If we cannot conceive naturally, it’s good to know which options we have in the world of artificial reproduction treatments (ART).

When we are confronted with the fact that we are not able to have a child in the natural way, we are directed to a fertility center. At the clinic it’s easy to get overwhelmed with all the new information we have to take in. As beginners, we didn’t even know which are the ways to consider or what are the differences between the different forms of fertility treatments. The most commonly known fertility treatment is IVF, but it’s not the only one. But which are real options for us, and which direction should we take?

"We also have to talk about the classic in vivo fertilization. Simply put, have sex because anything can happen at any time."

The first two are relatively simple solutions to treat infertility, such as Planned Intercourse and Artificial Insemination.

The simplest fertility treatment is called Planned (or Timed) Intercourse. In this procedure a mild ovarian stimulation can be involved, promoting the growth of 2-3 follicles ideally. If the follicular growth is optimal (the doc checks it though ultrasound), ovulation can happen naturally or can be provoked by a trigger injection. By the end of the process the doctor will determine the days when it is most recommended to be together (have sex). This is a relatively natural fertility solution with some extra help. I think it’s an option for couples with good test results.

The second option is Artificial Insemination. The treatment starts with hormonal ovarian stimulation, and followed by a trigger injection. Even the most fertile days are determined by the doctor. However, the fertilization doesn’t take place by natural intercourse. By the end of the stimulation phase the male partner is asked for sperm collection. Sperms that have been washed and concentrated are placed directly in the woman’s uterus, cervix or fallopian tubes around the time the ovaries release one or more eggs to be fertilized. Insemination is usually recommended when everything is fine with the sperm and the woman’s fallopian tubes (or at least one of them) are permeable. The procedure is completely painless, it’s less expensive compared to IVF, but the success rate is lower: only 15-20%.

The next option is IVF (In Vitro Fertilization), which I think is the most known fertility treatment type. The main difference compared to the previous treatments is that the fertilization happens outside the body – ‘in vitro’ means ‘in a test tube’. The procedure is longer, more expensive, more complicated and involves a higher hormonal load than insemination.

What are the main stages you are going to undergo during an IVF treatment?

1. Ovarian Stimulation. The goal of ovarian stimulation is to achieve multifollicular development by administering daily hormone injections, hoping more follicles, more eggs will be available for fertilization. There are several different medication protocols in use to achieve this. In the case of short protocol, the stimulation starts on Day 2 or 3 of the menstrual cycle, and takes about 7-11 days. The long protocol can take up to 4 weeks. It starts on Day 20 of the menstrual cycle with a 10-day long medication which helps to shut down the ovaries first. In step two the same ovarian stimulation starts as in the short protocol.
2. Trigger Injection. If the follicles are sufficiently mature, the Trigger helps the growth and maturing of eggs.
3. Egg retrieval, and Sperm Collection. 36 hours after the Trigger Injection the Egg Retrieval is going to take place. Using ultrasound, the fluid containing the eggs is collected from the follicles through the vagina with a needle. At the same time sperm is collected from the male partner.
4. Fertilization. After collection, the eggs and sperm are cleaned in the embryologist’s laboratory, then a group of sperm is put together with the eggs to be fertilized. Practically the same thing happens in the incubator as in nature. There is no special intervention, they just organize a date between the eggs and sperm.
5. Embryo development. The fertilized eggs spend 3-5 days in a special incubator at the embryology lab. The embryo divides and multiplies its cells. The embryologist selects the most viable embryo(s) for transfer by the end of the process.
6. Embryo transfer. 3-5 days after fertilization, the most viable embryos are transferred back to the uterus with a simple, quick and painless procedure.
7. 2-week-wait. The time period from embryo transfer to pregnancy test. If all goes well, implantation takes place during this time, and the embryo attaches to the uterus lining and continues its development there.

It’s also good to know about ICSI (Intracytoplasmic Sperm Injection), as a special type of IVF treatment. It is practically one of the methods used in egg fertilization. It is usually recommended when sperm quality is not the best, or only a few eggs are available for fertilization. During ICSI procedure the embryologist selects the most beautiful and healthiest sperm and injects it directly into the egg. This can increase the chances of successful fertilization.

We also have to talk about the classic in vivo fertilization. Simply put, have sex because anything can happen at any time. We can meet a million wonderful stories; I also have several close friends who once had a baby arriving magically. Yet they had a paper about that impossibility. Never give up!

IVF is an emotional roller coaster that we have to be prepared for not only physically, but also emotionally. In my opinion, we do not speak about this particular side of IVF enough.

My partner and I are new to the world of IVF, but we are completely aware that this journey will be full of emotional ups and downs. The fact that we do not even know what is going to happen to us during the process or what the outcome will be… it just does not make it any easier.

Instead of listening to others, focus on listening to your own body and soul.

The whole process of preparing for our first IVF cycle looked quite fascinating, and, surprisingly, simple at the same time, especially the technical side of it. However, we do not know how we are going to react to the treatment itself and how we are going to face all of the upcoming challenges. But most importantly, what is the outcome going to be?

It feels impossible to prepare for everything. However, there are two things that are extremely important in order to get through all of the challenges together: a solid foundation in a relationship and, above all, communication. Talking about feelings, fears and even doubts in these new, unknown life situations with maximum understanding and open minds is key to tackling them together.

We visited a specialist who handles the emotional side of infertility and fertility treatments. We had sessions individually and together as a couple. It was very liberating for me to speak openly about my feelings, especially when discussing my fears. The therapist and I discussed all the emotional phases that me and my partner are most probably going to face during the treatment. It still feels like a very abstract way to describe what lies ahead of us, but at least we got another guideline that can help us get through all of it. By the end of our sessions, we built a list of some great suggestions and tips for our upcoming journey. These are not magic tricks but they can probably be useful for anyone who is on the same path as us.

1. Instead of listening to others, focus on listening to your own body and soul
2. Try to limit the use of Google. Chances are that googling will only add to your stress.
3. Plan your days ahead. This can help you to reduce anxiety and stress
4. Go for a walk or perform light exercise, such as yoga. Your body will produce dopamine and release endorphins. These are known as “happy” hormones and they have the ability to lift you up when you are feeling down.
5. Try to do something creative every day. Activities such as painting, drawing, colouring or even baking can increase positive emotions, reduce stress and decrease anxiety.
6. Keep a diary. Writing your feelings down on a page will help you express yourself better. Journaling can also help you reduce stress and prioritise your fears and concerns.
7. Learn how to relax. Meditation is a great way to harbour self confidence and improve stress and anxiety, which can be a part of the IVF process.

The chances for a successful IVF can be significantly increased with a well-prepared body and mind. Let’s focus on our body first.

Until now, I was a little bit confused by the technical process of IVF, and to be honest, I did not think much about what I can do to increase our odds of success. We spent most of our time and energy on finding the right clinic, choosing the best doctor, getting all of our tests done in time, but do we know how to prepare our body to become the perfect place for our future baby?

Do your best but take it easy. Do not make any major or significant changes during this time, like going gluten free, vegan or start training for a Marathon if you were not doing so already. We do not have to be superwomen (because we already are). We just have to try to do our best.

As I just recently learnt, preparation of the body is as important for IVF as other stages of the fertility treatment. Preparing the body should begin 4 to 8 weeks prior to the start of the actual IVF cycle. This means that it is not enough to start living a healthier lifestyle at the beginning of the actual treatment.

A well-prepared body may tolerate the IVF treatment better. It could have a great impact on the egg quality, as well as our hormonal environment, which can result in a significant increase in our odds of a successful fertility program.

I found some helpful tips that could be beneficial for all of us ladies going through fertility treatments:

1. Use your diet as a fertility booster

Starting now, eat healthy, balanced meals. The following tips can be obvious for some women, but to be honest, not all of them were obvious to me, so it is helpful to address them again:

Say goodbye to processed foods and focus on clean eating as much as possible

Fill up on fresh fruits and vegetables. Leafy greens are especially good for us

If you are a meat lover, stay away from red meat and choose free-range chicken and wild caught fish instead.

Avoid refined grains, and try to incorporate whole grains, such as quinoa and whole grain pasta.

High protein diet is very favourable. Opt for beans, chickpeas and lentils in your diet

Switch to full-fat dairy products. Greek yoghurt is an excellent choice.

Eat healthy fats, such as avocado, extra virgin olive oil, nuts and seeds

Try to limit your salt intake. Flavour your food with herbs and other spices instead

2. Vitamins

The selection of your vitamins and minerals should be discussed with your doctor. Your provider will tell you exactly which vitamins and other supplements you should take based on the results of your blood tests. I had to start taking vitamin D, which plays a significant role in fertility by acting on the ovaries and the endometrium, as well as folic acid, which is an important vitamin for both men and women who are trying to conceive. Aside from these three supplements I have decided to take vitamin C to boost my immunity, and CoQ10, which helps the eggs to stay healthy. My advice to you is to invest in high quality vitamins if you decide to start taking any.

3. Smoking, alcohol, caffeine

All of us probably know that drinking alcohol and smoking cigarettes is not a good idea while trying to conceive, so I do not feel like it is necessary to discuss this topic. However, what should we do about caffeine? Excessive consumption of caffeine has a negative effect on female fertility, so keep your caffeine intake below 200 milligrams a day, which includes your coffee, tea and soda drinks consumption. 200 milligrams is equal to two mugs of tea (350 ml), one mug of filtered coffee, two mugs of instant coffee, five cans of cola or two energy drinks.

4. Get enough sleep

Sleep and fertility are closely connected. A 2013 study on sleep and fertility found that the pregnancy rate for those who sleep 7 to 8 hours every night was significantly higher than those who slept for shorter or longer durations. A hormone called melatonin regulates both sleep and reproduction. It peaks between 9pm and midnight, therefore the ideal time to fall asleep would be between 10 pm to 11 pm.

5. Workout

Too low or too high levels of BMI (body mass index) can have a negative impact on fertility, therefore it is important to keep active to achieve and maintain a healthy BMI. Taking part in moderate exercise regularly can help boost your fertility. Walking, jogging, yoga and Pilates can be a fantastic choice of exercise, if you are not a sporty girl like me. It is recommended to be active at least 30 minutes a day, and taking a 10 minute walk three times a day definitely counts!

+1 Just do your best!

It’s time to take our part of the fertility journey: let’s boost the little guys.

There are very few men left on the planet who don't need any help to boost their fertility. I am not one of them, so I decided to do as much as possible to improve my sperms’ health. I am going to have very little to do during our IVF program compared to my wife, so this is the least I can do to increase our chance of success.

"With any positive changes, we can do a lot to consciously improve our fertility."

Let’s continue to learn more factors which can affect the health of our sperms and male fertility.

1. Ideal weight: Both too much and too little fat have a negative effect on hormone production, and sperm health and count. Moreover, in overweight men, fat pads warm the testicles, and as we learned, sperms don’t like heat. Weight is something that we cannot change overnight. Making a significant and healthy change on it, can take months (sometimes even years). Losing or gaining weight should be part of a well-planned preparation. I have 4-5kg extra weight on me, and it is impossible to lose (in a healthy way) in 4 weeks (at least for me).

1. Caffeine: The most popular stimulant. That's how I start the day every morning. But keep in mind that energy drinks and cola also contain caffeine. Funnily caffeine can be a double-sharp weapon. In a small amount it stimulates sperm production in small amounts. Great news! However, in larger quantities, it can be one of the causes of sperm deterioration, and also can reduce its quantity. Another important fact that is important to remember, that beverages that contain caffeine, have diuretic effects and may cause dehydration, which is not good at all when we try to conceive. I am a coffee lover but fortunately I am not a big fan of energy and soft drinks. So, it will be easy for me to be a good boy on this.

1. Exercise: Sport is one of the best things in the world if you do it within normal limits. It relieves tension (so you can reduce stress), creates good conditions, and makes you balanced. It can help you reach your ideal weight as well. But you don't want to be Schwarzenegger for now. Do not touch anabolic steroids, muscle and weight gainers. Firstly, your testicle can get smaller (you will look stupid), secondly, you can even reset your sperm count with them.

1. Toxins: Unfortunately, improper nutrition already delivers a lot of toxins into our bodies. We can come into contact with many toxins at work and home (solvents, cleaners, pesticides) as well. Try to avoid them if it is not possible, or at least use appropriate protective equipment.

Obviously, there are many things listed above that are difficult to change. These are just some important factors – at least - to be aware of. With any positive changes we can do a lot to consciously improve our fertility. And if we were “accidentally” keeping these lifestyle changes for the long term and living healthier by the way, we could hold not only our own child, but hopefully even our grandchildren in our hands. Is it enough motivation? Is there more motivation than that?

Step 1 of preparation: speak the IVF language.

I believe that self-education is a very important step for IVF preparation. You can find plenty of articles and studies to read. One topic is going to lead to another, giving you endless information about IVF and all its details.

"To be honest, it was very difficult for me to understand the comments at first, because of these almost code-like short form terms. It is like a secret language which is spoken by our special community only."

Visiting fertility or IVF forums can be really helpful as well, and these are a great source of information especially for a new bird like me. It helps me to know what is going to happen with me, and I also can gain knowledge from other’s experience (and sometimes learn from other’s mistakes, for example: why don’t take a pregnancy test too early).

I don’t know how much time you have spent on IVF or fertility blogs, but if you have visited at least one, you might have noticed that it’s full of acronyms. To be honest, it was very difficult for me to understand the comments at first, because of these almost code-like short form terms. It is like a secret language which is spoken by our special community only.

To make the life of the new birdies – as myself – easier, I decided to collect the basics of the IVF vocabulary. Have fun, learn a lot, educate yourself!

2WW: 2 weeks wait (from embryo transfer until pregnancy test)

AF: Aunt Flo, Period, or Menstrual Cycle

BCP: Birth Control Pills

BA: Baby Aspirin (low-dose aspirin to improve chances)

BD: Baby Dance (sex)

Beta: HCD pregnancy test

BFN: Big Fat Negative (negative pregnancy test)

BFP: Big Fat Positive (positive pregnancy test)

CB: Cycle Buddy (someone who is on IVF at the same time)

CD: (menstrual) cycle day

DE: Donor Egg

DH: Dear Husband

DI: Donor Husband (sperm donor)

DPO: Days Post-Ovulation

DPR: Days Post-Retrieval

DPT: Days Post-(Embryo)Transfer

DP5DT: Days Post 5-Day Transfer

DW: Dear Wife

EPT: Early Pregnancy Test

ER: Egg Retrieval

ET: Embryo Transfer

Frostie: Frozen Embryo

FSH: Follicle-Stimulating Hormone

HCG: Human Chorionic Gonadotropin (pregnancy hormone)

HPT: Home Pregnancy Test

HX: History

IF: Infertility

IUI: Intra-Uterine Insemination

IVF: In Vitro Fertilization

LMP: Last Menstrual Period (first day)

LSP: Low Sperm Count

MC: Miscarriage

MF: Male Factor

O, OV: Ovulation

OB/GYN: Obstetrician / Gynecologist

OHSS: Ovarian Hyperstimulation Syndrome

PCOS: Polycystic Ovarian Syndrome

PG: Pregnant

PMS: Pre-Menstrual Syndrome

POAS: Pee On a Stick

RE: Reproductive Endocrinologist

RPL: Recurrent Pregnancy Loss

SA: Semen Analysis

S/S: Signs/Symptoms

TTC: Trying To Conceive

TX: Treatment

US: Ultrasound

WNL: Within Normal Limits

How you can improve sperm quality and quantity with some changes in your daily life and habits. Beware, you might notice positive changes in other areas of your life as well.

If you are like me, you never really paid attention to your sperms (I mean in a scientific way). It completely changed when I received my sperm analysis result, and it’s not too great a number. I felt like it’s time to learn more about them (especially when it comes to their parameters).

"Studies show that a smoker has 15% less sperms compared to a non-smoker, and more lazy sperms with abnormal shape."

I read about many factors which can cause sperms with abnormal shape, not enough quantity or pure concentration. BUT I also learned that actually there are many things that I can do, and make improvements on these parameters. These are mainly lifestyle changes, and most of them don't cost too much, I just need to pay a bit more attention and be willing to change.

1. Smoking: I was a heavy smoker for 15 years, but I quit 15 years ago though. I know exactly how hard quitting is. (This is not the easiest lifestyle change, I know, but I wanted to start with the most difficult one.) BUT you have to know smoking has a huge negative impact on the quality and quantity of your sperms. The problem is mainly caused by the nicotine (so electric cigarettes are not really an option either). Studies show that a smoker has 15% less sperms compared to a non-smoker, and more lazy sperms with abnormal shape. SMOKING + ABNORMAL SHAPE + LAZY SPERM = NOT IDEAL!
2. Alcohol: At this point I started to be worried a bit (I love red wine). Actually, I don’t have to be abstinent (a big release!), I just have to be careful with the quantity. 2-3 glasses of wine or beer weekly won’t do a huge harm on my sperms. A bigger dosage of alcohol would lower the chances of my boys, because they can have an abnormal shape and a smaller army in numbers. It sounds doable to me.
3. Drugs: I cannot share any personal experience about this point, but what I learn for sure: they don’t do any good for our hormones. They can reduce our testosterone level, have a negative effect on the shape of sperm, and the sperms go nuts (as you do) if you are on drugs (I don’t know what does it mean exactly, they might move too fast?).
4. Heat: It never even would cross my mind. Using my laptop on my laps, or enjoying the comfort of the seat heating in the car actually can overheat my sperms. They don’t need too much heat as they are super sensitive. If they get some extra, unwanted heat on their outer layer, it’s enough for them to die. Riding a bicycle, spending time in a sauna can also cause extra heat. It is also better to switch from hot baths to showers for the health of our sperms. I think here I am going to face some difficulties (laptop usage, love of hot baths and bicycling).
5. Stress: I know, it’s easy to say, do not stress these days. At least be aware that too much stress has a huge negative impact on every area of your life. Speaking about sperms: it decreases the concentration, makes them lazy, and will affect the shape as well. So, just take it easy!

There are still a few possible lifestyle changes I would like to share with you in my next articles, but I find it easier to take these changes step by step.

How we won an extra month for IVF preparation. Always see the bright side.

While waiting for the second beta-HCG test unfortunately my period arrived. Of course, I was still hoping that all could still be alright, as you can find many stories of successful pregnancies of women having periods while pregnant. Unfortunately, my blood test confirmed later that the HCG level dropped, meaning the pregnancy ended.

I really needed some time to digest what just happened....

"According to Dr. Lauren Averbuch study, 30-50% of women have had one chemical pregnancy in their fertile years, but many women don’t even know about it if they don’t take a pregnancy test."

The pregnancy was real, that’s for sure. Which is amazing news, because it means I am able to conceive, we are able to make a baby.

I had a ‘chemical pregnancy’, also called a ‘very early miscarriage’, which happens on the fourth or fifth week of pregnancy. Actually, chemical pregnancies are fairly common. According to Dr. Lauren Averbuch study, 30-50% of women have had one chemical pregnancy in their fertile years, but many women don’t even know about it if they don’t take a pregnancy test. This type of miscarriage is usually caused by some kind of chromosomic, genetic abnormality of the developing embryo. It’s somewhat comforting that in almost all articles I read about this topic it was clearly written that it cannot be my fault, I could not do anything to prevent it. I decided to believe it, and not to carry the anxiety with me.

When my period ended, I paid a visit to my doctor. He confirmed that he cannot see anything to worry about. Everything is in great order inside and my uterus lining started to build up again. New month, new chances. ☺ He gave me three good reasons to be positive:

1. This unexpected pregnancy confirms that we are able to have a baby. The egg of mine and the sperm of my husband were happy to meet, and they are ready to cooperate.
2. Because of the hormonal changes caused by the pregnancy, we have a higher chance to conceive again in the next few months.
3. If we are ready, we can start our IVF treatment by my next period.

As we have to wait one more month to (finally) start our first cycle, we decided that we are going to use this extra time for some preparation, and boost our bodies and minds as much as we can.

TIP: Don't drive yourself mental during your fertility journey by getting a diagnosis of your symptoms by Dr. Google. Don’t do this to yourself.

More and more men are affected by fertility problems. Why is this topic not spoken more about?

To make it short, on the second consultation, we got the green light from the doctor to go for IVF, as our only one chance of having a baby. Actually, the plan was that in a week or so, we will start our fertility treatment.

"It never crossed my mind before how much I can do to improve my reproductive health. To be honest, it did not cross my mind either that I have to do anything for it."

As you could read in my previous article, I am going to face our first IVF cycle with my ‘not too tragic’ but ‘not great at all’ semen analysis result. After the stage of ‘Unbelievable’, I entered the phase of ‘Acceptance’, then I started to think about how I can improve my result.

I dived into the world of ART (Artificial Reproductive Treatments), and came across my new favorite word: fertility awareness. We hear about many different awareness and consciousness, but the term ‘fertility awareness’ was completely new for me. It never crossed my mind before how much I can do to improve my reproductive health. To be honest, it did not cross my mind either that I have to do anything for it.

Fortunately, the sperm production is continuous in our body, and takes approximately 3 months to create a completely new army. It means that with some changes in our diet, lifestyle, and habits, we can do a lot for sperm who will be formed in the future. Of course, this cannot happen overnight. It takes about 3 months to notice significant improvement on the result.

Unfortunately, in my case, I had too little information about this topic, and too little time left for big improvement or to correct my bad result. But, of course, it didn’t discourage me to start some changes, because – I believe - every journey starts with one step.

It would be great if this information wouldn’t reach only those couples who are already participating in IVF programs. It’s scary to read that there’s a tendency for men’s fertility to deteriorate from decade to decade, and moreover, typically, men don’t like to test and face it. How much easier it would be to avoid a lot of setbacks, stress and sometimes relationship problems that come with fertility failures. Fertility awareness is all about avoiding these above.

Edit: Our IVF cycle is postponed, because a little miracle happened. Who knows how, but we were able to conceive naturally. We had a chemical pregnancy, meaning that one of my sperm was able to fertilize an egg naturally, but unfortunately the implantation was not successful. This is proof: we can do it! ☺ We have to wait a month to start our fertility treatment, which also means that I gained an extra month to improve (even a bit) my sperm condition.

Stay positive on the journey, because it’s pretty sure you are going to face some unexpected situations.

As we got the ‘green light’ from the doctor to start our IVF treatment, we don’t have anything else to do just to wait for my period to start, and on the first day to contact the clinic.

"And BOOM! There are two famous lines, the first time in my life. "

It’s the first time in my life actually waiting for my period to arrive. I am sure you know the feeling when you are actually sure your period just started, but nothing happens. I started to have these pre-menstruation symptoms (PMS) one week prior to my normal time. Thanks to my Period Tracker, I know when she should arrive.

Four days before my expected time, I noticed some spotting, which made me super happy as it is a good sign: my period is going to start the same day or next day at the latest. But the following day nothing really changed. I was running to the toilet every 30 minutes to see if there's any change, but all the same. It’s still the same spotting or super-duper light flow, what can be my period, even though it’s absolutely unusual for me.

I don’t want to make any mistake and risk that I don’t start the stimulation in time. I don’t really care if the doctor is going to think I am an idiot and not be able to tell if I am menstruating or not, so I decided to pay a visit to the Clinic. I must be not the first one with this ‘stupid’ question, because my doctor doesn’t give me any strange look. ☺ He does a short ultrasound test on me, and confirms that it’s not my period yet, and we have to wait until the normal flow. (Hopefully I will be able to recognize what ‘normal’ means, but I will try my best.)

The next few days were nerve-wracking. The day of my expected period arrived, but still all the same, and so on the day after.

I really don’t know why, but I got a stupid idea stuck in my mind: I should take a pregnancy test. I ran to the closest pharmacy, bought a super sensitive test. I took it with absolute peace of mind, because as the doctor confirmed a week ago, there is no way that I can be pregnant. And BOOM! There are two famous lines, the first time in my life. I am shocked, and so is my husband. I cannot believe it! I know that it is almost impossible to have a false positive test, but I need a second opinion. Fortunately, there’s a lab close by, where I can get a beta-HCG blood test done today, but I have to wait for the result till next morning.

The difference between home pregnancy test and blood test is that the blood test can detect a smaller amount of HCG (pregnancy hormone) compared to a urine test. The result of the blood test is also more accurate, because the lab test result shows the quantity of HCG hormone found in the blood.

If there is something that I really cannot deal with is the: uncertainty. I never got pregnant in my life before, and now - just a few days before our IVF treatment to start - I (most likely) am.

The next morning finally, we received my result via email: I do have HCG in my blood, so I am PREGNANT, but the level is low. I called my doctor, but unfortunately, he cannot help me too much... He confirms that there is a pregnancy detected, but hormone level is low (which doesn’t mean too much). He asks me to take another test in 3 days, as the HCG should double by then, and will give us more information.

This day leaves us with more questions than answers.

How I learned that sperm analysis isn’t about getting a certificate about my fertility superbness, but showing me there’s room for improvement.

On the next consultation with our doctor, unfortunately it became official, which was only my guess until then: the result of my semen analysis is – let’s say - not ’the best’. The doctor pronounced it clearly: I am involved in our fertility journey as much as my wife is. I am the other 50% in the formula, and the reason why IVF is our only way of having a child together. It didn’t break me, but it was not a comfortable feeling either. I needed some time to digest the situation. I read a few studies about the fact that male fertility has become a bigger problem these days than female fertility. Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side. Studies also show that men’s sperm count dropped, and the capability of fertilization decreased drastically (to its half) over the last few decades in Europe. It surprises me, because if it’s really such a big, common problem, why don't we speak / know more about this?! Knowing that I am definitely not alone with this problem helps me put my mind to ease but it still bugs my ego.

Anyway, let's see what a sperm analysis is about, and my result?

"Most of the studies say that minimum 30% (some of them say up to 50%) of infertility problems come from the male side."

1. During the test, they measure the volume of the semen. The normal parameter is 1.5-6 ml (I had 5 ml, so I was OK with this part). This factor is important to show us how big our army will be to start with.
2. They also check on its pH. The ideal value is 7.2 (slightly alkaline), but it is considered normal between 7.2-7.8. (Mine was 8.)
3. They also check on the motility of the sperms, which is significant because they have to take a long way to reach their goal. If we calculate from the total sperm count, at least half of the little fighters should have good movement. In my case, the progressive motility (when the sperms move in a straight line along a large-arc circle) was 50% (this is ideal). My non-progressive motility value (when sperm moves along a small-arc circle) was 5%. 50% + 5% = 55% in total (which is ok!). I’ve never been a great dancer, but at least my spears are moving well.
4. Sperm concentration and sperm count are also determined. Sperm concentration shows how many sperm are present in 1 ml of semen, and sperm count shows the total number in the whole ejaculation. These indicators are changing so mournfully, that an acceptable normal minimum value is no longer even set. The WHO (World Health Organization) has recently given the normal values at 15 million / ml and 39 million / sample. I had 10 million / ml and 50 million / ejaculation, which are not particularly good values.
5. They also examine the morphology of the sperms (if the sperm head is in the right shape or size). The sperm head, for example, plays an important role in breaking through the egg wall to be able to fertilize it. According to the WHO numbers, at least 4% of the sperms should be in formal order (unfortunately, this was only 2% for me). Interestingly, I also came across a study that showed that 29% of men with 0% normal-shaped sperm were able to fertilize an egg in the natural way (not with IVF). So, sperms with abnormal head shape doesn’t mean that there’s any genetic problem with them.

The official diagnosis of seeing all my numbers together was: oligo-teratozoospermia. Meaning I have reduced sperm count and low sperm motility.

However, there is a significant advantage for men over women. While the number of eggs is given at birth, and from then this number decreases and then runs out, in men the sperms are renewed cyclically. The process of sperm formation (spermatogenesis) takes 74 days. (Because we cannot know which part of this cycle we are in, it is better to calculate with 3 months). Meaning: in most cases, men have a chance to improve their ‘sperm situation’ in three months.