what is the best reproductive option if a couple is diagnosed with oligozoospermia and pcos?
to answer this question we have to take into account several aspects. 

the first of these is the assessment of the male factor. when we speak of oligoazoospermia we refer to a low concentration of sperm in the semen. we consider an altered concentration when there are less than 15 million spermatozoa per milliliter (ml) of ejaculate. 

but although 15 million per ml is the reference parameter for talking about oligoazoospermia, when we assess the seminogram we must take into account the degree of deviation from that normality. that is, a concentration of 13 million/ml, where we would speak of a mild oligoazoospermia, is not the same as 1 million/ml, where we would speak of a severe oligoazoospermia. in addition we must also assess the other parameters of the study of the semen (total volume, motility). 

in order to group all the important parameters of the seminogram into a single value that will help us decide which assisted reproduction technique to use, the concept of msc (mobile sperm count) is established. this tells us the number of spermatozoa with good motility in each milliliter of ejaculate after the training of the semen in the laboratory. 

it is considered that in order to perform an artificial insemination (ai), the msc must be over 3 million spermatozoa. 

therefore, as far as the male factor is concerned, it will depend on the severity of the oligoazoospermia and how it influences the msc whether the technique of choice is an ai or, on the contrary, we have to opt for a more complex technique, such as in vitro fertilization (ivf). 

the second aspect to take into account is the female factor. in this case we are presented with a woman with a polycystic ovary syndrome (pcos). pcos is an endocrine pathology that is often difficult to achieve ovulation. when a woman is unable to ovulate, she will not be able to become pregnant and the clinic that most women with pcos consult for will appear, which is the absence of menstruation. 

thus, what we must do with this patient is to give her medication to help her achieve, first, follicular development and, later, ovulation. once ovulation is achieved, the semen sample should be added either by ai or by directed intercourse. one option or the other will depend on the quality of the semen. 

to achieve ovulation in a patient with pcos we perform an "ovulation induction" treatment. for this we have several therapeutic options. as first-line drugs we would have the drugs for oral administration (clomiphene citrate and letrozole) and, as second-line treatment, we would have the drugs for subcutaneous administration (gonadotropins). 

even so, before considering ovulation induction treatment in a patient with pcos, we should assess the patient's age. the main reason for this is that ovulation induction treatments end with ai or directed intercourse. it is known that women over 38 years of age do not benefit from these techniques due to poor egg quality. in such cases, the first option should be an ivf. 

therefore, and in response to the initial question, the most likely treatment of choice for this couple is ai with ovulation induction, but before indicating such a technique we must take into account other parameters such as emr and the age of the patient.
sorry about your diagnosis. i too was given the diagnosis of pof this past february, after a failed ivf cycle. i was told that my only chance to have a successful ivf cycle would be to use donor eggs. so that is what my husband and i are doing next month. i have regular monthly periods though, apparently unlike you. if you truly have a diagnosis of pof, there are not any fertility medications that will make it possible for you to create a genetic family. sorry. it's a fact. you can use the strongest fertility stim meds at the highest doses, and it won't do you any good. furthermore, having a period does not mean that you're ovulating...which is exactly the point of having pof. there is no pharmaceutical way, nor technological way available right now to provide the opportunity for a woman who has pof to have her own eggs retrieved. perhaps you were mistaken with what your diagnosis was? i would ask your re again. best of luck to you. if you have any further questions, please feel free to email me. i am here to provide support for you as well.
addtl info: i just realized that you stated that you aren't able to get into an re until june 2nd. so who gave you the diagnosis of pof? i suppose your gyn? not meaning to knock your doctor, but the reality is that a gyn is simply not educated enough nor specialized enough to make this diagnosis. coming to the conclusion of pof is made via blood work and exams. also, it usually is made only after a round of stim meds fails miserably. i suggest you get a real diagnosis when you see an re. you probably simply will find that you just need a some clomid to help "kick start" your period. but that's a far cry from actually having pof. unlikely but not impossible. i would suggest that you start your new method of contraception as soon as possible.<br><br>best wishes i would get on some sort of birth control. this sounds like a hormone thing. your body is trying to regulate itself again and birth control would even out the hormones. dear scary j<br><br>a vasectomy is a safe and highly effective operation designed to make a man sterile. a doctor cuts the two tubes — called the vas deferens — that carry sperm from the testes to the pouch in the scrotum that holds the semen prior to ejaculation. in the simplest terms, a vasectomy blocks the only outlets sperm have to leave the body. the sperm is reabsorbed into the body. men who get vasectomies can still have sex and ejaculate, but their semen won&#39;t contain any sperm, so it can&#39;t fertilize an egg and cause a pregnancy. <br><br>in the most common type of vasectomy, the doctor makes a small incision, or cut, on each side of the scrotum. he then lifts the vas deferens tubes to the surface, snips them in two, cauterizes their ends or ties each end off (some doctors use a titanium clip instead), and stitches up the scrotum. the procedure is usually performed right in the doctor&#39;s office. it takes about 30 to 60 minutes and only requires a local anesthetic, so you&#39;re awake through the procedure.<br><br>i would suggest that you collect a number of sperm samples for freezing purposes before the vasectomy is done. in this way the good quality sperm can be kept and frozen for future use and may be cryo-preserved for at least 10 years if not more. in this way, should a decision be subsequently made to have another pregnancy, the situation can be dealt with by means of a simple intra-uterine insemination process. it is a good option in such a situation, a couple typically can just add condoms for may, and not have to think about these things. june will be the second month back on birth control pills, and if no missed pills, june will be fine and safe. condoms work great, and a couple should always have some on hand. condoms are versatile. good for back up use, etc... no worries. see more... look into dr. shettles method, we were just talking on a post about this the other day. he tells you how to have a boy or girl. most people do both, but obstetricians deal with pregnancy and gynaecologists with non-pregnancy female problems.<br/><br/>best wishes oophorectomy is removal of the ovaries. salpingo is removal of the tubes. these are usually closely attached so are easier to remove at the same time than leave behind.<br><br>best wishes You can consult me privately on lybrate ..as full and detailed case history is required here..
Sexual issues can be treated with homeopathy..depending upon the severity of the case