by Fred Licciardi, M.D.
So a little story about a couple I saw recently. She was a poor responder with borderline FSH levels, normal tubes and a favorable age. He had low sperm counts. They had been through IVF. I suggested that he see a urologist because maybe there was something that could be done to improve his counts. She still ovulates every month, so by upping the odds on the sperm side, maybe they could get lucky and get pregnant on their own.
My statements were very surprising to them. They had been told that because of her “fertility status”, meaning her FSH was a little high, pregnancy could not occur naturally, so why bother with the sperm.
This may be close to accurate but it is not completely true. Unfortunately, many couples with significant fertility problems never get pregnant, but for some, the pregnancy rate per month is not zero. Even if it is ½ percent per month, after a year, a few women with normal tubes, borderline FSH levels and good sperm will get pregnant (age helps).
Can you count on it? No, but if there is something fixable, you might as well explore the options.
This is also the reason that some doctors suggest a laparoscopy after many failed IVF cycles. Even if the odds of tubal disease are low, correcting a small problem may improve the odds of a spontaneous pregnancy down the road.