IUI - poor sperm morphology

iVillage Member
Registered: 10-02-2007
IUI - poor sperm morphology
3
Fri, 01-25-2008 - 4:23pm

Hi, My SA analysis results showed 1% sperm morphology (Strict criteria) while the count was 171 million and 50% motility.

We did our first IUI with Clomid-50mg and HCG injection this month and it failed. The sperm count after the wash was 84million and ~80% of washed sperm was motile. Sonogram results showed 2 follicles and my wife ovulated the day after IUI. Everything seem to have gone as expected other than the end result. We are very disappointed :(

We are planning to try again next month. Is there anyone out there who had successful IUI with low sperm morphology? How many follicles are normally required for increasing chances with IUI? Is it better to try two IUIs before and after ovulation? Any recommendations are greatly appreciated

Thanks
Dave

iVillage Member
Registered: 06-14-2007
Fri, 01-25-2008 - 5:57pm

Dave,


How nice it is to see a guy here for a change!

siggy#4
iVillage Member
Registered: 10-19-2004
Sat, 01-26-2008 - 5:43pm

Hi Dave,

Have you tried taking pycnogenol and a multivitamin, or a supplement like fertileaid for men? There is a a study that shows pycnogenol helps with morph, not much does, though anecdotally I have seen some slight results with supplements, though countas can vary for no apparent reason so it's hard to say if that's why.

My Dh has 3% morph and low motility as well, ranging from 14-44%, depending on when it is taken. What is perhaps more important than the motile % is the forward progression, which is the quality of the movement. My DH's is usually 2. We have done 4 IUI's all failed. One was with injects and I produced 5-6 mature eggs. Still didn't work. WE did get pg with a frozen embryo transfer of a frozen blast left over from our IVF/ICSI, but it ended in chemical pregnancy/very early miscarriage. To get your wife pg naturally or with IUI you usually need FP of 3 or better, which is rapid forward profgression.

My RE says that with 1% morphology, they will generally not see normal fertilization even if the dump the sperm right on top of the egg in IVF, so ICSI is really a wonderful thing for men with male factor infertility. That being said, if you have good forward progression, since your counts are fine and motile % is normal, you could get lucky and have IUI or even trying naturally work, it just may take longer. Your chances are lower, but if you and your wife are young, and especially if the IUI's are covered by insurance, there is no harm in seeing if they work. Your post wash motile % and numbers are GREAT, so that is a REALLY positive sign. However your chances will be MUCH better with IVF/ICSI. If you/she are in your mid 30's or later, or are paying out of pocket, I wouldn't spend too much time and money with IUI's.

You should also be aware that when morphology or motility (or both) are very low there is risk of of significant DNA damage called fragmentation. There is a test you can take for this. If fragementation is normal you may have a chance naturally or with IUI. If it is high, over 30%, there is virtually no chance you can get her pg naturally or with IUI, and if you do IVF/ICSI there will be lower chance of success (though not impossible, just reduced chances) and higher chance of m/c/chemical pregnancy/and possibly of birth defects/childhood cancer if pregnancy does occur.

We just did this test (www.scsadiagnostiocs.com) and are waiting for the results. If they are OK we will do IVF/ICSI again. If they are bad, we are finally going to move on to donor sperm, which my husband suggested many months ago. He says it's more important to him to pass on his values than his DNA. I would really prefer to have his biological child if we can, but we have no IF insurance, and time and money are limited, and after this last loss, I'm not sure how much more we can take. We want a healthy baby, and if our risk of further losses or birth defects/childhood cancer is significantly higher due to fragmentation, I guess that's the "proof" I need to be OK with moving on. Of course, this is a very personal issue and no right or wrong answers, only what each couple decides is right for them.

Good luck, whatever you do.

-Jenna

- Jenna
iVillage Member
Registered: 09-11-2006
Thu, 01-31-2008 - 12:38am

Hello Dave!


Welcome to the board.