How worried should we be? Borderline low semen analysis

My husband just got his sperm analysis and it was all at the very very bottom of “normal.” Technically only the motile count is “below normal values” but they are all at the extremely low end of normal… how worried should we be about this? Is ICSI likely? What can we do to fix this? Our doctor won’t be available to talk about the results until our next appointment and I’d like to be a bit more emotionally prepared for what they’re likely going to say. Volume 1.2 (normal is 1.2-20) Concentration 21 (normal is 18-1000) Total motile count 14.5 (normal is 15-2,000) and 4% morphology (normal is 4-100) All my cycle day 3 bloods were either in the good or excellent category.
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Luckily lifestyle changes can make a big difference to semen quality: avoiding hot showers, wear loose boxers, avoid alcohol, caffeine, cannabis. Have him take a prenatal and coQ10. Exercise more and eat healthily, lose weight if applicable. My husband was diagnosed with male factor infertility and we got pregnant naturally after 18 months. He got started on clomid right before we fell pregnant. There are a lot of options!

@M.J he is already taking all the supplements, no alcohol or other drugs, no caffeine, loose boxers, but I will speak to him about hot showers. Mediterranean diet, he’s a healthy weight and we both exercise regularly. Glad I insisted on all these interventions since these are the numbers doing everything “right”

It can take months to see results from lifestyle changes. But sounds like he is doing everything right. Does he exercise? How long between ejaculations? I think your doctor will probably have the answer for you. My husband’s results were inconsistent. It seemed to us like his best results were when he waited 5 days or more. We chose icsi but got pregnant “naturally” while prepping for an embryo transfer but experienced breakthrough ovulation and they cancelled the transfer. Silver lining is at least they are still mostly considered normal.

Zinc and potassium is what my OH was told to take to help boost his count. As above, no hot showers. Baths, laptops on laps, even dinner on lap, any heat should be avoided remember the testicles are on the outside for a reason. No tight underwear, male vitamins. If I think of anything more I'll pop back and add. X

@Lorreen we started the supplements back in June, but we’ve always eaten healthy and gotten exercise. He went 5 days for this test. We know we need IVF because of tubal factor on my end so just trying to see if ICSI is likely indicated.

My partner used to eat a banana a day. Our timeline for pregnancies isn't great as we were never properly trying more of a not preventing, we started our journey in April 2010, first pregnancy was 2013, (MC) second was in 2022 (MC), third was 2023 (my daughter and we are now pregnant again. Our huge gaps are due to not actively and consistently trying as some months we both just wasn't up for it. Hence, I say we were more not preventing. Xx

Oh, my partner was also suggested to take maca root, but it caused him spontaneous erections so he didn't take it for long. Wasn't a good look delivering customers' orders with a erection. X

Please give him high dose omaga 3 / vitamin D. Proxeed men one schtay in morning with orange juice one in evening with orange juice and with vitamin c 1000mg. No red meat at all . No sugary food at all no junk food at all. Drink lots of water.

@Deb he works from home, that’s a side effect we can live with!

@Nabs we already follow a Mediterranean diet. I’m allergic to mammal meat so we already don’t have any in the house. I will start him on orange juice. He gets omegas from his fish oil and his multi contains vit c and d but I’ll ask him to add extra vit c.

Is this the first test he takes? If so, they'll likely ask to repeat it in 3 months. Even a cold can affect sperm results and they should be average over 2 or more tests. My partner had 3 tests last year: january one on the low end of the spectrum; april one, really bad (all <5 percentile except volume) but he had the flu a week before; and the 3rd in July that was normal- he'd improved his life style, though we were always pretty healthy. When we did IVF this April the clinic didn't repeat his test ahead of time but said that they'd decide between IVF and ICSI on the day of egg retrieval based on his sample. Different clinics take different approaches (we're in the UK), but if you're doing IVF regardless of male factor, this could be one way to go. My impression is that in the US they might say do ICSI with these results, but doctors will advise.

Please give him proxeed men one schtay in morning with orange juice and one in evening with orange juice and with both time vitamin c . Proxeed men is specifically designed for men sperm health so definitely start that it helps us a lot. I am not talking about only orange juice I am saying to take proxeed men it’s in schtay form so you need to dissolved it in orange juice. Even our urologist recommended proxeed men. So you definitely start

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