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Q: Infertility + Abnormal Sperm
asked by: DoctorQuestion on June 10th, 2007
Hi,

I have one kid now and we had another baby boy but he passed away! I am trying for the last 8 months to have another baby but when I visited the doctor, he asked me to do some tests in the lab and the results were not good...since I have one for the urine and another one for the seminal.


The results for the urine was good but I had few bacteria and the W.C.C was 44 which is high, the rest was ok....
for the seminal test the results was the following:
Volume:1.5ml
Liquefaction:50 Min
PH:8.5
Concentration:6.5mil/ml
Motility Data: after one hour Zero
after 2 hours:25
after3hours:40
After 4 hours;35

Total Motile C.:Zero
Motility Index:90
Cell Count : Erythrocytes:700
Leucocytes:1400
Neutrophils:20%
Lymphocytes:80%
Normal Sperm:30%
Abnormal Sperm:70%
Head:40%, Middle:20%, tail:10%

I made another Seminal test long time ago and the only problem that I had before was the immotile was 70% and the speed was not that good.


I changed my Doctor and the new one diagnosed that I have veins and he recommended to do a surgery…Which I did 40 days ago…..I did another test last Thursday and the results was having WCC 10 and the count became 0.8m/ml and the abnormal sperm became 95% and the immotile 95% with 5% slow


Please note that I did the same seme test 5 years ago and sperm count was 27m/ml and the motility was 20%.


Can you please help me and advise me what to do?


Thanks


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Dr. Nikola Gjuzelov , MD
replied on June 26th, 2007
Infertility Answer A2945
According to the medical standard, it seems that your sperm test results are not normal:
1. Sperm volume should be 2.0-6.5 ml; yours is 1.5ml and is referred to as "hypospermia";
2. The time required for liquefaction should be up to 30 min; your measures at 50 min;
3. pH value should be 7.2-7.8; yours is 8.5 which indicates bacterial infection. The presence of bacteria and increased white cell count (WCC) in the sperm also confirms bacterial infection. The presence of erythrocytes and white blood cells with predomination of lymphocytes over neutrophils could indicate tuberculosis of the testicles;
4. Spermatozoid concentration should be >20 millions/ml; yours is 6.5 million/ml and is referred to as "oligozoospermia";
5. Total sperm mobility should be greater than 50% and 4 hours after ejaculation less than 30% of the spermatozoids should lost their mobility; your values have not been reported
6. Vitality of the spermatozoids: >50% of the spermatozoids should be alive; again, there is no data about the vitality of your spermatozoids;
7. Spermatozoid morphology: >50% of the spermatozoids should have normal morphology and in your case there are only 30% with normal morphology (teratozoospermia).
Abnormalities of the sperm are probably the reason for your sterility but it is very hard to say what caused those abnormalities. Enlarged veins of the testicles, or "varicocela", can cause sperm abnormalities... but in your case there are also evidences for persistence of some testicular infection. A specific infection (such as tuberculosis) must first be excluded before proceeding. After establishing a proper diagnosis and treating the infection you can evaluate your fertilization ability. You can consult a urologist for an expert opinion.





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