Just curious ..Why couldn’t you do IVF at 7 million? We are looking at doing IVF and I’ve been on TRT for about 8 years and don’t have living sperm. But from conversations with our fertility doc it doesn’t sound like he needs many living sperm cells to make it work.
Oh, we certainly could have done IVF at only 7 million sperm count. But given the reality of the odds, and the expense of the IVF process, you are much better off going into it with as much sperm and as many eggs as possible, to have enough suitable embryos to have a chance of success. The simple fact of the matter is that, depending on many factors including sperm quality, but especially the age of the mother (maternal age is the most important factor), only 20-50% of the eggs fertilized by sperm will actually survive to the 5-day blastocyst phase where the embryos can be successfully implanted back into the mother.
I will use our case as an example. I am a 50-year-old man who has been using testosterone and other steroids for 27 years now, so my sperm count was zero when we started, and eventually through using HMG and HCG increased to 35 million sperm per ml.
My wife is 41 years old, which they consider to be high risk for trying to conceive, and heavier than she should be, which also doesn't help our chances.
Fortunately, my wife was a hyper-responder to the FSH and other fertility meds. They couldn't access the left ovary because it was blocked, but just from the right ovary alone they successfully harvested 21 eggs, of which 20 were mature. This is very unusual, and we were very lucky to get so many eggs.
Fortunately, my sperm count had increased to 35 million, and the motility and quality both increased thanks to HMG, so my sperm successfully fertilized 14 out of her 20 mature eggs.
But, out of those 14 initial embryos, only 3 embryos survived to the 5-day blastocyst phase. These are typical odds (about 20% survival rate), especially considering my wife's age. And according to her fertility doctor at the IVF center, women my wife's age have a 48% chance of having a successful pregnancy from each implantation.
We already implanted one of our 3 surviving embryos, but it didn't take, and the pregnancy test came back negative, which was very disappointing. So now we are waiting for my wife's hormones to stabilize, and then we will try to implant the last 2 embryos. Hopefully at least one of them will result in a successful pregnancy.
But, just looking at the numbers, you can see how quickly we went from having 21 eggs, to 14 fertilized embryos, to only 3 5-day blastocysts, to now only having two chances left. Those are the reality of the odds for IVF, only between 20-50% of the embryos will survive, and even those may not result in a successful pregnancy for the mother.
So, you are always best off going into the IVF process with as much sperm and as many eggs as possible.
I hope that I explained that well enough. You can read more if you go to the fertility and IVF boards, there are plenty of women and couples on those boards who discuss the IVF process, the odds of success, and how disappointing it can be if things don't work out.
My wife and I are praying for success with the next implantation. We will see how it goes.
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