Pregnancy with low sperm count
Dear Dr Mitchell,
My husband has low sperm count and we need help in getting pregnant. Therefore I need some information about cost and the suitable procedures as well as a referral for who can help us.
Male infertility is a factor in at least 40 per cent of couples who are unable to become pregnant. The problem is usually confirmed when a semen analysis is done. A low sperm count is a common finding in addition to low sperm motility. In some cases, the couple gets the unfortunate revelation that there are no sperm in the semen analysis.
The finding of a low sperm count needs further investigation. Your partner needs to have a detailed physical examination and hormone profile done to determine the cause of the low sperm count so that treatment can be undertaken in an attempt to improve the quality of his semen.
Factors that can cause a low sperm count include smoking, excessive alcohol consumption, increased scrotal temperature from tight clothing, hot tub baths or showers, long-distance driving in trucks with heated engines, and the use of certain drugs. Infection is also a major factor, and a sexually transmitted infection and mumps can cause low sperm count and decreased motility.
The presence of a varicocele or hydrocele can also affect the sperm count and motility. A varicocele is a condition that presents with dilated veins around the scrotum. A hydrocele presents with excessive fluid around the scrotum. Both conditions can result in infertility but can be treated successfully by doing surgery.
Your spouse needs to be evaluated by a urologist and an attempt at treatment done. If the treatment is unsuccessful in causing a significant increase in sperm count, then you should be referred to a fertility specialist to see if artificial insemination or in vitro fertilisation (IVF) is feasible. Artificial insemination is cheaper than (IVF), and should definitely be considered especially if the count is not too low. IVF can be done even if the count is extremely low and with good outcome. If the sperm are abnormal then this will reduce the success of IVF. The embryologist will choose the best sperm from the semen, in order to get the best results.
In some cases, donor sperm have to be used if there are no sperm or too many abnormal sperm, in order to optimise the outcome. A suitable donor who closely resembles your partner would be chosen so that the baby will look like him.
Consult your family doctor or gynaecologist who will refer you both to the Fertility Management Unit at the University Hospital of the West Indies. There are several trained infertility specialists which include specially trained doctors, nurses, embryologists, and other support staff. The results from the unit are very good and comparable to first-world countries. The cost for the IVF is also extremely reasonable and only a fraction of the cost in first-world countries, making the procedure more accessible and affordable to a wide range of couples.
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
