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Question

I am 32 year old and my husband and I have a five and a half year old son. We’ve been trying to conceive for about two years now. We have also been using fertility monitor for the last half a year. In May I had a hormonal blood test on day two. My doctor said that everything was normal, but estrogen was 75, which he thinks is a little high. My luteal phase also seems to be short: 12-13 days. I had an ultrasound at the middle of the cycle and the doctor said that I ovulate and my mucus is very good.
In addition to the above my husband had semen analysis and it was the following: Count:129, motility 43, morphology 77. My doctor said that it is quite weak. I have tried progesterone vaginal capsules for one month and my luteal phase increased to 16 days but I did not get pregnant.

The next step my doctor said should be Clomid therapy with hormonal blood test on day three and ten, and IUI. Do you think this is a right step or we should do more testing? Do you think it is possible to conceive naturally with this sperm count?

Thank you very much.

Answer

Last Updated: July 24, 2013
Sorry, I do not have enough information about you to determine if Clomid is justified. To determine that, in our office we do a complete hormone workup with at least three progesterone and estrogen samples of the luteal phase, as well as pre-peak estrogen samples. We also would want to know thyroid, prolactin and androgen values and possibly fasting glucose and insulin levels. As far as your husband’s semen analysis, the count and morphology are good but the motility is a little low. Normal in many labs is over 50 or 60% motile sperm; however, his motility is not in a really low range, and pregnancy is certainly possible. To improve his motility the following measures may help: reduction of alcohol and stopping tobacco, boxer shorts, discontinuing certain medications that can affect semen adversely. Some men have a subtle thyroid problem. Lifestyle changes to reduce stress, improve nutrition, and improve sleep can help. Also, there is a good supplement, Proxeed, that can be obtained from the web site www.proxeed.com. At some point if you do not get pregnant it might be useful also to check to see if your Fallopian tubes are open, or check for endometriosis.

Best wishes,

M.Davenport, MD

Answered By:

Mary Davenport, MD, MS
Mary Davenport, MD, FACOG, an obstetrician/gynecologist from the Oakland Region of California, offers telehealth services over MyCatholicDoctor.com She graduated from Tufts University School of Medicine and completed her residency at UC San Diego. Dr. Davenport is a Fellow of the American College of Obstetrics and Gynecology, and serves on the Advisory Board of the California Association of Natural Family Planning.

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