Male Factor: Urologist or RE?

aphrodite2 · April 2009

Hi, ladies. I've never posted on this board, but I've lurked for the past month or so & I am amazed by the genuine outpouring of support that takes place here on a daily basis!

DH & I are a couple weeks short of the one-year mark for TTC, but my OB/GYN has already done CD3 b/w on me (normal) and an SA on DH. ?Just got the SA results today: low motility & low count.

The nurse I spoke with suggested 3 options:

1. Wait a month & re-do SA (I'm not wild about this one)

2. See a urologist

3. See an RE

Just wondering what your opinions are? ?The nurse seemed to push the RE idea the most, but would an RE be able to evaluate DH as well as a urologist?

Thanks so much for your thoughts on this! ?Also, please let me know if you think there is a more appropriate board on which I should post this question.?

?

caityr · April 2009

The RE will repeat the SA and then if the results are still low on both counts he would likely refer DH to a uro. Our RE also prescribed antibiotics to help with white blood cells present in the sample-he did that for I think 10 days and when he had his repeat at the uro, things looked much better. I think I would go to the RE route b/c the RE is trained to look at the whole picture-you guys as a couple, vs just a piece of the puzzle.

Mrs.LisaP · April 2009

Get in with a urologist as soon as you can. Dont get too worried, because it really takes more than one s/a to determine male factor.

preheatedoven · April 2009

I agree with caityr, see the RE. We are dealing with MFI too, and while the uro was helpful, the RE just ran all the tests again b/c they look a bit more thoroughly at things.

Good luck!

mrs.goget · April 2009

I recommend seeing a urolgist, but please make sure you find one that also specializes in male infertility. The urologist will test him and be able to tell you more information as to why and how it can be fixed.

hillaree · April 2009

Sorry for the difficult news about the SA!

I would definitely repeat the SA just to make sure the low count and motility were not just a lab error (ie the sample was sitting out to long). I would also suggest making an appointment with BOTH a urologist and an RE. From what I can tell, RE's do look at the couple but are technically ob/gyn's. They can do treatments that get around MFI, but generally a urologist will try to treat any underlying causes of the MFI. Make sure you husband gets his hormone levels tested, and they will check for any physical causes.

GL with your next steps, and you are definitely welcome to post here!! We also have a MFI check-in on Mondays.

aphrodite2 · April 2009

Thanks for the opinions, ladies! ?I hadn't thought about making appointments with both, hillaree...that sounds like a great idea.

Yeah, the news about the SA wasn't the best, but at least we have something to work with now. ?:)?

gidge · April 2009

Our first SA was done at the RE's office and he referred us to a urologist.

JackieMac824 · April 2009

I would suggest going to see a Uro and an RE - the RE can do extra testing on you to rule out anything on your side and the Uro can do a follow up SA on your DH and an exam.

LizzyB11 · April 2009

Hi there Aprhodite! My DH also has low count and low motility (and has two daughters who are 8 and 10). We were supposed to see the uro tomorow, but now it's been pushed back. I am going to set up my own appointment for an RE because I also have low progesterone. I was kind of waiting to see what the uro said before moving ahead, but now I am just going to schedule an initial meeting and see both doctors! Good luck! You are not alone in this!

MoFree · April 2009

My husband's first SA was ordered by my gynecologist after a year of TTC. Based on very, very low numbers on all 3 counts, he was referred to a urologist who specializes in male fertility. I would go to a urologist. As PPs have said, though, results can vary greatly from one SA to another depending on many factors, so don't assume that your have MFI based solely on this one test.

Good luck to you and your DH.

caden · April 2009

My DH also went to a urologist that specialized in MFI. I take all the lab work and everything we learned from the uro back to my RE.

Jamers125 · April 2009

When we were getting to the year mark of TTC, I raised concerns to my ob-gyn. She ordered CD3 blood work for me and said she'd order an SA for DH if he didn't want to do it through his doctor. He already had a urologist for past issues with kidney stones, so he requested the SA through his urologist. After one bad SA result, the urologist referred DH to an RE's office for another SA. Our RE works with this urologist all the time, so it worked out well for us. This RE is also the one who was recommended to me by my PCP AND my ob-gyn, so we felt like we were in the right place.

I agree that you should make appts with both, or ask the RE's office what urologist(s) they work with and go from there. Our doctors have all worked very nicely together.

aphrodite2 · April 2009

Thank you for all the excellent input, ladies! ?I talked to DH & he was comfortable with seeing the RE first & getting his input on what urologist he should see. ?Since I was able to get in to see the RE recommended by my OB/GYN so quickly (May 12th - eek!), I think we'll go this route.

Thanks again for the support & letting me know we're not alone! ?:)

Bradbride · April 2009

I would get to a urologist that specializes in fertility ASAP!!! Treatment for MFI takes so long as a new batch takes 3 months.

FMrsY · April 2009

When we started doing our tests, my OB/GYN told us to make an appointment with an RE after we got DH's 1st SA back. It was definitely the way to go for us because he got started on doing tests on me...the CD3, but also an HSG and SHG, and he re-did DH's SA and did an AR test. A month later, we pretty much know where we stand (IVF/ICSI).

So I highly recommend going to the RE.

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