where it discussions would surround investigations focussing on implantation (uterine factor) and sperm DNA fragmentation. A conversation about pre-genetic screening (PGS) could also take place but none of these would unfortunately provide an absolute answer to improve success.

Sperm cryopreservation for someone with very low semen volume

Is there a minimum volume of semen that the lab needs to be able to analyse and freeze my sperm?

My partner has low ejaculate volume due to testosterone deficiency. He's ejaculating less than half a ml. The doctors want him to go on testosterone replacement because the deficiency is affecting him quite badly, so we are hoping to get back up sperm freezing because we know that TRT can cause decline in sperm production. But since he's not producing much at all, we are worried that the lab won't be able to analyse or freeze his sample because there won't be enough of it?

Thanks in advance for any insight or reassurance you can give us. He's not had a semen analysis so we don't know what his count is like right now.

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

You would firstly need to provide a semen sample to assess, regardless of volume. If volume is low then multiple semen samples for storage would be recommended (if the first semen sample is satisfactory) and would definitely require sperm freezing before testosterone replacement. 

Our options

My partner has had a vasectomy 20 years ago and is 20 years older than me at 51 now. As far as I know there aren’t any reasons why I’m unable to have children personally but then again I’ve never tried. I wondered what our best option is, could we get sperm aspiration and then insemination or would we have to go down extraction and then fill IVF? Thanks

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Manchester Fertility woild be able to help you if you want to try to conceive. From the history you have provided, one option would be sugical sperm retrieval (SSR) which would then have to be used in an ICSI cycle. Alternatively your partner could have a vasectomy reversal. Our expert on male factor fertility, Dr Muhammed Akhtar, would be happy to see you to advise you of your options. If you wish to make an appointment, please contact our patient advisors on 0161 300 2730.

Zika virus

I'm thinking about holidays while we are on a break from treatment. Which countries should you avoid due to the zika virus? Also if you did travel to these countries how does this effect your treatment?
Many thanks

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

If you plan to travel to a Zika affected area, you should seek travel health advice before your trip from the Public Health England (PHE) website on the level of risk

What treatment is better for me?

Hi
I have been looking through your treatments and was wondering what the the best one for me would be. I have polycystic ovaries and my partner has a low sperm count. We have conceived naturally in the past so were looking at the IUI with clomid. Do you think this would be the best treatment for us? I am just looking for information at this point.
Thank you

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

In this instance, it would be best to come in for a consultation. Based on the quality of your partner's sperm, we will then be able to decide on the treatment.

If you'd like to book a consultation with us, please telephone our team on 0161 300 2730.

IVF using egg donor

Good evening

As a same sex female couple is IVF using both sperm and egg donors available to us? We had originally hoped that my wife could donate her eggs to me to then carry the baby, however, having researched the subject we have discovered that my wife is over the age threshold for egg donation so therefore this isn’t an option. Having discussed it further we have decided it would be the best option to use both donor eggs and sperm. Only having viewed your pages when I try to access this it will not give me the option for egg donor treatment as part of a same sex female couple. I am 37 years old and my wife is 49 years old.

Many thanks in advance
Sarah

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Our Expert's Answer

Please note that all the answers we give are on a generic basis only, as we cannot provide more in-depth answers without access to your medical history. If you need a more detailed response, tailored to you, we would recommend a consultation with one of our Fertility Specialists for more comprehensive medical advice.

Hi Sarah,

The short answer is yes, we would be more than happy to see you and your partner and disucss this in further detail. We are also looking into why our site wouldn't allow this option when you tried to select it. please do call us on 0161 300 2730 and we'll be happy to talk through your options.

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