Other questions on fertility

Where to get sperm test done?

Q . I am interested in having a sperm test to see what my sperm count is like as my partner and I are considering trying to have children. Where is the best place to have this done? I live in London.

A. You can have this done privately and your GP will advise you for your region but if you are trying for children and there appears to be a problem or you have had a vasectomy reversal, undescended testes, injury to your testes etc you can have it done on the NHS by visiting your family planning clinic. The addresses are in the Book.

What options if vasectomy reversal doesn't work?

Q . My boyfriend is 46 years old and had a vesectomy 14 years ago. We have been to the hospital and been told there is only a 20-30% change of him being able to give me children. He is still going to go through with the reversal. However, my worry is what if it does not work - what other options are open to us? How does this sperm bank work? I am 36 years old and very keen to have children.

A. Please do not give up hope and it is pointless crossing bridges before you meet them. Why not wait until he has had the reversal? Don't forget the chances are based on an average for all men who have the reversal done and it includes those with very poor chances indeed. Even at the odds of 30% this is much better odds than most horses in the Grand National and we still all bet millions every year. Give the Family Planning Association a ring for basic information but my advice is to see how you get on first.

What is the success rate of vasectomy reversal?

Q . I had a vasectomy three years ago and now I would like a reversal. What are the success rates and options available to me?

A. You are in good company. An increasing number of men are seeking reversal of vasectomy which may reflect the steady rise in the number of failing long term relationships. A great deal depends upon how yours was performed but it is generally true to say that it carries a greater success rate than that for tube reconstruction in women.

It is not a particularly dangerous or technically difficult operation. It is the closure of the duct on either side of the snip. As a small piece of the tube is removed to ensure that the correct operation has taken place, this gradual closure can be extensive. It is impossible therefore to give you an accurate answer and you need to talk to your surgeon or urologist. It is possible though to use assisted insemination even if the reconstruction is not successful. Your local family planning clinic will provide good advice on your own personal history.

Low sperm count

Q . I recently had a sperm test which was found to be a very low count. As me and my wife are trying for another baby what can I do to improve things?

A. The very good news is that despite low sperm counts it is possible for many couples still to have children although you might need a good sense of humour for some of the ways your doctors might ask you go about it.

Without knowing your actual sperm count it is difficult to give you definitive advice but I can tell you that the number of sperm present can be less important than the 'quality' of the sperm. Those without tails, which have two or three heads, fail to swim when stimulated or like most of us men, swim the wrong way, will all determine whether the sperm will reach and fertilise the egg.

If you have not already done so you should put your names down for a visit to the fertility clinic. Most will not see you until a couple of years after trying for a child, irrespective of your sperm count. Then the fun really starts. You will both have complete checks and a range of treatments proposed. You can help yourself by quitting smoking, drinking in moderation (or better still not at all), avoiding any dangerous chemicals at work and generally looking after yourself better. It used to be thought that too frequent sex reduced your chances of conception but we now know that sperm production rate is more or less constant and any unused sperm are reabsorbed rather than stored for later use. Even so it does make sense to make love during the most important times in your partner's cycle, just when she ovulates and releases an egg. You can get good advice from the FPA (Family Planning Association). There are many ways of helping you conceive but at the end of the day the government is making adoption much easier for couples. I suspect you will be hearing the sound of tiny feet before too long.