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Update from previous thread
I appreciate all the feedback. I wanted to give everyone an update.
Last week I meet with a urologist that specializes in male infertility (actually a woman doctor). She gave a complete physical examination and has scheduled an ultrasound (end of next week). She also ordered another SA. My counts were slightly improved (concentration was up to 19 million but my motility and morphology were still below normal levels) from my SA in the beginning of August.
She has narrowed it down to one of three causes. 1.) Recurrence of my varicocele (I had it repaired when I was younger) 2.) Lingering effects from an SSRI I stopped taking in late July. 3.) No explanation (she said that 20% of her patients have no clinical explanation for low sperm counts.
My hormone levels were perfect and I had negative results from genetic defects (Y deletion and karotype).
She did notice heaviness on my scrotum cord, which could signal a varicocele return. The ultrasound should conclusively determine. I was also very fortunate to see this urologist as she is currently leading a clinical study into the effect of SSRI's on semen quality. She believes that some men experience lower sperm quality due to them taking SSRI's (it impacts sperm transport not production), and that it can take up to 1 to 2 months for their counts to return to normal after stopping the drug.
The urologist and our RE are now discussing what the next step should be. Because we are still young (I'm 29 and my wife is 30) we believe that we should wait until the results of the ultrasound, and possibly one additional SA if the ultrasound does not show a varicocele to see if after 2 months the SSRI was the cause, before making a final decision to move to IVF. Maybe I'm in self-denial that my sperm counts are low but if they do return to normal then the last two IUI cycles we have had were severally hindered.
I truly do feel for everyone else on this site. This has been extremely trying and requires an unfair amount of patience and positive thinking.
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