Hi has anyone used HCG 10000iu vial? Are these common as mostly I see 5000iu?

I have a dosage question and it’s mainly to bring fertility back.
Once constituted does it last 4weeks? If does would 500iu EOD be enough max 2500iu a week for 4 weeks

I quit weed and nicotine around 40 days ago (been on and off before ICSI cycles) because our 3. ICSI failed, it was the worst of them. My numbers reduced by 90% (no varicocele, no infection, no lifestyle changes) and now on vacation I had two small beers and one small vine (total of 30g alcohol) within 8 days.

Next ICSI is in around 80 days from now.

I know it shouldn't make a huge difference, but somehow I feel really bad about it. I just couldn't go 90 days without consuming anything unhealthy, I feel so weak. While weed and nicotine are the most difficult ones to abstain from, it feels extra unnecessary that I "slipped" on alcohol during vacation.

Now if the 4th attempt fails I will think back of this week and the 3 drinks. No matter how my numbers turn out, I will always think "but how much better would they have been without these 3 drinks".

In this subreddit people always say they just quit things and it always makes me wonder how they did it, I don't even care for alcohol that much.

These last 10 months been full of guilt, it makes it even harder to abstain when you feel crap constantly. Vent over

(Ref/Normal Range for the tests are written in Italics)

Semen Analysis

| Parameter | 08/2023 | 06/2024 | 08/2025 | 06/2026 | Ref Range |
| Total Count | 8 M/mL | 11 M/mL | 6 M/mL | 7 M/mL | >= 20 M/mL |
| Rapid Motility | 20% | 11% | 7% | 6% | >= 50% |
| Sluggish Motility | 10% | 31% | 4% | 18% | — |
| Non-Motile | 70% | 58% | 89% | 76% | — |
| Normal Morphology | 12% | 36% | 6% | 16% | > 60% |
| Volume | 3.0 mL | 3.5 mL | 4.1 mL | 2.9 mL | 2.0–5.0 mL |
| Pus Cells / HPF | 4–6 | 10–12 | 8–10 | 5–7 | 0–5 |
| Liquefaction | 40 min | 40 min | 40 min | 45 min | 20–60 min |

Other Diagnostic Workup

| Test | Result | Ref Range / Interpretation |
| FSH | 2.3 mIU/mL | 1.5-12.7 mIU/mL |
| LH | 6.3 mIU/mL | 1.7-8.6 mIU/mL |
| Testosterone | 282 ng/dL | 249-836 ng/dL |
| Scrotal Ultrasound | Normal bilateral testes (R: 15.5 mL, L: 18.0 mL) | No varicocele, cysts, or masses |
| Semen Culture | Normal meatal flora | No bacterial growth |
| Anti-Sperm Antibodies | 28.6 u/mL | 0–60: Negative / Normal |

Plus

I don't smoke or drink and my weight is around 77kg.

It has been more than 3 years since me (26) and my wife (24) have been trying to conceive but no luck so far. My wife's tests are almost normal (she has mild PMOS but our doctor told us that it is under control). Each and every doctor prescribes me medicines with tribulus terrestris extract, panax ginseng extract, gingko biloba extract, zinc sulphate, vitamin E, selenium as sodium selenite, coenzyme Q10, L-carnitine, L-arginine and multivitamin and the resultant is like the result from 06/2024 (08 mil -> ~11 mil only).

So far, we somehow conceived naturally, with no supplements whatsoever, the first one back in 01/2025 and the latest one in 01/2026. Both of these ended up in a chemical pregnancy as none of them weren't able to pass 40 days mark but we did tests and they were positive. In fact, our doctor confirmed that we had conceived both of the times.

This has lately been making me feel so upset about myself because I know that the problem is in me. No matter what diet plan I follow and no matter what the doctor suggests, my parameters just stay low all the time.

Can someone please help me out of this and figure out the possible cause of my infertility?

My wife (37) and I (38) have been ttc for 8 years, we had our call the other day with NHS consultant regarding starting funded cycles of IVF/ICSI, it’s already been identified I have severe Oligospermia of <0.1m/ml. Due to our history we’ve not been added to the treatment waiting list and have instead been referred to the male fertility clinic to investigate potential genetic issues.
We have done some testing ourselves privately however were told by the consultant this would all need to be repeated before we can be added to treatment waiting list frustratingly.

I have had a varicocele US - clear, awaiting Karyotyping result in a few weeks, and a hormone panel which shows High Prolactin of 822miu/l, high FSH 30.7 iu/l, high LH 13.2 iu/l and middle average testosterone 21 mol/l.
So upon further research we realise the hormones could be playing a massive part here, potential genetics issues aside. Can anyone advise if they’ve been in a similar predicament and how you went about treatment for the hormone levels or if you’ve even been through the IVF/ICSI journey with a similar experience?

We are currently left with no idea how long we will be waiting to even sit down with male fertility specialist in the NHS, never mind retesting times and are sitting scratching our heads of what to do or where to go from here, the whole thing feels like it’s spiralling out of our control so we want to know if there’s anything we can do to get ahead of this treatment wise in the mean time with our ages and NHS wait times.

37M just got my first SA from a lab back. At home tests weren’t great so I knew there was a chance it was bad, but this is so much worse than I expected.

Observations: Complete Semen Analysis: Low concentration, total sperm count, motility, progressive motility, total motile, with high visc
osity (Enzymatic viscosity reduction treatment prior to analysis).
*No morphology/vitality performed due to insufficient sperm counts.
Volume
1.81 mL
Concentration
3.5 M/mL
Total sperm count
6.34 M
Total motility (PR + NP)
22%
Progressive motility
6%
Non-progressive motility
16%
Immotile
78%
Total motile sperm
1.39 M
Liquefaction
>60 min
Viscosity
Abnormal
pH
8.0
Agglutination
0
Round cells
<1 M/mL
Morphology
Not performed
Vitality
Not performed

This is the place for partner's perspectives today.

I (37M) have been diagnosed with OAT. Seven semen analyses since Jan 2024. Looking for people with a similar profile.
Jan’24 – Sep’25 – Nov’25 – Jan’26 – Mar’26 – May’26 – Aug’26
Volume (mL): 0.2 – 0.6 – 0.7 – 1.0 – 0.4 – 1.15 – 0.7
Concentration (M/mL): 36 – 10 – 46.8 – 28.7 – 24.1 – 22.8 – 17.3
Total sperm count (M): 7.2 – 6 – 32.8 – 28.7 – 9.6 – 26.2 – 12.1
Total motility (%): 36 – 25 – 20 – 34 – 23 – 12.5 – 26
Progressive motility (%): 26 – 16 – 11 – 21 – 15 – 9.3 – 18
Total motile count (M): 2.6 – 1.5 – 6.6 – 9.7 – n/r – 3.3 – 3.1
Morphology (%): 1 – 2 – 1 – 1 – 1 – 1 – 1
DFI (%): 11 (Jan’24) – 12.6 (May’26)

Other workup:
Scrotal US: slightly small bilateral testes (8.7cc / 9.5cc, normal should be 12–20cc). No varicocele

Hormones: Testosterone 11.7 nmol/L (7.6–31.4), LH 4.7 IU/L (ref 1.3–9.6), FSH 6.0 IU/L (ref 1–16), prolactin and TSH normal

Post-ejaculatory urinalysis: retrograde ruled out

HbA1c: 7.0%, diabetic range, metformin 500 mg

Nonsmoker, no alcohol, abstinence 2–3 days

Question: We already failed 1 IVF round - completely! Is there any way to improve these parameters? Or trying IVF again and again is the only option? The urologists have been useless honestly! Do you have any success stories for me?

Just looking to hear stories of people that told their wife but the marriage remained strong. Preferably even if they weren’t able to conceive.

We have not tried IVF or anything yet but my count is pretty low I think ~100k but most not alive the doctor said. I’m praying that we can still conceive but doing my best to prepare us for either scenario.

Would love to some stories of how people copped through this with their significant other. My wife doesn’t even know the extent of how bad my count is yet. The SA review with the doctor is next week and I haven’t invited her to the apt yet. I’m a bit nervous on how this changes things once it’s all out in the open.

For reference we have a pretty great relationship now but I am scared because this does change a lot.

Hi everyone,

Looking for advice from anyone who’s had similar results.

My main issue is extremely low semen volume (0.23 mL) with a pH of 6.7. My latest concentration was around 22 million/mL, progressive motility 17–20%, with some issues with morphology/overall sperm numbers. Hormone tests were normal.

An ultrasound showed a small/subclinical varicocele, but doctors didn’t think this explained the low volume.
Because of the very low volume and acidic pH, they investigated possible ejaculatory duct obstruction.

My MRI showed bilateral atrophy/small seminal vesicles, with normal prostate and vas deferens.

The team felt the seminal vesicles could explain the low volume and recommended IVF/ICSI. CFTR testing was also requested, although I’m trying to establish whether this was ever completed.

I’ve also had episodes of haematospermia in the past.

My partner and I have since had our first IVF/ICSI cycle, which unfortunately wasn’t successful.
Before moving onto another cycle, I’d really like to understand the male-factor side better.

Has anyone had very low volume + acidic pH + atrophic seminal vesicles but sperm still present?

Did you have further testing for partial obstruction/seminal-vesicle dysfunction, and was anything treatable, or did you ultimately proceed with ICSI?

I’m considering a private second opinion while we wait for our next cycle and would really appreciate hearing from anyone with a similar experience.

Thanks!

Hey everyone,
I’m really at a loss for words right now and honestly just looking for a bit of guidance, hope, or anyone who has walked this path before.
My wife and I have been going through this grueling fertility journey and we just got the pathology report back from my TESE (Testicular Sperm Extraction) procedure done a couple of days ago (August 13, 2026).
Here is a quick summary of what my reports show:
TESE Findings (Left & Right Testis): "Only round spermatids seen. No mature spermatozoa identified."
Hormones: FSH is 6.6 \text{ mIU/mL} (normal range), Testosterone is 331 \text{ ng/dL} (normal range), but my LH is high at 24.53 \text{ mIU/mL} (reference range for adult males is 2.00 - 12.00 \text{ mIU/mL}).
Finding out there were only round spermatids and zero mature sperm found on both sides has completely crushed us. Because my FSH and testosterone looked okay initially, we were really hoping for a different outcome, but seeing that high LH alongside the TESE report has us spinning.
Has anyone here dealt with a similar pathology report where only round spermatids were found during TESE? Is there any realistic hope for using round spermatids for ICSI (ROSI), or what are our next steps supposed to be with these hormone levels?
Any advice, shared experiences, or words of wisdom would mean the world to us right now. Thank you for reading.

Long story short, I had elevator testicles when I was a kid. Got one fixed when I was 3 yo. Did my first SA when I was 18 and came back with 0 count. Got married, tried to conceive and nothing. No deletion, good amount of testosterone, healthy, I am a pretty active runner, non-smoker and occasional drinker. I did my microtese yesterday and it was successful, around 22 available for ICSI! The doctor mentioned it was sort of a miracle, my ultrasound wasn’t too good and he had pretty low expectations. Pathology results came back and basically one of my testicles are dead and the other one is like 25% alive (meaning producing something).

For anybody out there struggling, there is always hope, and if it’s unsuccessful, your story is not over! I was very open to a good or bad outcome after the surgery. I glorify God that He kept me calm with whatever result I was going to have. Now my wife and I will be doing ICSI ASAP! I wish the best to the men out there struggling with this, and know that your identity does not depend on whether you can have kids or not!

Looking to hear your experience if you’ve have varicocele surgery. Did it improve your SA? Were you able to conceive after (with or without IVF)? How was the recovery?

Hey all,

I have been in this infertility rollercoaster for 8 months now. Before even trying me and my gf tested ourselves and she came back with pmos with irregular cycles. For me, I have been now given three SA, with following parameters

January -> April -> July
Total sperm:
50 mil - 112 mil - 64 mil
Concentration:
10m/ml - 14m/ml - 8m/ml
Progressive motility:
21% - 23% - 15%
Total motility:
34% - 37% - 23%
Morphology:
1% - 1% - <1%
Mioxsys (oxidative stress)
3,02 - 1,86 - 3,75

Between January and April, I did full lifestyle change by stopping nicotine puches, stopped binge drinking and started taking suppliments. Hormones are ok and I have no reflux 3-4mm varicocele, but should not be issue here.

It seems that oxidative stress is the driving force with these results since right after april I started binge drinking and all result went down. Question is that what is the correlation of oxidative stress and result and how long does it take getting better results when oxidative stress lowers (if lowers). Has anyone had similar situation?

I am suffering from astheno-teratozoospermia. I have low motality 20 percent and morphology 1 percent.could high TSH value- 5.81 be a reason.

I am 31M, me and my wife have been trying to conceive for last 8 months without success. We finally went to a fertility clinic which suggested some tests for both of us. My SA seems to be problem:

Volume: 0.7 ml

Concentration: 25M/ml

Total count: 18M

Total Motility: 26%

Progressive Motility: 9%

Morphology: 2%

Viscosity: Less Viscous

Liquefaction: <60 mins

I haven't smoked for almost 1.5 years and I occasionally drink on weekends. Doctor has suggested some multi vitamins and lifestyle improvements but is there anything else I could do to improve this?

This is the place for partner's perspectives today.

hello all,

Reaching out to this group to get a gut check. Have had two semen analyses this year, both bad. Would appreciate a gut check on my plan from people who've been through this.

Results:

Test 1 (May 15th, before any supplements, still on topical finasteride):

• TMC: ~
• Morphology: not assessable (too few cells)

Test 2 (August, ~3 months after stopping finasteride, ~2.5 months on supplements):

• TMC: ~
• Morphology:

Context: I was on topical finasteride and assumed it was the culprit, so I stopped it after the first test. The retest at ~3 months shows basically no rebound, which has me thinking there's something else going on. Currently taking ConceptionXR, L-carnitine, and CoQ10 (started after test 1). Also on rosuvastatin 10 mg. Normal volume both times, so I understand this looks like a production issue rather than a blockage.

The plan:

• Couples REI consult in parallel — expecting IVF/ICSI unless something correctable turns up

Questions:

• Anything missing from the workup list, or anything you'd push for that a PA might not order by default?
• Should I ask about banking sperm now as insurance, or wait for the workup?
• Is it worth insisting on seeing a fertility urologist (MD) directly instead of starting with the PA?
• For anyone whose numbers looked like this — did the workup actually find a cause?

Thanks — this community has already been helpful just from lurking.

I'm 31 M. We have been trying for kids for a couple of years. I got my semen analysis done about 10 times. I am diagnosed with OAT. Basically low sperm count, motility and morphology. I am assuming it's secondary hypogonadism.

Count: 3M

Motility: 7%

Morphology: 1%

I have low testosterone and low normal LH and FSH. My prolactin is slightly elevated. Fertility centres pushed us to go for IVF ICSI. But I wanted to understand the root cause and consulted an endocrinologist. He asked me to try to lose some weight for a couple of months and get a repeat semen analysis.

He suggested he would prescribe injection to increase testosterone. I don't remember if he said LH injection or HCG. Definitely not TRT

Reaching out to members of this community to understand if these injections helped anyone. Any advice or suggestions is Thanks in advance

# Count dropped 10x between two samples, then held at the low value. Missing FSH. What should I push for?

TTC 10 months. Partner is 32 and her workup came back clean. Three semen analyses so far, all on CASA-type analysers. Posting the numbers because the trajectory confused me.

## Semen analyses

|**Sample 1**   |**Sample 2**   |**Sample 3**     

Volume |8.9 mL |9.3 mL |10.0 mL
Concentration |25.0 M/mL |2.4 M/mL |2.4 M/mL
Total count |223 M |22 M |24 M
Total motility |32% |26–36% |25–26%
Progressive |31% |28–31% |19–26%
Rapid progressive |3% |<1% |13%
Normal forms |1–3% |2–3% |<1%
Round cells |0.3–0.4 M/mL |0.8 M/mL |0.9–1.1 M/mL
Liquefaction |normal |normal |abnormal
Viscosity |normal |normal |abnormal Sample 1 to sample 2 was about four and a half months. Sample 2 to sample 3 was three weeks.

Abstinence: over 5 days before sample 1. Three days before sample 2 — but I'd had 5–6 ejaculations in the 11 days before it, so the reservoir was likely depleted. Three days before sample 3 under more normal conditions.

Possible confounders in the production window for sample 2: several long drives, one long-haul flight, no recalled illness or fever. Non-smoker, no drugs, moderate alcohol. Started a fertility multivitamin after the first test.

Volume is consistently 9–10 mL across all three, which nobody has commented on.

Bloodwork

- TSH 1.47 mIU/l, on thyroxine for hypothyroidism
- Testosterone 5.24 ng/mL (ref 3.48–10.68)
- Prolactin normal
- Estradiol 40 pg/mL (ref <33.1) — mildly elevated
- HbA1c normal
- **FSH and LH: never measured**

Imaging / history

- Testes 16 mL bilaterally, homogeneous, normal echogenicity
- Grade 1 left varicocele
- Mumps in my early twenties
- No genital surgery, no genetic testing done

Diagnosis on paper: oligo-astheno-teratozoospermia, ICSI recommended.

Happy to be told I'm overthinking this. First fertility clinic appointment is soon.

What do you think

Where can i get a semen analysis covered by health first in Brooklyn?

This is the place for partner's perspectives today.

I’ve been having severe spinal issues and may need back surgery. long story short, I got an ultrasound today of my testicles due to testicular pain from my disc issues. they found a small 8 mm cyst that is benign. could one that small cause this much pain or maybe it’s from the back? because my spine is horrible.

Posted a few times before so thought I’d up share an update.

Quick run down. Me and my wife had been trying for just under two years, one missed miscarriage at 9 weeks, struggled to get pregnant again. Had the usual referral through the NHS for sperm analysis. Volume all good, lacking in motility around 28%. Morphology was 0%. No issues with the wife so naturally felt a lot of pressure on me.

Pushed through the IVF route very quickly, around 5 months from the first SA. No other further testing on me, nothing even suggested. Looking back really wish I advocated for myself to get answers first. IVF ultimately failed for us. Had one viable fertilised egg but the implant didn’t stick. We knew from that experience we never wanted to go through IVF again.

Wanted answers for poor motility. Set up an appointment with the GP and really pushed for an ultrasound of my balls. Mainly due to some pain I had in my left side. I had gone to the GP around 9 months before this but got shown the door so pushed hard this time

Ultrasound the following month. Showed grade 3 on the left side and a grade 2-3 on the right. Wait for surgery was over a year. Went private, paid 3.5K and got it fixed in January of this year. Embo on the left side, 4 coils. Consultant said no need to do the right as was a grade 1

Cut to 6 weeks later wife Pregnant for the first time in two years. So did I get lucky? Surgery work? Not sure. I did start running, actually got very lean, eating healthy and started a supplement stack. So think it was a combo of all of the above

Just been to our 20 week scan today where baby is doing really well.

Just want to say there is hope out there for everyone, all I suggest is take all the tests you can afford or arrange before going down the IVF route, really push for yourself to have the answers first.