Male Fertility Question

[Reece]

Hi Doctor:

I apologize in advance for the long message and multiple questions.

A few weeks ago my wife and I decided to start trying to conceive. I took one of the home sperm check tests, which showed that I had a count higher than 20 million per ml. I also drastically reduced sexual activities in the weeks leading up to ovulation, which led to discomfort in my prostate and small amounts of semen in my urine every 2 or 3 days. I've read that these symptoms are common when cutting back on masturbation and sex, and that semen in urine is a sign of an enlarged prostate.

Will either of these symptoms have a negative impact on fertility? I do not have a problem with retrograde ejaculation, though additional semen usually comes out about a minute after I ejaculate initially. This leads me to my next question - is the fact that I don't shoot semen very far when ejaculating and that it more dribbles out a bad sign for fertility? I'm also worried that not all semen and sperm produced is used since it does not come out until about a minute later.

And yes, I realize I'm a bit neurotic about these things.

Thanks again.

[Reece]

I used a small tens unit in my groin area for about a day to help relieve the pain. Was that a bad idea?

[Dr. Wisot]

What is a bad idea is not ejaculating for long periods of time. Not only can that actually reduce your fertility but it is probably causing your symptoms.

Ideally a one to two day interval between ejaculations gives the best specimen for fertility. You get better motility and less DNA fragmentation.

So go back to your usual pattern and ditch the Tens unit.

If your wife is not pregnant in a few months with well-timed intercourse as determined by an ovulation predictor kit, then get a formal semen analysis and some basic tests for her.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California

[hshed]

Greetings,

My wife and I have been trying to have babies for almost a year and no luck. I visited a urologist and he ordered some tests. below is the test results. Please help me understand what is wrong and if I can have kids. I know one thing for sure that whenever I ejaculate, the volume is very little!!!

Thanks



Tailpiece Defect, % 31
Midpiece Defect, % 55
Head Def,% 75
Normal Morphology, % 17
Viability 74
Total Motile 11.1
Concentration 106.1
Immotile 79
Sluggish 6 See Comments %
Rapidly Progressive 15 See Comments %
Motility 21
Ph 7.6
Viscosity NORMAL
Volume 0.5
Liquefaction Time 30
Appearance NORMAL
Abstinence Period 3
Time Received 2:40
Time Collected 2:13

[Dr. Wisot]

With a good count and low volume, motility and morphology I would be looking at starting IUIs.

How you manage the cycles and where you go from there depends on your partner's issues.

Arthur L. Wisot, M. D.
Reproductive Partners Medical Group
Redondo Beach, California