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What Does This Semen Analysis Report Indicate?
Question: TTC for last 2.5 years. Baby was born in 2011 (Normal Delivery) but could not survive due to Asphyixa. Baby could survive for only 15 days. We tried for baby after 1.5 years. Visited a gynecologist. Suggested for blood test. All the test were normal except prolcatin was 35 ng/ml. Test was conducted on 18-03-2013. Sperm test of my husband was also done on the same date and the results are as follows:
Macroscopic Findings: Volume: 1.0 Ml, Color: white, Reaction: Alkaline.
Microscopic Findings: Spermatoza Count: 95 mill/cu.mm , Motile: 60 to 70%, Non- Motile- 30%, Normal- 70%, Deformed-Head/Nect/Tail- 25-30%.
Medications were given by Doctor, but could not conceive within year. My husband had to go out of country for around 6 months hence had to stop all medications and there was gap of around 6 months . We started visiting Gynecologist in the month of Sept 2014. Again tests were conducted and the results were all normal, expect prolactin was 35.72 ng/ml. Doc suggested Cabgolin 0.5 mg for 10 weeks. But we had to shift XXXXXXX in the month of XXXXXXX 2015, due to unavoidable circumstances and hence had to change doctor. We started visiting Doctor in the month of Feb’15 and again blood test and Ultrasound were done on 3rd day of the cycle (24-02-2015). In this blood test the results were normal and prolactin had decreased to 21.13 ng/ml. But in Ultrasound a cyst was detected in left ovary 1.6 cm X 0.9 cm. Following were the medicines suggested by Doctor, Bestova 100, Susten SR-200 along with folvite and ecosprin.
Ultraosund was again done in 28-03-2015 (3rd day of the cycle). Left ovary cyst was 3.2 cm X 2.4 cm. Follicle study started on 9th day (03-4-15) of the cycle. The results are as follows:
03-04-15 (9th day) : ET-3mm, RO Follicle (14mm X 12 mm, 15 mm X 12 mm), LO Follicle (13 mm X 10 mm, 13 mm X 10 mm), POD- Clear. (Remarks: Polycystic change seen in both the ovaries)
The results for 13th day (07-04-15): ET- 5mm, RO Follicle (16 mm X 17 mm, 19 mm X 16 mm), LO Follicle (19 mm X 14 mm, 20 X 15 mm), POD- Normal. Trigger shot was given on this day.
15th day (09-04-2015): ET- 5mm, RO Follicle (23 mm X 19 mm, 20X 18 mm), LO Follicle (23 mm X 16mm, 23mm X 16 mm), POD- Clear. Follicle had not ruptured. Hence another trigger shot was given day 16th (10-04-15). I would like to know the following:
1. Looking at the above history what are the chances of getting pregnant. My age in 33 years and periods vary between 30 to 32 days. (Dates for last 3 months are 23-Jan-15, 22-Feb-15, 26-Mar-15)
2. Have stopped taking medicine for prolactin as suggested by Doctor, will it again increase.
3. Even after giving trigger shot follicle had not ruptured, what are the reasons.
4. Will cyst affect the chances to conceive.
Macroscopic Findings: Volume: 1.0 Ml, Color: white, Reaction: Alkaline.
Microscopic Findings: Spermatoza Count: 95 mill/cu.mm , Motile: 60 to 70%, Non- Motile- 30%, Normal- 70%, Deformed-Head/Nect/Tail- 25-30%.
Medications were given by Doctor, but could not conceive within year. My husband had to go out of country for around 6 months hence had to stop all medications and there was gap of around 6 months . We started visiting Gynecologist in the month of Sept 2014. Again tests were conducted and the results were all normal, expect prolactin was 35.72 ng/ml. Doc suggested Cabgolin 0.5 mg for 10 weeks. But we had to shift XXXXXXX in the month of XXXXXXX 2015, due to unavoidable circumstances and hence had to change doctor. We started visiting Doctor in the month of Feb’15 and again blood test and Ultrasound were done on 3rd day of the cycle (24-02-2015). In this blood test the results were normal and prolactin had decreased to 21.13 ng/ml. But in Ultrasound a cyst was detected in left ovary 1.6 cm X 0.9 cm. Following were the medicines suggested by Doctor, Bestova 100, Susten SR-200 along with folvite and ecosprin.
Ultraosund was again done in 28-03-2015 (3rd day of the cycle). Left ovary cyst was 3.2 cm X 2.4 cm. Follicle study started on 9th day (03-4-15) of the cycle. The results are as follows:
03-04-15 (9th day) : ET-3mm, RO Follicle (14mm X 12 mm, 15 mm X 12 mm), LO Follicle (13 mm X 10 mm, 13 mm X 10 mm), POD- Clear. (Remarks: Polycystic change seen in both the ovaries)
The results for 13th day (07-04-15): ET- 5mm, RO Follicle (16 mm X 17 mm, 19 mm X 16 mm), LO Follicle (19 mm X 14 mm, 20 X 15 mm), POD- Normal. Trigger shot was given on this day.
15th day (09-04-2015): ET- 5mm, RO Follicle (23 mm X 19 mm, 20X 18 mm), LO Follicle (23 mm X 16mm, 23mm X 16 mm), POD- Clear. Follicle had not ruptured. Hence another trigger shot was given day 16th (10-04-15). I would like to know the following:
1. Looking at the above history what are the chances of getting pregnant. My age in 33 years and periods vary between 30 to 32 days. (Dates for last 3 months are 23-Jan-15, 22-Feb-15, 26-Mar-15)
2. Have stopped taking medicine for prolactin as suggested by Doctor, will it again increase.
3. Even after giving trigger shot follicle had not ruptured, what are the reasons.
4. Will cyst affect the chances to conceive.
Brief Answer:
Likely polycystic ovarian syndrome
Detailed Answer:
Hi XXXXX, I have gone through your question and understand your concerns. The report of the semen analysis of your husband is completely normal. I would like to give your answers as you have asked:
1. Chances of pregnancy in this cycle will depend upon the fact that whether the follicle has ruptured after giving the second trigger injection. If the follicle has ruptured, then the chances of pregnancy in this cycle of ovulation induction( by bestova 100 , which is enclomiphene) is around 35-40%.
2. Serum prolactin do increase after stopping cabergoline, especially when stopped abruptly. I would suggest you to consult with your doctor and start Bromocriptine for controlling prolactin levels, as it is a safe drug in pregnancy. Deranged prolactin levels also lead to irregular or no ovulation at all and hence decreased fertility.
3. Sometimes, when the hormonal disturbances like hypothyroidism, hyperprolactemia or polycystic ovarian disease are present in the body, the follicle become resistant and do not rupture even after hCG trigger injection.It is therefore advisable to optimize the hormonal levels by appropriate management and then plan to conceive.
4. The cyst in your left ovary is 3.2 x2.4 cm, and sometimes ovarian cyst do secrete hormones which may effect chances of conception. However, you have mentioned in your follicular monitoring that ovaries were polycystic, the cyst may have formed due to hormonal disturbances.
I would like to know your weight and height, as weight reduction and lifestyle changes in polycystic ovarian disease increase the response to fertility treatment and thus increasing the chances of conception.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Likely polycystic ovarian syndrome
Detailed Answer:
Hi XXXXX, I have gone through your question and understand your concerns. The report of the semen analysis of your husband is completely normal. I would like to give your answers as you have asked:
1. Chances of pregnancy in this cycle will depend upon the fact that whether the follicle has ruptured after giving the second trigger injection. If the follicle has ruptured, then the chances of pregnancy in this cycle of ovulation induction( by bestova 100 , which is enclomiphene) is around 35-40%.
2. Serum prolactin do increase after stopping cabergoline, especially when stopped abruptly. I would suggest you to consult with your doctor and start Bromocriptine for controlling prolactin levels, as it is a safe drug in pregnancy. Deranged prolactin levels also lead to irregular or no ovulation at all and hence decreased fertility.
3. Sometimes, when the hormonal disturbances like hypothyroidism, hyperprolactemia or polycystic ovarian disease are present in the body, the follicle become resistant and do not rupture even after hCG trigger injection.It is therefore advisable to optimize the hormonal levels by appropriate management and then plan to conceive.
4. The cyst in your left ovary is 3.2 x2.4 cm, and sometimes ovarian cyst do secrete hormones which may effect chances of conception. However, you have mentioned in your follicular monitoring that ovaries were polycystic, the cyst may have formed due to hormonal disturbances.
I would like to know your weight and height, as weight reduction and lifestyle changes in polycystic ovarian disease increase the response to fertility treatment and thus increasing the chances of conception.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Shanthi.E
Thanks mam for your advice and suggestions.
My height is 5ft 3 inches and weight 55 KGS.
Had ultrasound today follicle has ruptured (12/04/15) ie on the 18th day. After it has ruptured how many hrs it will last. Didnt had intercourse in last 2 days.
My height is 5ft 3 inches and weight 55 KGS.
Had ultrasound today follicle has ruptured (12/04/15) ie on the 18th day. After it has ruptured how many hrs it will last. Didnt had intercourse in last 2 days.
Brief Answer:
Ovum is viable for 24 hours after follicle rupture
Detailed Answer:
Hi XXXXXX, thanks for responding. Your weight is normal for your height, and your Body mass index ( BMI) is 22, which is also normal.
After the rupture of the follicle, the ovum is viable for 24 hours. So, I would suggest you to have unprotected intercourse within 24 hours, so that the chances of conception are increased.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Ovum is viable for 24 hours after follicle rupture
Detailed Answer:
Hi XXXXXX, thanks for responding. Your weight is normal for your height, and your Body mass index ( BMI) is 22, which is also normal.
After the rupture of the follicle, the ovum is viable for 24 hours. So, I would suggest you to have unprotected intercourse within 24 hours, so that the chances of conception are increased.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Yogesh D
Got report today et 7 mm. Follicle ruptured. But pod remarks: slight skin fluid behind uterus. We are worried. Please suggest
Brief Answer:
Ideal conditions for conception
Detailed Answer:
Hi XXXXX, thanks for responding. Endometrial thickness of 6-14 mm is considered ideal for implantation. Yours being 7 mm lies in this ideal range.
Slight fluid in the POD ( pouch of Douglas) is confirmatory of the follicular rupture, as the fluid released from the follicle iscollected in the POD, which is a space behind the uterus.
However, I am not clear about the word ' skin' in between the slight fluid, as it does not indicate anything.
You have ideal circumstances for conception, with ovulation and an ideal Endometrial thickness( ET).
I would suggest you not to worry, and to keep a positive attitude and be hopeful.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Ideal conditions for conception
Detailed Answer:
Hi XXXXX, thanks for responding. Endometrial thickness of 6-14 mm is considered ideal for implantation. Yours being 7 mm lies in this ideal range.
Slight fluid in the POD ( pouch of Douglas) is confirmatory of the follicular rupture, as the fluid released from the follicle iscollected in the POD, which is a space behind the uterus.
However, I am not clear about the word ' skin' in between the slight fluid, as it does not indicate anything.
You have ideal circumstances for conception, with ovulation and an ideal Endometrial thickness( ET).
I would suggest you not to worry, and to keep a positive attitude and be hopeful.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
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Above answer was peer-reviewed by :
Dr. Pradeep Vitta
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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