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Consultation regarding alternative medic
Dear Doctor, I am writing to seek your advice regarding our family planning. We have been trying to conceive for the last 1.5 years without success. I recently had some tests done, and the results show elevated pus cells (4-6/hpf) and 50% dead sperm. Because we are actively planning for a baby, I would like to request you to review my current rheumatology medications. Could you please suggest alternative medicines that are safe for family planning and do not negatively affect fertility or sperm count? Please let me know if we need to schedule a consultation to discuss this further.
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Answers (1)

Your semen report shows a good total count, but 50% dead sperm and pus cells of 4 to 6 per HPF suggest reduced sperm quality, often linked to an underlying infection. Methotrexate, which you are currently taking, is well known to reduce sperm production and quality, so it is a reasonable medicine to review while you are trying to conceive.
Next Steps
Ask your rheumatologist whether a fertility-friendly alternative is possible while you are planning a baby. A fertility specialist can also treat the pus cells in your semen, which often improves with a short course of treatment and repeat testing after.
Health Tips
Please do not stop or change your rheumatology medicine on your own. Discuss this with your rheumatologist and a fertility specialist together, so your joint condition stays controlled while you plan for a baby.
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Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
Disclaimer : The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding your medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.