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Molly1

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  • "Molly1" started this thread

Posts: 32

Reg: Sep 25th 2009

Location: Britain

Children: Bourn Hall

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Monday, September 28th 2009, 6:08pm

Can you help please Paul?

Hi Paul,
I am hoping that you can offer your thoughts on the following: My husband and I have now been trying unsuccessfully for 11 cycles. He has had 3 sperm tests which all have a volume of 3 - 4.5 ml, count between 59 and 87 million per ml. It is the morphology and motility that seems to be really variable as shown below:
Test 1rapid progressive 1% sluggish 49% non-progress 15%non motile 35% morph 2 %
Test 2 21% 36% 11% 32% morph 4%
Test 3 7% 28% 16% 49% 10%
We're really pleased that the morph has improved but the motility has gone down. What are these figures like and could we achieve a natural pregnancy? If not, is it enough for IUI?

My other question is about me. I have a regular cycle and I've had blood tests to confirm that I ovulate. I also take my temp and use a fertility monitor. I am really worried though because every month I get a brown discharge before my full period starts. This normally begins on day 21 of my 28 day cycle. The discharge begins as a brown tinge to cervical mucus but becomes heavy with clots. It is enough that I have to wear a sanitary towel. I have asked both the GP and fertility consultant about this and both have said that many women have it and it won't be a problem in getting pregnant. Is this right? I was worried that I had a short luteal phase and low progesterone but my 21 day bloods said not and my temperature also stays up until my 'proper' period starts. I am still really worried about it. If I were to get pregnant, would I still get this discharge prior to the 28th day? It is really hard feeling down on both the day I get this brown stuff and on the day I get my proper period. Also, if we do need have an IUI or IVF, will this interfere with our chances of success?

Please help, I'd really value your opinions.

Thank you
Molly1
Molly

Posts: 2,505

Reg: May 2nd 2007

Children: A boy and a girl, both living in London

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Thursday, October 1st 2009, 11:17pm

RE: Can you help please Paul?

Hi Molly,

Firstly I have copied part of my reply to you on another thread about the chances of conceiving naturally :

"There are more than enough sperm and enough good quality sperm present in his specimens to achieve a pregnancy naturally. It is important however that you are adequately fertile to make the best use of these. So if you haven't already been fully investigated then you need to be, in particular having your progeterone tested to make sure it is higher enough to give good implantation, ie over 30-35nmol/L

To maximise his sperm quality he needs to ejaculate regularly every 2-3 days, and if you are making love regularly this will also ensure that there are always his best sperm inside you whenever there is an egg around. Timing intercourse risks missing ovulation so try not to do this.

I have seen many pregnancies happen naturally with much much lower counts and qualities than this. It may take a little longer so you need to persevere. 1 in 10 of all pregnancies to fertile couples takes more than 14 months, so 11 months is not long enough to prove that it cannot or won't happen. Regarding zinc for sperm motility. If DH is taking no more than twice the zinc dose suggested on the bottle then he will do no harm. Taking any higher than this will do no more good and it is just possible that it might make him unwell or cause indigestion."

Your brown discharge before your period starts is very common and for most women it usually lasts only 3/4 days. As I am sure you realise, you normally do not count this as day one but wait until the period with bright blood suddenly starts. However sometimes the early discharge changes only slowly into the true period and it can be difficult to know what to call day one. This discharge is usually of no consequence and many women who are very fertile get this effect. It is less common for it to start as early as day 21 in a 28 day cycle, but the main problem is when it is present during ovulation when it can make the mucus hostile to the sperm trying to swim through. We do not know what causes this brown discharge to happen so early. It seems that the uterine lining is irritated by something, perhaps a polyp or even a fibroid. This does not have to have a major impact on fertility but it is unpleasant for you I can understand.

You may or may not get this discharge in the cycle when you get pregnant, only time will tell, and it might very well be that you will have this and then, to your surprise, it will not turn into a proper period and you must then do a test as you could be pregnant. I don't feel that this is going to interfere with IUI or IVF, especially so with IVF as the drugs should over ride this effect.

So keep up your hopes Molly, you are not wasting your efforts. And look out for any odd periods which may indicate very early pregnancies, and do a test.

Good luck.

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

Molly1

Newbie

  • "Molly1" started this thread

Posts: 32

Reg: Sep 25th 2009

Location: Britain

Children: Bourn Hall

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Thursday, October 8th 2009, 5:42am

more bad news, please help again Paul

Hi Paul,

I'm really sorry to bother you again but I could do with some more advice and your knowledge. It is half five in the morning and I am sitting writing this because I can't sleep.

Very recently you advised me about my DH's sperm and my strange brown discharge which was incredibly reassuring. I asked you whether it was too early to be referred to a clinic for treatment and you advised us to carry on trying because 11 months was too short a time to give up. I finally felt positive about the possibility of conceiving and having a baby.

Anyway, yesterday the hospital copied me in to referral to a fertility clinic. It says the referral is for 'mild male factor' however it was the note against my tubal patency which alarmed me. It said 'BICORNUATE UTERUS, BIL SPILL'. I didn't have a clue what this meant (and I still don't know what Bil Spill' means) but I put bicornuate into google to see. What I found was loads of really scary stuff about high rates of miscarriage and inability to conceive. It has really shaken and upset me. Now all I think is that DH has problems with his sperm and now it doesn't matter because I would struggle to carry a baby to term anyway. I feel so distressed. No mention of this has been made at any point, not by the nurses doing the HSG, the nurse who did my ultrasound or the consultant himself. Surely if it was really bad they would have said something?

Please help Paul, I could really do with your advice,

Molly
Molly

Grace

Princess of the Universe

    United Kingdom

Posts: 3,405

Reg: Jul 29th 2008

Location: Berkshire

Children: 1 beautiful little son conceived through ICSI and one equally beautiful little boy concieved naturally!

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Thursday, October 8th 2009, 8:01am

Hi Molly,

Obviously I'm not Paul but I just couldn't read and run.

A bicornuate uterus can come in a variety of severities from just having a bit of a lip at the bottom to being completely bicornated so don't panic until you find out from the Drs how bad it is, if they didn't mention it to you then it's likely it's not severe. My mother had a bicornate uterus (as did my granny) and had 3 children no problem with no miscarriages. They didn't find out she had one until she had her last child (me) as the placenta got stuck after delivery and they had to give it a bit of a wiggle to get it out so it's not all bad news but googling will often give you the worst case scenarious as people who don't have problems seldom blog or go on forums.

Anyway I'm sure Paul will be able to give you far more information than I so I hope he's along soon.


ICSI BFP DS1 born Nov 09
Natural BFP DS2 born Sept 11

Posts: 2,505

Reg: May 2nd 2007

Children: A boy and a girl, both living in London

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Thursday, October 8th 2009, 12:28pm

RE: more bad news, please help again Paul

Hi Molly,

The best good news first is the "Bil Spill" means bilateral spilling - meaning that when your tubes were tested the dye went freely through both tubes and then spurted out of both of the ends into the pelvic cavity. If the ends of the tubes (the inner fimbrial, finger-like ends, not the ends leading out from the womb)) were badly adhered together then the dye, having travelled down the tubes, gets to the ends then it just dribbles out past these adhesions or collects in the ends if the ends are sealed over completely. In you case this did not happen. Your tubes were fully open right up to the end and the dye spilled out happily.


Secondly a bicornate uterus is not that unusual and it is certainly compatible with normal fertility and full term pregnancies - often with pregnancies in both 'horns' (halves) of the uterus. As Grace has shown you this should not be a problem, and many women who conceive naturally, without investigation will often be found to have had a biconate uterus.

So please stop fretting, things are looking good for you.

Kind regards,

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

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