Hello doctor,It has been four years since we married. My husband is a little bit of tensed nature. So, he is not able to ejaculate during intercourse. While doing masturbation, he is able to ejaculate within seconds. Now, he is taking medicines for reducing anxiety. I have undergone five cycles of IUI. Today, I did AMH and prolactin test. Now the doctors advised us to undergo ICSI as the AMH level is low and prolactin is very high. Kindly advise me whether I can get pregnant naturally or should I go with ICSI?
Hello. How are you doing? After going through your reports (attachment removed to protect patient identity), only AMH (anti-Mullerian hormone) seems to be the problem. Let me put forth a few facts. Your age is within the normal range for pregnancy and you should be having good egg count (this is what is assessed by AMH). Basic question is, is your period regular? If egg count is normal, you will ovulate every month on 28 +/- 7 days frequency. If ovulation is regular, forget prolactin. If you are tensed, around period date, had a sleepless night, been worried about something or been seeing that lab and needle for some time, all these and more can alter prolactin levels. Your scan shows lots of eggs in both ovaries, so I really doubt the credibility of the AMH. About your husband's problem, IUI (intrauterine insemination) is a very good option. Do not get disheartened by a failed IUI. Better ovulation protocol and methods can get you better results. Hope his semen has good motility and morphology. Hope your fallopian tubes have also been evaluated. Only then, IUI can help. ICSI (intracytoplasmic sperm injection) is always an option, but better keep it to the last. A young lady like you with seemingly no big problem should try all the smaller routes. ICSI is 45 % success. If that fails what next? So, always keep the big steps to the last. Try everything else before that. In short, I feel you should try other options or natural methods for some more time. Hope I have clarified your query, do write back if any more queries. All the best. For more information consult an infertility specialist online -->