Thursday morning, Terra got her period. She asked to come in and talk to me on Saturday to review the plans for this month. When she came that day, I also did an ultrasound which confirmed, as expected, that there were no mature follicles growing. Both ovaries were quiet. This came as no surprise, as it was D#3 of her cycle, a time before any significant follicles are seen. Her lining was very thin. Again, this was no surprise as Terra described her flow as being the heaviest the day before. The reason her lining was thin was because all the previous lining had bled away and it would be another two weeks before the lining rebuilt back to it’s optimal thickness.
After their first office visit, Terra’s husband had done his semen analysis. While someone from our office had called her immediately to tell her the results last week, she was eager today for an in-depth discussion on the implications of the results. Ironically, her husband had gone golfing rather than be present for today’s discussion. Terra said she didn’t mind because he had old friends from out-of-town and this was a special occasion for him. Besides, he had asked her permission. She told him to have a good time with his friends and she agreed to get the information and relay it to him. His results were as follows:
Volume 3.0 cc
Count 96 MILLION per cc
Motility: 50%
Morphology 70%
Sometimes, people think of a semen analysis as an ultimate test that will tell them without a doubt whether a man can father a pregancy or not. This is not true. Rarely do we get an absolute answer. While it’s true that a man with a 200 MILLION count and 80% motility almost for sure has sperm that is functional, there is still that rare chance that he has some unusual genetic defect that renders the sperm incapable of fertilization, even though the numbers sure look good on the surface. On the other extreme, we can have a man with a 5 MILLION count and 10% motility. While this gives us a strong suspicion that the sperm is a problem, it doesn’t rule out the possibility that he could still naturally initiate a pregnancy. The chances are low, but still not impossible.
So in general, an average count is about 70-250 MILLION per cc. Counts under 40 MILLION per cc would be in the low-normal range, while those under 20 MILLION per cc are officially considered abnormally low (according to criteria set by the World Health Organization).
So Terra went home and waited for Miles to return, so she could tell him the good news that his count and motility were in the normal range. Terra was scheduled to come back on D#9 of her cycle for another ultrasound. She would also have her HSG that day to answer the question of whether or not her tubes were clear.
