IVF - Second Appointment

It never rains but it pours...

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It's taken me 3 weeks to write this post. Our second appointment wasn't quite the positive experience we were hoping for and I'm still not sure how I feel about it.

We thought we knew where we stood with our problems, I was the issue. I wasn't ovulating properly, I wasn't having regular cycles, my body couldn't hold on to an embryo. When we went to the recurrent miscarriage clinic last year I asked if there was any benefit in repeating my husband's semen analysis but they said no, his counts were so good in 2021 that they didn't see the point, that wasn't the problem. I was the problem.

Fast forward to January 2025 and the 'simple repeat semen analysis' has turned into yet another unwanted bump in our infertility journey. He has oligoasthenoteratozoospermia (yea, I couldn't pronounce it either...) They shorten it to OATS and apparently it's one of the most common cause of male factor infertility, as though that is supposed to make us feel better.

Devastated is probably the best word that goes some way to describing how we felt. It made no sense, how could his counts go from "super sperm" as the NHS clinic dubbed in back in 2021, to low count with abnormal morphology and crap motility?

For anyone that might be interested in the numbers, here are the results:

	2021	2025
Count (normal >39 million)	537.6 million	3.98 million
Motility (a+b, normal >32%)	49%	4%
Normal forms (normal >4%)	4%	1%

We received the results 2 days before our appointment with the consultant which gave us some time to start processing what this meant and formulate a whole list of questions to ask.

The actual appointment went as well as could be expected and the consultant definitely helped us feel less sh*t about the whole situation. My husband had flu/covid in December, high fevers for 3 days and it took him 2 weeks to recover which is unusual for him. He's one of these annoying people that bounce back from illnesses after 48 hours like nothing happened. Apparently an illness like that can kill off most of your sperm in a few days. He also runs marathons and, again, the long distance running can increase testicular temperature which also kills off sperm. Add in the Christmas break and the excess alcohol consumed over those 2 weeks and we had 3 clear reasons for the catastrophic decline in his counts.

Of course the consultant caveated all this with saying it could just be that the count has dropped for no reason and may not improve but we're clinging onto whatever hope we can at this stage.

The consultant discussed our options, wait 3 months to repeat the semen analysis and see if the count improves (while avoiding alcohol, long distance running and sick people that might give us another bout of flu) or continue with treatment and with the current results we would require ICSI rather than conventional IVF.

Oh, and I almost forgot the next issue that they presented us with; because of my PCOS my follicle count and AMH (28.3 pmol/L) are at a level where this clinic do not offer fresh embryo transfers due to the increased risk of ovarian hyperstimulation syndrome. So our only option is freeze-all transfers, meaning after egg collection any embryos that get to day 5 will be frozen and we have to wait until my next cycle to transfer them. To be honest, this made our decision easy. We're done with waiting, and the idea of waiting 3 months to repeat a semen analysis that may be exactly the same, or worse, felt pointless to us so we're going ahead.

So here we are, 3 weeks later with our treatment planning appointment scheduled for next week. Why has it taken 3 weeks you may ask! Well, the clinic needed us both to have virology blood tests done (HIV and hepatitis), and I needed an up-to-date thyroid blood test. We tried to ask our GP but they said no, the response being it's come from a private clinic and therefore any blood tests they ask for can't be done for free on the NHS - another frustrating experience but I understand why they said no.

In hindsight, I wish I'd discussed our plans to have IVF privately with the NHS fertility clinic and asked if they could have done the scans and blood tests for me. The NHS clinic were always very helpful and, although in comparison to the overall cost of IVF the tests are a small part of it, it would have been nice to have saved some money. I also wish I'd pushed the recurrent miscarriage clinic to repeat the semen analysis. It either would have been positive results or we'd have realised there was an issue 7 months earlier than we have and saved ourselves 7 months of disappointment each month. Anyway, you live and learn and I'm beginning to realise the rollercoaster of IVF and infertility is one big, unenjoyable ride that I wish we weren't on.

L x