Not enough focus on male fertility, feeling frustrated...

[Milly2021]

We’ve been with a well known London clinic for two failed cycles and all the focus has been on myself, I changed from gonal f to menopur and rattle when I walk with all the supplements I’m taking. Bit frustrated as it’s taken to now for the consultant to recommend that my husband sees a male fertility specialist as it’s clear that our embryos were strong on days 1-3 then started to break down so it’s clear it’s the poor sperm (grade 1/2). Just wondering why clinics do not encourage for these male tests at the beginning (he had 2 sperm analysis but I mean more thorough testing) and is there any advice on improving the sperm grades? I know diet is key, we’re waiting for an appointment with a dietitian, but feeling really deflated that the main focus was on my side and only now they are talking about the male.

[Camkid12]

Hi Milly. I totally agree with you! Our story is slightly different in that my GP did a few tests on me, and hubby's GP sent him for sperm analysis really early on. He provided 2 samples and both had low count. Rather than try to find out why it is low, they advised straight away to do IVF with ICSI. We've both had lost more tests done and hope to start treatment in September/October. It seems so unfair that the immediate solution is to do IVF where the female has to take all of the drugs, scans, poking and prodding etc. Surely it would be sensible to do some male investigation to see if that is a more simple fix? We are entitled to 2 cycles on the NHS which is amazing, even though it's taken a year and a half to get to this point. It sounds like you are paying private? If so I would have expected them to assess both male and female at the same time, I'd certainly be asking them the question! Good luck with your journey. xx

[Milly2021 in reply to Camkid12]

Thank you Cam, i really don’t understand why they don’t investigate both sides at beginning. I do have low AMH & the menopur improved my egg quality but now we’re wasting time on figuring out what’s wrong on the male side when they could have done the checks at the beginning. Good luck with your journey too xx

[Running79]

I have to agree - with us we were really lucky that my husband was an old bloke - he was about 55/56 when we started IVF.

The consultant mentioned straight away about a dna fragmentation test, purely based on my husbands age! His morphology was slightly on the low side - so it was suggested we had ICSI from the off

In the two rounds we did with my eggs, we had a good fertilisation rate and we’re left with 2/3 blasts

Unfortunately our second round we had PGTA tested and they were chromosomally abnormal

I was 40 yrs old, and we decided that it was better to go for donor egg, as it was clearly me that had the issue - my sister donated, first transfer, I’m 14 weeks + 5 today

So it was the right choice for us.

So for us the dna fragmentation at the start was the best thing for us, as it helped us to make informed decision going through the rounds

[Belangalo]

I completely agree with you. We went into IVF because after a year my husband was not producing much sperm at all - but we considered it a win that he was producing anything at all since we started with zero sperm! But once we got into IVF...even though hubby's low sperm count and year long journey to produce any sperm was documented...the focus was straight away on me! We went into IVF with known male fertility problems but I was the one being tested.

After out first cycle of three transfers failed it was ME that got the barrage of tests. They ALL came back normal or perfect. Hubby didn't even have to do another sperm test even though he had to produce TWO samples to fertilise my six eggs on the day of egg collection. There is a significant bias towards the woman being the issue in IVF. I think its because there is so much more that can potentially be wrong with us so they want to rule things out and give the best possible results for us. As it is, we fell pregnant naturally waiting to start our second cycle after I'd been through the wringer with tests and operations. My guess is that our fertility issues remain male fertility issues for the most part but they aren't exploring that option. 🤷‍♀️ I will insist (when we restart IVF to hopefully give this little one a sibling 🥰🥰) that we do a full work up on hubby's sperm. I want DNA fragmentation tests and I'll be close to 40 if not 40...so I'll be egg banking and I only want good sperm to meet those precious eggs. It's just wasting time otherwise since he can produce much more sperm than I can eggs. 🙄

Insist on testing. Get your answers!!! Good luck! Xx

[Running79 in reply to Belangalo]

I whole heartedly believe it is part and parcel of the money making process - if your husband has a know issue it just screams money making to keep testing you for no reason!!

It does make me laugh that they run all these tests yet they don’t have a test to give us a definitive report on the actual quality of our eggs alone

[PurplePiggie]

Totally agree with there needing to be more focus on the male side early on, we had 2 sperm analyses done which looked good numbers wise and it wasn't till the 3rd actually at the clinic that we chose for treatment that their analysis showed high levels of anti-sperm anti-bodies so natural pregnancy was unlikely. I've never understood why tests on the male side are so basic initially. As numbers were ok OH didn't need to do anything else as they just recommended ICSI but I'm sure you'll get some good advice here, good luck xx

[soccerkt6]

I second all of these comments. We were “lucky” that after our first failed cycle our consultant recommended my husband get a dna fragmentation test done. Like you, we had good fertilisation and embryo development until day 3. But quite frankly, we were 2.5 years into ttc by that point and doctors had previously waved away my husband’s slightly low morphology numbers as normal, so I was still pretty livid when I realised that there was further (simple, non-invasive!) testing he could have had done, and not one consultant had even mentioned it as something to consider. I'm still at a bit of a loss why lack of focus on the male factor seems to be so prevalent, but I think it's a combination of women being predisposed to assume that the problem is with us, a persistent rumour among fertility specialists that there's nothing to be done for male factor issues (we had one consultant tell us this early on in our journey 🤯), and I think most importantly, the fact that sperm dna fragmentation tests aren't covered on the NHS. If it was, I think doctors would be much more willing to refer men for further investigation earlier on in the process.

The good news is you can start doing things immediately to try to improve his sperm quality while you wait for an appt with the male fertility specialist. Have him start Impryl, Vitamin D and omega 3s (cod liver oil is best). Limit contact with plastics and get rid of non-stick cookware. Increase colorful fruit and veg intake (I found freeze-dried wild blueberries and blackcurrant powder online that my husband puts in his porridge every day) and avoid fried or prepared foods.

Once you see the specialist, I imagine they’ll have him do a dna fragmentation test, ultrasound to check for varicocele and maybe some urine tests to check for infections. Are you going to see Dr Ramsay? Best of luck, lovely xx

[Milly2021 in reply to soccerkt6]

Thanks so much, my husband is healthy with food but think we need to up the supplements. We’ve been recommended to see Dr Yap but my friend said Dr Ramsey was brilliant so I’ve queried this. Fingers crossed it will happen for us as the consultant started talking about sperm donor and I just don’t want that route. xx

[soccerkt6 in reply to Milly2021]

Oh good. I'm sure this is your plan anyway, but don't let them fob you off with talk of sperm donors before you've exhausted all investigations for your husband and been on a supplement plan for at least four months. There are several stories of ladies on here who, once they addressed their partner's sperm issues, conceived naturally or had much more successful IVF rounds. xx

[Milly2021 in reply to soccerkt6]

Thanks so much, I was losing faith yesterday as these private clinics are so blaze about just going straight to donor option. X

[Marisa32]

For some reason, UK clinics (NHS or private) heavily focus on women being an issue and glaze over men. I did IVF in the US and in central EU and all 3 clinics investigated the man thoroughly (DNA frag etc) before proceeding with IVF on me. Even though everything was fine on his end, it was comforting to know that I'm not undergoing this invasive treatment just to find out something is wrong with him down the road. There is an interesting video on male's infertility out at bbc, definitely more awareness on male infertility is needed.

bbc.com/reel/playlist/a-fai...

[Milly2021 in reply to Marisa32]

Completely agree, we need more awareness on the male isssues.