Brief Answer: detailed explanation below. Detailed Answer: Hello and welcome to HCM. Thank you for the query. I understand your problem. I would however like to have some information about the PCOS, the other medicines that she is taking and reports if any, duration of marriage and also the complete semen analysis report. As of now, your query about Maxoza L: This contains Vitamin C and amino acids. These are drugs that are anti oxidants. Most of the cell degeneration in the body occurs due to oxidation reactions. Vitamin C prevents these reactions and helps to improve the life of cells and also restore different metabolic processes. The use of this vitamin in improving sperm count is debatable and not properly researched. Some studies do indicate that use of antioxidants and other drugs like lycopene and vitamin C help in improving the count. So there is no harm in taking it. I would also like to share some more information about sperms. It takes about 3 months after use of any drug to show results in semen. This is the time required for the sperm to come from testis to the ejaculatory system. So any repeat test must be taken at least 2 1/2 to 3 months later. Also sperm quality and semen quality is affected by high temperatures, tight clothes and trauma to the testis. So avoid using tight undergarments and exposure to high temperatures. Use XXXXXXX warm water for bathing. Also the use of natural antioxidants like lemon and lime juice, oranges, in fact all seasonal fruits and green vegetables are loaded with them. So increase their intake and it will help. A sperm count of 30 million is it the total count or it is 30 million per ml. If it is 30 million per ml then it is normal. 60% motility is also normal. So please upload the complete report if possible. Another thing is the PCOS. The history of irregular cycles suggests that some element of PCOS is there. As you are getting investigated for issues with fertility, a minimum investigation is an ultrasound of your wife, a test to see if tubes are open and an ovulation study. Ovulation or release of the female egg [ normally occurs on day 12-16 but may occur at any time between day 10-20 in women with regular cycles] is missing or irregular in PCOS. An ovulation study detects if the ovum is getting released or not. If it is getting released then simple measure like an intra uterine insemination using processed semen may solve the issue. If it is not getting released she may need drugs to assist in this. The timing of things is the main issue in all cases related to fertility. Ovum is available for a short time of 36 hours. If contact occurs during ovulation then pregnancy occurs. Rest all the days will not result in pregnancy. I hope that this answered the query. I am waiting for the other results to provide a better opinion. Any further questions are welcome. Also please feel free to ask about any points that may seem unclear to you. Thanks for the query. Dr Madhuri Bagde Consultant Ob Gyn

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Brief Answer: Reports are positive. Detailed Answer: Hello and welcome back, The semen report is fine and you have been well advised to stop smoking. It affects the sperm count and also has long term adverse effects. So this is a good advise. Since your wife is ovulating then on day 15-16, I suggest alternate day contact between day 9-12 and then daily. This is because the semen is stored in a organ called the seminal vesicle. It is filled after every ejaculation and it takes some time to fill it. Repeated ejaculations lead to dilute semen with a lower count. So it is not that the count is low, but repeated emptying and slower filling lead to semen being dilute. After day 12 you may have regular contact daily. The ovum is available for fertilization for 36 hours after ovulation. So alternate day contact has more chances of fertilization as the sperm count is good and it is possible to catch the ovum due to the 36 hour window. Another thing is about conceva F. This is again not an FDA approved drug for fertility issues. It is being prescribed a lot. Kindly check the contents and see if it contains clomiphene. All the information I was able to gather for this drug is that it is similar to the antioxidants prescribed to you. However if she is ovulating without use of clomiphene then it is very good considering the PCOS. So there is not much worry now. The count is good and ovulation is there. So just keep regular contact. It takes about 6 months to 1 year for an average couple to conceive. But if timed properly during ovulation, conception may occur sooner. There are two investigations that I suggest if it is more than 3 months since you are trying. One is to check if her tubes are open [ a tubal patency test] and another is an endometrial biopsy. The biopsy we advise if couples do not conceive about 8-12 months. If you have been timing the sexual contact at ovulation since 3 months and have been unsuccessful. Get a tubal patency test done to see if tubes are properly open. If they are then you may wait for another 3 months. The test is done on 5th day of period by a radiologist. Also give her folic acid tablets 5mg daily for 2 months. This is a vitamin that is commonly deficient in women and taking it before pregnancy helps in preventing brain defects in the baby. So best of luck from me. I am always here to help you whenever you may need. Sometimes the answers are delayed as I have some surgeries so please excuse me for the inconvenience it causes. I feel sorry for it, but unfortunately it is unavoidable. Regards Dr Madhuri

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