Hello XXXXXXX
Thank you for your query.
The report of your semen analysis is compromised in certain aspects. Let me elaborate them one by one in order to explain you the prognosis :

Sperm Count:
Though it only takes one sperm to fertilize an egg, a normal sperm sample should contain 20 million sperm per milliliter (mL) or more per ejaculation. Below this count, the condition is called oligospermia. However, your sperm count is in the normal range.

Morphology:
The term morphology refers to the size, shape and appearance of the sperm. Every sample will have some abnormal-looking sperm. As long as more than 30 percent of the sperm have normal shapes, fertility issues shouldn’t arise. In your case, percentage of abnormally shaped ( defective ) sperm is very high, which is abnormal. This is called teratozoopermia.

Motility:
This number identifies how well the sperm move. For conception to occur, sperm must be able to swim through cervical mucus, across the uterus and out into the fallopian tubes to reach the egg. If motility drops below 50 percent, potential problems may exist. This is called hypoasthenospermia, and exists in your case.

pH Levels:
Ideally, sperm need to have an environmental pH level of 7.1-8.0 . When the number is too low or too high, sperm may die, or they may be unable to penetrate the egg and achieve fertilization. The pH in your case is normal .

Basically, the problem is in abnormal sperm morphology and decreased sperm motility.

I would recommend a visit to a Urologist/ XXXXXXX at the earliest. Causes of sucha report vary right from genetic causes, infections, hormonal deficiencies, smoking/drug ingestion, age related changes, physical blockages, varicoceles, or erectile/ejaculatory problems. Other reasons are : Infections, High fever, Usage of illegal drugs, Alcohol consumption, Congenital testicular abnormalities, Varicocele – Enlargement of veins within the scrotum. Toxin exposure , Cigarette smoke , organic solvents etc.
A thorough physical checkup and appropriate further testing is necessary to establish the cause.

Also, sometimes, in certain conditions, fertility enhancing medication might improve your semen count. Hence, after consultation with a doctor, a repeat semen analysis after 3 - 4 weeks is recommended.

Looking at the current situation, the chances for natural conception are low, though not impossible, because both motile and normal shaped sperm are essential for pregnancy. As you and your partner are trying to conceive since 7 months, if the Urologist detects some abnormality which would not respond to medication, I would suggest going in for ART ( assisted reproductive technologies ). This includes both IUI ( intra uterine insemination ) and IVF ( in vitro fertilization ). However, in your case, you can definitely try for IUI first, as it is less invasive and less costly.

For this, engage the services of a reputed Infertility Practitioner, who would evaluate your partner thoroughly , before going in for one or two cycles of IUI , which if failed, you should undergo IVF. It is important to have basic tests of your wife also done, including her tubal patency and ovulation studies, as well as hormonal evaluation.

Please go for a karyotype ( chromosomal evaluation ) also, as certain latent chromosomal disorders cause abnormal semen analysis reports, and these can be passed on to your offspring in case conception occurs.

Meanwhile, avoid tight clothing/exposure to radiation/ working in hot environments for prolonged periods.
Avoid smoking/alcohol/tobacco consumption in any form/drugs/ exposure to organic solvents or radiation.
Maintain an ideal body weight, and exercise regularly.
Many nutritional supplements can be recommended by your doctor, after examining you, for a treatable cause of your problem.

Please take care, and feel free to ask for further clarifications.
All the best.

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