Dear Doctor, I'm 31 years old and my husband is 32. We have been trying to conceive for the last 20 months. Last year (June, July & August) I took Fertomid and Dexona (under doctor’s advice), did ultra sound from 12th day, injected IUI 10,000 on the instructed day, and ovulated every time. But, there was no success. In November I did a HSG and my tubes were fine. But, I had endometrial polyps and they were removed. After that we have tried 2 cycles without success in the natural way without any medications. Can you tell me what could possibly be wrong that I am not conceiving? Sperm analysis was done on my husband and the doctor said its normal. Please help... I would also like to know the minimum mortality % and sperm count to be present for conceiving.

The process of conception is very complicated. It sounds like your evaluation was normal for the most part, as was your husbands. As far as the minimum motility and count to conceive, that is a difficult question. The lower limit of "normal" on a semen analysis for count is 20 million per mL and 50% motility. Clearly, at these numbers people are conceiving regularly. I have personally taken care of couples where conception was achieved with lower levels. For intra-uterine insemination, we like to see a minimum of 10 million sperm with 30% motility to perform this procedure. If your doctor told you the count was normal, then your husband has enough sperm to conceive naturally. Many cases of infertility like yours are not explained. Occasionally, subclinical infections can contribute and stress plays a negative role. Otherwise, as long as you were evaluated by a good infertility doctor, keep trying.

Answered by Dr. Jonathan Schiff, M.D.