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Varicocele Description Sheet
Varicocele Description  

Sonar Detecting Varicocele
Sonar Detecting Varico  
Hello Dr.Edward Joseph,
I am from Iraq and happy to get benefit from your rich experience. My husband and I are looking to have a baby since I was married -one year ago November 2014. I made a sonar in January 2015 to check my condition as I have regular period and found my egg was 20 mm in size. My doctor told me to use Pregyl Amp. 5000 unit with no questions about my husband seminal liquid. However, I decided to not go with that medication to keep natural. Recently, my husband found  that he had infection and Varicocele so he took a treatment for infection. After that, there became improvements in the infection reduction, the total count of motile from 40 to 65 million. However, in percentages of active mortal  remained the same as follows:
active motile grade 4: 5%
grade 3:  10%
grade 2: (sluggish Motile)  10%
grade 1:  15%
Other information in the new test (after treatment) are considered normal in the view of the doctor, which are as follow:
Microscopic:
Non motile (dead): 60%
Abnormal: 10%
Pus Cells: 2-4/ HPF
RBCs:0-2/HPF
Others: Epith. cell few (Mucous - Nill)
Macroscopic:
Color: Milky
Volume: 3ml
Reaction: Alkaline
Viscosity: Within 15min
My questions are:
Does my husand need the Varicocele surgery to get the active motile higher in percentage?
If I go with the advise of the previous doctor by taking the the injection of pregyl, will there be a chance to get pregnant with that 5% of motile before or without the Varicocele surgery.
Will there be side effects of using the injection if pregyl on my health like getting weight of growing hair?
Best Regards and thanks for your time to read and answer my questions

Answer
Hello Sara from Iraq,

1.  It is questionable whether or not the varicocele surgery will help with the motility but there is a possibility so I think it reasonable to give it a try.  If it doesn't work then you will need to either attempt IUI (insemination) or better, go to IVF with ICSI.
2.  Pregnyl does nothing more that trigger ovulation (release of the egg).  It does not help in any other way so it will NOT help you get pregnant if sperm is the problem.
3.  There are no side effects, especially not gaining weight or growing facial hair.

Good Luck,

Dr. Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com
info@montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.  

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Edward Joseph Ramirez, MD, FACOG

Expertise

I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience

I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 19 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

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