Dr. Khant Shahil Ramesh Bhai
Urology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I have done my sperm analysis. The gynecologist suggested low motility grade A, and I have been taking Fertisure M for the past month but, was a bit irregular in medicine but now following the strict timeline. She suggested consulting a urologist for agglutination or pus cells, etc. Kindly suggest some line of treatment. I do not smoke and drink once a month (even if that is not regular). I used to drink cold drinks but have given up now. I have reduced junk food and consume fruits, vegetables, and non-vegetarian food. I sleep for seven hours and do exercise, and walk regularly. Kindly suggest a remedy for agglutination based on your analysis of the report.
Hi,
Welcome to icliniq.com.
I want to know what problem you have. Are you suffering from infertility? If yes, since when? Did you try any other treatment before? I have seen your report (attachment removed to protect patient identity). It appears fine regarding quantity and motility. Regarding clumping, it can be either because of infection in semen or autoantibodies. Most common is the infection of semen. So, I will ask you to get a semen culture and sensitivity test done. If it comes positive, then we will start antibiotics according to the culture. If not positive, then we will start empirical antibiotics.
Patient's Query
Hi doctor,
Thank you for the reply.
We are trying for a baby for the past six months. I am not sure how to define infertility. Treatment to date is 30 tablets of Fertisure M over the past two months (it was irregular, but for the past three to four days I am using it on a regular basis). I will get the semen culture done next week. Are semen sensitivity and semen culture different tests?
Hello,
Welcome back to icliniq.com.
Six months is not a long time. Actually, we label infertility after one year of unsuccessful attempts to conceive. So, relax and do not worry. Culture and sensitivity are different tests but both are related together and will be performed on the semen sample. You just need to ask semen culture and sensitivity test.
Patient's Query
Hi doctor,
Thank you for the reply.
I had consulted you a few months back regarding sperm analysis and sperm culture. My wife reports are so far normal. I am taking Fertisure M for the past one and a half months. Here I am attaching the latest sperm analysis test report and sperm culture report. Kindly suggest if I should concentrate more on my end or should we go to the gynecologist as well. My wife's most of the ultrasound reports are perfectly normal. I feel I need to work more on my treatment. Please suggest.
Hello,
Welcome back to icliniq.com.
Relax and do not worry. Yes, I remember regarding your consultation.
I have suggested semen culture and sensitivity for agglutination and pus cells in semen. As per your recent reports, your semen parameters are normal. There is no agglutination also. Though there are 2 to 3 pus cells, the culture is negative, and it is not significant. I would suggest you wait, as many normal couples require one to one and a half years to conceive. There is no problem for your side. If you wish, then you can get a check-up for your wife from a gynecologist. Please do not get restless. Continue Fertisure M.
Patient's Query
Hi doctor,
Thank you.
How long should I continue Fertisure M? I am taking two tablets a day and 60 tablets till now. Our Gynecologist had suggested three months course earlier.
Hello,
Welcome back to icliniq.com.
Yes, continue Fertisure M (Levo-carnitine 340 mg, Coenzyme Q10 50 mg, and Zinc 5 mg) for a total of three months, and then, you can stop.
Patient's Query
Hi doctor.
Thank you for the reply.
I have attached latest semen analysis report. Motility A has increased, but agglutination is again positive, but last time it was negative. Please, suggest some antibiotic doses. Basically, my wife has been going through Follicular Monitoring, and a small egg size was diagnosed. In last month's cycle based on medicine, her egg size was good but we were not able to conceive. This month, she is taking Fertomid. Her follicular monitoring will start next week and we have advised for intercourse during the period. Please advise for agglutination and general suggestion.
Hi,
Welcome back to icliniq.com.
Good that your semen quality has improved. Regarding agglutination and pus cells I would suggest taking tablet Levofloxacin 500 mg twice daily for 10 days. Then 500 mg once daily for 14 days. This is just empirical treatment as you are planning to conceive. Thanks.
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