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SA v. PCT?

riveridgionalriveridgional member
edited July 2015 in Trouble TTC
So, my husband and I have been seeing a fertility specialist for about 4 months now. My doctor has never ordered a sperm analysis for my husband since the post-coital tests show multiple swimmers with high motility. We just received our BFN for this cycle, which was the last round of Clomid for me. My doctor has recommended moving on to injectables.

Before we do a round of injectables, does anyone have thoughts on whether or not a sperm analysis would be beneficial for us given our 2 postcoital tests with great results (the doc mentioned each was one of the best he's seen and our bodies were highly compatible)? Basically, I'm not sure if a sperm analysis would reveal any answer as to why we aren't getting pregnant since the post-coital tests are showing the number and motility as great. The nurse just stated she could ask the doctor if he would order one if it was something my husband and I wanted to do. We're at the stage where literally every penny we save goes towards plans "A" and "B" so we'd rather not waste $250 for a sperm analysis if we won't get any relevant information from it.

Thanks in advance!
Married to DH 10/6/12
TTC since 5/14
Unexplained with (controlled) hypothyroidism and suspected ovulatory dysfunction (but, I do ovulate on my own)
Clomid 50 mg 3/15 (unmonitored) - BFN
Clomid 50 mg + metformin 4/15 (unmonitored) - BFN 
First RE appt. 5/15; Natural cycle 5/15 monitored with 2 mature follicles and Pregnyl Trigger (full dose) + prometrium - BFN
6/15 HSG - clear tubes & normal uterus; great PCT test results
TI - 100 mg Clomid + prometrium (AM & PM) + vaginal estrace (AM & PM) 6-7/15 (monitored) --> no additional response and thinned lining - BFN
TI - Injectables (follistim + Gonal-F, Ganirelix, & 1/2 dose Pregnyl) + prometrium (AM & PM) 9/15 --> 3-7 mature follicles (3 definites and 4+ that could have matured due to trigger) @ O -->BFN + 5 large cysts
BC for 2 weeks due to cysts
TI - Injectables (Gonal-F, Ganirelix & full dose Pregnyl) + prometrium (AM & PM) 10/15 --> 1 mature follicle --> BFN 
TI - Last attempt at injectables (Gonal-F, Ganirelix & 1/2 dose Pregnyl) + crinone (AM only) + vaginal estrace (AM & PM) 11/15 --> 3-4 mature follicles --> BFP!! 11/27/15 @ 13dpo (shockingly, actually waited until then to test)

Beta #1 @ 16dpo (11/30/15) = 1,075
Beta #2 @ 19dpo (12/3/15) = 3,150
One baby: Saw heartbeat @ 5w5d (114 bpm; baby measuring 2.3mm)

"Great Things are Happening"
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Re: SA v. PCT?

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    GoldenKeysGoldenKeys admin
    Hmmm that's a good question.  Did your doc mention anything about the morphology of YH's sperm?  I'm assuming that if they were swimming well that it would be fine.    I kind of subscribe to the 'no stone unturned' camp because skipping over tests can lead you to some really expensive and unnecessarily long months of trying.   In the grand scheme of things an SA is cheap in comparison to the other stuff.

    That being said... your RE  *did* say that it was one of the best post coitals that he's ever seen, and since finances are an issue I don't think it would be a huge mistake to skip it.  IF your RE is cool with it, then I do think that you're good to go!


    Married for 7 years, TTC for 4 years
    dx:  Diminished Ovarian Reserve
    2 Clomid IUI's + 4 injectable IUI's= 5 BFNs and 1 mc




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    riveridgionalriveridgional member
    @GoldenKeys I am also in the no stone unturned camp as I would much rather have a more pointed and productive plan in place and think the more info, the better. My doctor did not say anything about morphology, and I've read that the sperm analysis can measure a lot more than the post-coital. The nurse I talked to yesterday was not the most helpful for my question. Luckily when I called today, I got one who could help a little better. DH and I decided to take August off, so the nurse is asking the Dr. if, given the few chances I financially have left, he would recommend getting an SA before proceeding with injectables. I do fully trust my RE as I have a lot of doctors in my family who did a little recon on my doctor and he came highly recommended. So, if he says it's not needed, I guess I'll go with it.

    Thanks for your thoughts. They are greatly appreciated! Once I hear back, I'll update this post just in case anyone else out there is in a similar situation with a similar question.
    Married to DH 10/6/12
    TTC since 5/14
    Unexplained with (controlled) hypothyroidism and suspected ovulatory dysfunction (but, I do ovulate on my own)
    Clomid 50 mg 3/15 (unmonitored) - BFN
    Clomid 50 mg + metformin 4/15 (unmonitored) - BFN 
    First RE appt. 5/15; Natural cycle 5/15 monitored with 2 mature follicles and Pregnyl Trigger (full dose) + prometrium - BFN
    6/15 HSG - clear tubes & normal uterus; great PCT test results
    TI - 100 mg Clomid + prometrium (AM & PM) + vaginal estrace (AM & PM) 6-7/15 (monitored) --> no additional response and thinned lining - BFN
    TI - Injectables (follistim + Gonal-F, Ganirelix, & 1/2 dose Pregnyl) + prometrium (AM & PM) 9/15 --> 3-7 mature follicles (3 definites and 4+ that could have matured due to trigger) @ O -->BFN + 5 large cysts
    BC for 2 weeks due to cysts
    TI - Injectables (Gonal-F, Ganirelix & full dose Pregnyl) + prometrium (AM & PM) 10/15 --> 1 mature follicle --> BFN 
    TI - Last attempt at injectables (Gonal-F, Ganirelix & 1/2 dose Pregnyl) + crinone (AM only) + vaginal estrace (AM & PM) 11/15 --> 3-4 mature follicles --> BFP!! 11/27/15 @ 13dpo (shockingly, actually waited until then to test)

    Beta #1 @ 16dpo (11/30/15) = 1,075
    Beta #2 @ 19dpo (12/3/15) = 3,150
    One baby: Saw heartbeat @ 5w5d (114 bpm; baby measuring 2.3mm)

    "Great Things are Happening"
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    AdorkablePixieAdorkablePixie member
    I'm guessing your doctor has already don't other needed tests such as the HSG and all that? If he thinks you don't need an SA, then he is probably right, especially if your post coital tests were all good.

    Me: 31

    DH: 29, SA - Great

    Married: June 12,2011

    TTC #1: 1/2014

    Diagnosis: Hypothalamic Amenorrhea

    Treatment: Clomid:  50mg, 100mg, 150mg - not successful and not monitored

                      Menopur 75ml (upped to 112.5ml), Ovidrel, & IUI  IUI #1 8/31/2015

    9/15/2015: BFP HCG - 400, 9/17/2015: HCG - 827, 9/21/2015 - HCG 3,327!
    Heartbeat 10/2/2015: 118bpm
    DS: 5/27/2016

    TTC# 2: 12/2017
    BFP: 4/20/2018
    EDD: 12/29/2018
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    riveridgionalriveridgional member
    Yeah, I had the HSG and all is good with that. The nurse asked my doctor for me re: any benefit of the SA given our PCTs. He responded that based on the PCT results, he believes there is less than a 5% chance that my DH has any abnormality. And, given the number of great sperm he sees in the PCT, it shouldn't be affecting our chances if so. He also sees no indication to do IUI at this time with my next cycle (injectables) since he believes it would be a waste of money (insurance doesn't cover anything for me).

    So, I'm just going to try one round of injectables and if that doesn't work, move on to IVF and hope if the first doesn't work we get large enough Christmas bonuses to help us do #2!
    Married to DH 10/6/12
    TTC since 5/14
    Unexplained with (controlled) hypothyroidism and suspected ovulatory dysfunction (but, I do ovulate on my own)
    Clomid 50 mg 3/15 (unmonitored) - BFN
    Clomid 50 mg + metformin 4/15 (unmonitored) - BFN 
    First RE appt. 5/15; Natural cycle 5/15 monitored with 2 mature follicles and Pregnyl Trigger (full dose) + prometrium - BFN
    6/15 HSG - clear tubes & normal uterus; great PCT test results
    TI - 100 mg Clomid + prometrium (AM & PM) + vaginal estrace (AM & PM) 6-7/15 (monitored) --> no additional response and thinned lining - BFN
    TI - Injectables (follistim + Gonal-F, Ganirelix, & 1/2 dose Pregnyl) + prometrium (AM & PM) 9/15 --> 3-7 mature follicles (3 definites and 4+ that could have matured due to trigger) @ O -->BFN + 5 large cysts
    BC for 2 weeks due to cysts
    TI - Injectables (Gonal-F, Ganirelix & full dose Pregnyl) + prometrium (AM & PM) 10/15 --> 1 mature follicle --> BFN 
    TI - Last attempt at injectables (Gonal-F, Ganirelix & 1/2 dose Pregnyl) + crinone (AM only) + vaginal estrace (AM & PM) 11/15 --> 3-4 mature follicles --> BFP!! 11/27/15 @ 13dpo (shockingly, actually waited until then to test)

    Beta #1 @ 16dpo (11/30/15) = 1,075
    Beta #2 @ 19dpo (12/3/15) = 3,150
    One baby: Saw heartbeat @ 5w5d (114 bpm; baby measuring 2.3mm)

    "Great Things are Happening"
    Report Reply
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    krbjoykrbjoy member
    @riveridgional Good luck! I hear ya. My insurance doesn't cover anything either. I am pretty tapped out at this moment. Those damn meds are expensive! And the cost was much more than the RA "estimated". Like doubled. I was kind of shocked. Oh well, it's only money, right? 
    Married for 4 years. TTC for 3.
    Me: 38 DH: 39
    DX: Unexplained Infertility; found a few fibroids this time around during SIS

    March 2012: Clomid for 3 cycles  3 BFNs
    Sept. 2013: started injectables (Follistim, Ovidrel Trigger) IUI BFN

    May 2015: New RE. Going IVF. Tests, Tests, Tests 
    July 2015: Microdose Lupron 20u am & pm, Follistim 150iu 75iu am, Menapur 150iu 75iu pm
    Triggered 8/4 ER 8/6 ET 8/11 2 beautiful blastocysts; 2WW
    8/19 hpt BFP! Beta 8/25: 482
    2nd Beta 9/1......3707
    U/S 9/21: 1 beautiful little gummy bear



    Pregnancy Ticker
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