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Infertility and Reproductive Medicine Moderated by Scott Roseff, M.D.


Meet Scott Roseff, MD Reproductive Endocrinologist
Dr. Roseff offers cutting-edge fertility testing and treatments in Boca Raton, FL. He believes that patient care should be individualized and compassionate. Dr. Roseff has supported INCIID consumsers for more than a decade. He goes above and beyond the norm for his patients. Dr. Roseff is a proud supporters of the INCIID IVF Scholarship Program.

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Old 03-16-2009, 02:23 PM
HopeforSuccess2009 HopeforSuccess2009 is offline
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Default Sperm Morphology/Pycnogenol (ments)

I'm looking for some advice on methods to improve sperm morphology. By way of background, I'm 34 and my husband is 35. We conceived our first child easily but now have been TTC our second for 13 months without success. I've had standard testing (CD3 bloodwork, ultrasound, post-coital, HSG, endometrial biopsy) and everything has been normal. I chart and use a fertility monitor and all factors show that I ovulate every month, although with a luteal phase of 11-12 days. My husband's first sperm analysis came back "on the low end of normal" but we were not given exact numbers. We saw an RE for the first time last month and it was recommended that he repeat the sperm analysis but that we plan on moving forward w/ Clomid (50 mg)+ Ovidrel + IUI as soon as that is done and we feel ready. In the meantime, he's been taking FertilAid for Men and I have been taking a prenatal and doing acupuncture and yoga.

His most recent sperm analysis came back as follows:

volume: 6.8ml (>2ml norm)
Concentration:39 mil (>20 mil norm)
Motility: 67 % (>50% norm)
Total motile sperm: 178 (>8 norm)
Morphology: 6% (>15% norm)

We were told that everything was normal except for the morphology, which was 'low,' but with his other numbers still made for a 'normal' result, and that the recommended treatment wasn't altered. We are interested in trying other ways to improve his numbers if we think it might help us to conceive naturally before moving to Clomid and IUI. I am wondering if there are other supplements that can help w/ morphology and, in particular, whether you think that pycnogenol is worth a try. If so, how much should he take and when should we expect to re-evaluate to see if it is 'working'? Should he continue the FertilAid also or stop that and re-focus on other supplements?


Thanks so much for your time.
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Old 03-16-2009, 02:59 PM
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Scott Roseff MD Scott Roseff MD is offline
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Hi,
The FertilAid can't hurt, and in my research I found a significant improvement in sperm morphology with Pycnogenol.

As an aside, if a woman has normal, regular menstrual cycles, and if she ovulates normally on her own, then taking Clomid can potentially prevent her from getting pregnant or increase the risk of miscarriage....

Hope this helps,
Dr. Roseff in FL
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Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
PERSONALIZED/SUCCESSFUL Specialty care....

As youíre not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.
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Old 03-16-2009, 03:17 PM
HopeforSuccess2009 HopeforSuccess2009 is offline
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Thanks for the quick reply Dr. Roseff. I read your study and it looks like the dosage is 200 mg / day, right?

As for the issue of Clomid, I've been told that is the 'first line of defense' for infertility treatments, and that it's basically something that I need to do before I can move onto anything else. My cycles are basically regular (30-32 days) although I do have one or two cycles a year that run longer (up to 39 days). Since I have been charting I have ovulated every cycle, though, and my luteal phase has been in the 11-12 day range. The RE I am seeing suggested, nevertheless, that I may have mild PCOS (based on my reports of excessive facial hair and sudden weight gain as well as what he termed 'slightly irregular' cycles) or ovulatory dysfunction, and that Clomid might help. My OB had said the same thing (although I didn't ever consider taking Clomid under the care of an OB) as did another local RE that I consulted with. (I am in the DC area).

It sounds, however, like you completely disagree. I guess my question is what are the other options? IUI without Clomid? Injectables with or without IUI? We are not ready to move to IVF yet as I have a major emotional wall I have to get past before I feel prepared to take that step.
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Old 03-17-2009, 07:48 AM
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Scott Roseff MD Scott Roseff MD is offline
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Hi again,

You should read the Clomid section of what I wrote by clicking HERE.

Can't tell you, though, whether you should/shouldn't take Clomid since I don't know your entire history and you're not under my care. Also, I can't tell you what treatment is appropriate for you without a complete history, physical exam, and review of your records to date (sorry....).

Hope you have a superb RE and he/she guides you towards your most optimal treatment!

Dr. Roseff in FL
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Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
PERSONALIZED/SUCCESSFUL Specialty care....

As youíre not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.
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Old 03-17-2009, 08:30 AM
HopeforSuccess2009 HopeforSuccess2009 is offline
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Thank you Dr. Roseff. My research has indicated that my RE (and the other I saw for the second opinion) is highly qualified but I appreciate your insight and input. My understanding is that I will be monitored via bloodwork and ultrasounds, will have a trigger shot, and we will do IUI, and then I will take progesterone supplements to help with lining issues. I remain somewhat concerned that this is just the first line of treatment that is being recommended and plan to ask questions of my doctor as the situation progresses, but I am unsure of any further testing to ask for at this point. I also found out yesterday that my insurance will not cover any other medications until I have undergone 3 cycles of Clomid therapy. So, I don't really know what else to do at this point, and am hoping for the best. I appreciate your response and that I'm now armed with more information than I had before!
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Old 03-17-2009, 03:13 PM
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Scott Roseff MD Scott Roseff MD is offline
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Good luck,
Dr. Roseff
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Dr. Roseff - South Florida Institute for Reproductive Medicine - Boca Raton, FL
PERSONALIZED/SUCCESSFUL Specialty care....

As youíre not my patient, information herein may be incomplete/inaccurate & I can't be responsible for your actions. This is for educational purposes & should never be used to replace information & care rendered by your own doctor. No part of this message may be reproduced, printed, or posted elsewhere without express written authorization of Dr. Roseff or INCIID.
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