
I'm in a similar situation. My son was born after 6 months of NTNP/TTC and while I didn't neccesarily think we would conceive #2 immediately, I didn't think we had any major fertility problem. I never would have guessed we would be going on 2 years of hardcore TTC
When my DH had a SA after about 6 months of TTC #2, it was awful....1.3 million/ml with 36% motility. He saw a urologist, had the varicocele surgery and went on a hardcore vitamin regimine. 3 months after his surgery his counts were up to 12 million/ml, 50% motility and a total of 48 million sperm, so his concentration was still low but overall his counts and motility were on the low end of normal. We got pregnant naturally just ten days after that improved SA, but sadly I miscarried and we have had no luck since then in spite of his counts remaining improved

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Listed below is my DH's vitamin regimine. To be honest, I kind of believe the improvements come from the vitamins more than his surgery, but we'll never know for sure.
L-carnitine (3000 mg/day)
Acetyl L-carnitine (1000 mg/day)
Vitamin C (1000 mg 2x a day)
Vitamin B12 (1000 mcg/day)
L-arginine (4000 mg/day)
Zinc (50 mg/day)
Mega Men Prostate and Virility (2x/day)
N-Acetyl Cysteine (600 mg/day)
L-lysine (500 mg/day)
This is a TON of pills and it is expensive, but I guess it's worth it. Before his counts improved, we were told that IVF was our only option and now we are candidates for IUI. Most of these can be found cheaper at vitacost.com