Improving sperm counts for successful fertility.
To help a couple get pregnant quickly as possible, the goal is improving sperm counts to achieve a successful pregnancy. The benchmark is to increase the total motile sperm count to at least 80 million. This escalation has been shown to improve the odds of a spontaneous pregnancy. Concentration, motility, and volume all play a factor in determining the total motile sperm count. In men there are hormonal factors, anatomic abnormalities, and other unknown factors which can have a negative impact on the total motile sperm count.
Semen parameters that can be corrected.
At Urology Austin, every male infertility patient will undergo a thorough hormonal evaluation, be asked about their personal and family medical history, and have an in-office physical exam. There are a variety of medications which can influence a man’s hormonal profile and have a favorable impact on semen parameters. These medications include Clomid (clomiphene citrate), Arimidex (a type of aromatase inhibitor), and Exogenous Gonadotropins (such as HCG). The right choice of medication depends on the nature of the hormonal profile.
The male anatomy may provide clues as to what could be contributing to poor total motile sperm counts. For example, men may have a dilation of the veins in the testicles, called a varicocele. This urologic condition can have a negative impact on total motile sperm count and decrease the likelihood of achieving pregnancy. Fortunately, a varicocele repair is a common procedure that can have a positive impact on total motile sperm count, and sperm morphology. It can also have a positive influence on a man’s testosterone level.
Other therapies may be utilized to improve the total motile sperm count and sperm morphology including:
- Prescription anti-inflammatory medications.
- Over-the-counter supplements such as Vitamin E, Selenium, L Carnitine, Acetyl-L Carnitine, Folic Acid, and Zinc Sulfate.
Safe, effective doses of these supplements can be used to possibly improve sperm parameters. However, it is recommended that patients speak to their urologist first before choosing to take an over-the-counter supplement to ensure safety.
If there are high levels of white blood cells (WBCs) in a semen specimen, this is a sign of inflammation. Depending on the patient’s medical history and exam findings, options can include:
- Antibiotic therapy
- Anti-inflammatory medication
- A sperm harvesting procedure
- Antioxidant therapy
If semen samples show a pattern of low ejaculate volumes, possible explanations could include semen traveling in the wrong direction, or a possible blockage of the ejaculatory ducts. Retrograde ejaculation (semen traveling the wrong direction) can be tested with a specialized semen analysis performed on the first voided urine after ejaculation. A blockage of the ejaculatory ducts can be confirmed with a prostate and seminal vesicle ultrasound. For individuals with blocked ejaculatory ducts, transurethral resection of the ejaculatory duct (TURED) is a treatment option which can fix the low ejaculate volumes.
If you have questions about improving sperm counts, contact the Urology Austin office nearest you to schedule an appointment with one of our urologists.