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Abnormal morphology

Morphology

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#1 TeamD&M

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Posted 23 June 2012 - 05:08 PM

Hi - my husband just received his semen analysis results and are as follows:
pH 8 (normal 7-8)
Volume 1mL (normal >2mL)
Concentration 122million/mL (normal >20)
Total count 122 million (>40)
Motility 44% (>50)
Progression 2 (3-4)
Round cells 0.01million/mL (<1)

Strict Morphology:
Normal 2% (>7)
Severely amorphous 89%
-----Neck - 14%
-----Head - 74%
-----Tail - 1%

My husband is 28yo, I'm 30yo, both of us are healthy active people (BMI 22/23) however my AMH is low (0.62ng/mL) but otherwise I'm considered healthy re:fertility (normal FSH, LH etc). What are our chances (%) of conceiving A) naturally B) via IUI and C) IVF?
In your opinion, how long should we try "naturally" and is it even worthwhile to try IUI? We're having a hard time gauging how quickly we should move with this given we are otherwise considered "young".

Any help you can provide would be much appreciated.
Thanks!

#2 notalone2

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Posted 23 June 2012 - 05:38 PM

My husband had similar numbers but his was 6 morphology, which is mild. We wasted our time on 3 iui's and an ivf without iCsi. All failed the ivf none even fertilized. We just did ivf with iCsi and are in the 2 ww. We wasted a lot of money on things that we now know were never going to work. If you have the money go straight to ivf with iCsi
Feb 2010 natural bfp - miscarriage blighted ovum
March 2011 first meeting at Ofc - slight male factor poor morph
June 2011 iui - cancelled lead follicle grew too fast
July 2011 iui2 - 2 follicles - bfn
October 2011 iui3 - 1 lead follicle fee fast - bfn
January 2012 iui4 converted to ivf - 5 eggs retrieved 0 fertilization - no transfer
June 2012 ivf #2 12 eggs retrieved 9 mature 8 fertilized with iCsi - 2 blasts Transfered day 5, 2 frosties - bfn
Nov 2012 FET - thawed our only frosties (2) only one survived. Transfer 1 blast 3BB
BFP nov 20

#3 Cheddar

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Posted 23 June 2012 - 06:10 PM

Morphology is a tricky one, I've read. We have 1.5% Kruger and we had two unsuccessful IUI cycles. My DH started vitamins, quit smoking and cut back on alcohol after our first IVF failed. We'll have to see whether anything helped/

We had a poor fertilization rate, with just 3/5 through ICSI. Apparently ICSI solves everything, our doc said, so you have a good shot with ICSI. Don't waste your time on IUIs. They add up in cost, waste time and put your body through the stress of meds with little chance of success. We were given about 8% odds. That's a 92% failure rate! Just my two cents. Good luck!
TTC since February 2010

IUI #1: October 2011
Puregon 50, Ovidrel
Cycle cancelled, only one egg

IUI#2: December 2011
Puregon 75, Ovidrel, producing three eggs
BFN

IVF#1: March 2012 Antagonist
Puregon 175, Orgalutran, HCG, beginning March 5
Trigger: March 12, seven follicles visible on U/S
ER March 14: nine eggs retrieved, five mature, three fertilized on first day, two remaining day two (4-4 and 3-4). Both transferred.
Started my period 11dp2dt. BFN

IVF #2 Agonist
May 24: Start BCP
June 7: Start Suprefact
July 1: ER - 17 eggs retrieved!
July 2: Fertilization report: 9 out of 17 mature. 8 fertilized. Scheduled for a 5-day transfer.
July 6: Stunned to learn we have only two of the poorest-quality morulas left. No one called to say they'd all arrested Day 3. Transferred both but WTF?
July 13: Started my period

#4 notalone2

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Posted 23 June 2012 - 06:12 PM

We had zero fertilize with regular ivf and 8/9 fertilize with iCsi. For the additional $1500 I believe it's worth it.
Feb 2010 natural bfp - miscarriage blighted ovum
March 2011 first meeting at Ofc - slight male factor poor morph
June 2011 iui - cancelled lead follicle grew too fast
July 2011 iui2 - 2 follicles - bfn
October 2011 iui3 - 1 lead follicle fee fast - bfn
January 2012 iui4 converted to ivf - 5 eggs retrieved 0 fertilization - no transfer
June 2012 ivf #2 12 eggs retrieved 9 mature 8 fertilized with iCsi - 2 blasts Transfered day 5, 2 frosties - bfn
Nov 2012 FET - thawed our only frosties (2) only one survived. Transfer 1 blast 3BB
BFP nov 20

#5 startingajourney

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Posted 23 June 2012 - 09:26 PM

My DH had only 0.5% normal morphology, low counts, and low motility. He is also healthy, active, 30 years old and a non-smoker...however, his brother has similar counts (he and his wife also did IVF), so it is likely genetic. I am only 26, healthy, and have no known fertility problems. We were going to try a few cycles of IUI before going onto IVF, but my RE told us that with that severe of morphology, our chances of success were <2%. He gave us >70% chance of success with IVF with ICSI because of my age and excellent AFC. I liked those odds a lot better, so we went straight to IVF with ICSI! We had 11 of 14 mature eggs fertilize with ICSI, which is pretty standard. They expect 70-85% fertilization with ICSI. It was definitely worth the extra $1,700. And IVF worked for us the first time! :) I am currently 6w4d and counting! Have our first ultrasound on Monday! FX there is a heartbeat or two! Best of luck to you and DH on your journey!

Me: 28, DH: 32

Male Factor: low count, poor motility, 0.5% morphology
Married 4/2009, TTC since Fall 2010, 2 fur babies

April/May 2012 IVF #1 with ICSI:

5/22: ER: 15 eggs, 11 eggs fertilized with ICSI

5/27: ET: transferred 2 grade 4BB blasts, 5 frosties
6/5: Beta #1: 250!

6/7: Beta #2: 634!

9/4: 17 week scan: 2 BOYS!!! Cervix=1.7 cm with funneling. Strict bed rest! 
9/11: Cervix=1.1 cm with increased funneling...cervical cerclage placed

1/3/13: After 17 weeks of bed rest, our healthy twin boys arrived at 34w2d!  

 

Oct/Nov 2013 FET #1 to TTC #3:

11/25: ET: transferred 1 grade 3CC blast, 3 frosties left

Resulted in a chemical pregnancy! sad.png

 

Dec 2013/Jan 2014 FET #2:

12/19: Beta is finally back to zero...given the go ahead for another FET.

1/6: ET: transferred 1 grade 3CC blast, 2 frosties left

1/15: Beta #1: 139!, 1/17: Beta #2: 455!, 1/20: Beta #3: 1589!, 1/23: Beta #4: 4767!

1/30: Viability u/s: one bean on board, measuring right on track with a heartbeat! smile.png

It's a BOY! EDD 9/24/14

 


#6 fruitofthewomb

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Posted 24 June 2012 - 02:37 AM

My husband also had severe morphology issues (only about .5%). We are both (fairly) young-in our early thirties. Our RE took the decision out of our hands and told us our only option was IVF with ICSI. We are so happy that we went this route and didn't waste time and heartache (not to mention money!) on IUI's or IVF without ICSI. On our cycle, 13 eggs were retrieved and 12 fertilized! Fast forward a year and a half later and my perfect little man is now eight months old. :)
  • Highest hopes likes this
Me: 35 (mild endo)
DH: 36 (severe male factor)

History:

IVF w/ ICSI #1 January/February 2011
February 14th: ET 2 blasts transferred
February 20th: is that a second pink line?! OMG!
February 23rd: beta=106 (it's official-I am knocked up!)
October 11th: little man is here!!! :D

Natural BFP (whaaaaaa?!) January 2013
MMC at 7 1/2 weeks :(

FET #1 January/February (eeeeeeeeeeek!)

#7 TeamD&M

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Posted 26 June 2012 - 02:51 PM

Thanks for all of your advice - we're going to take the next month off (for our belated honeymoon abroad), then make a decision about what avenue to choose. I think ivf with ICSI is the best option but we'll have to save up for it...

#8 sookebunny

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Posted 05 August 2012 - 12:27 PM

Here is my husbands results

Semen Analysis
Hrs Old 2.0 0-2h h
Please note reference range changes.

Liquefaction NORMAL
Viscosity NORMAL
Volume 3.0 =>1.5 mL
Appearance NORMAL
Kinetics GOOD
Motility 65 =>40 %
Total Sperm Count 104 =>15 giga/L

Semen Morphology
Normal Forms A 3 =>4 %
Abnormal Forms A 97 <96 %
Pathologist Comments Reviewed by Dr. E. Zayed
Increased abnormal forms.

Start BCP 23/11/13

Ultra Sound and Lupron Shot Feb 25, 2014

Mexico March 13 2014


#9 Lindsey

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Posted 07 August 2012 - 07:29 AM

Hi there!

Just wanted to let you know that my hubby has only 2% morph and his counts are normally between 40 million and 60 million / ml with normal-low volume (only 1-2 ml).

I have been pregnant many times (7 in the last two years), all natural cycles. So I think it could definitely happen for you. :) My hubby has 98% head defects with his morphology. His progression is very good though, at 3-4. Unfortunately, I haven't had a successful pregnancy as some have been chromosonal, and others early losses- but it CAN happen for you and you are both young.

Is he on vitamins now? I found vitamins and varicocele surgery greatly improved my hubby's progression rating (it was never bad, but there was an improvement with vitamins). There are so many out there - but we found FertiliAid and NOW Foods Adam's Men's Superior Multi to be fantastic, along with additional CoQ10, Vitamin C, E and L-Carnitine (he also gets a lot of L-Arginine from his protein shakes, etc.). Just thought I'd mention in case you wish to try on your own for a bit. Not sure how long you have been trying, but if no luck naturally after 2 years, I'd move right onto IVF w/ ICSI and skip the IUI's.

Best of luck to you!

Lindsey

Me: 29 Hubby: 35

TTC #1 since August 2008 (5 years)

My homepage: http://www.fertilityfriend.com/home/Lindseyspage

Me: DX blocked tubes in July 2009 - Right tube opened with pressure, left tube remained blocked. DX mild endometriosis (stage II) during LAP in January 2013 - much of the endo was cauterized.

Him: DX bilateral varicoceles in August 2010 - surgery successful (we have MFI issues - morphology at 2-3%)Karotyping, blood work, diagnostic tests - all normal

Pregnancies: 8+ (many chemicals) - all natural, 1 in 2010 (3 months post-op for DH) and 6 in 2011, a few early chemicals in 2012/2013. All ended in miscarriage.

Recurrent Pregnancy Loss: unexplained. 1 baby passed at 10 weeks due to Triploidy, 68 XXX -21.

Clomid: 8 cycles (BFN), COH +IUI - 1 cycle, BFN

AART - Halifax, NS - IVF w/ ICSI #1 - August 2012.  Great response, excellent lining, 14 eggs retrieved.  13 eggs mature, and 12 fertilized.  All had excellent grades until Day 5 - Day 5, we were left with 5 good ones, graded 20/20 (hatching), 19/20 (expanded), 18/20 (expanded) and 15/20, 14/20.  One 20/20 blast transferred (we wanted to transfer 2, but RE recommended one) and 4 frozen, resulting in a BFN.  DH and I devastated, and exploring international adoption and further immune testing / treatment. 

I requested another LAP to see if anything has changed (mild endo found and cauterized Jan. 2013).

BFP!! - April 2013 - 3 months post-LAP and on a Letrozole (Femara) cycle (natural cycle, no trigger, normal BD).  Faint BFP very early, at 7 DPO (a full week before AF was due) - earliest BFP yet!

Betas:  11 DPO = 115, 13 DPO = 305, 15 DPO = 795 (31 and 34 hour doubling time)

2 ultrasounds in May show baby measuring 2-3 days ahead with great HB!  NT Scan on June 13, 2013.

 

L4g6m3.png

 


#10 Ope

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Posted 07 August 2012 - 11:03 PM

My DH also has low morphology with 98-99% head damage. Now we are both older, but when we started our journey, we barely started our 30's and all my result was good. Both times when we get to the point to have retrieved eggs and fertilized with ICSI we achieved pregnancy well beyond first trimester. ( one healthy baby, and I am 20 weeks pg with baby #2).

I find that IUI was a waste of time and money. Also with that morphology level, it is highly recommended to do ICSI and not just plain IVF.
The problem with sperm with low morphology, especially head defects, that they may carry abnormal DNA. If one of the abnormal ones wins the race and gets into the egg first, it may cause an abnormal embryo . Such embryo may not even start to splitting, or you miscarry it at early stage because it is not viable.
DH tried all the vitamins, minerals, l carnitine, acupuncture Chinese herbs and what not , but nothing changed the morphology level. All those natural remedies did is to increase count and motility, which was not our main problem.

I also suspect genetic factors in low morphology, because DH's dad is an only child and conceived after 10+ yrs of marriage at the time when contraception was not available.
right now me : 37 Dh:40

TTC #1: natural TTC 1.5 yrs
Dh: 35, Severe Male factor infertility, morphology is 1-2%
Me: 32 , tubes open, no endo, regular ovulation, all hormones are good, 3rd day FSH 5.3 , antral follicle count is 12, only problem is my weight BMI: 30

IVF/ ICSI #1: 2008 February -McGill, Montreal
Long protocol: BCP for 1 month, burselin from CD21, 300 Gonal F and 150 Luveris for 10 days
ER: 11 egg , 6 mature , 5 fertilized, 3rd day transfer:a 7 cell & an 8 cell embyos, no frosties.
1st beta : 13dp3dt: 77, BFP
2008,November 19th: Adam has arrived 7 lb 4 oz, 21"

TTC #2: natural TTC 1.5 yr
Dh :39 morphology went up to 4%, we meet the IUI cutoff! count are fluctuating from 30 to 105 million, motility is great. Caryotyping is normal
Me: 36 FSH is slightly elevated and keep rising 8.5, 8.8, 8.9, 9.8 , AFC is still 12, everything else looks good.

IUI #1: Edmonton, 2011 January ,Clomid 50mg (x5), 106 mil ,68% motile, grade 4 :BFN
IUI #2: Edmonton, 2011 February, Clomid 50mg (x5), 30 mil, 57% motile, grade 3: BFN
IUI #3: Edmonton, 2011 March, Clomid 50mg (x5), 88 mil , 49% motile, grade 4: BFN
IVF#2: 2011 May, Edmonton: long protocol , nasal suprefact : CANCELLED due to high progresteron & cyst
IVF#3: 2011 August, Edmonton: short protocol/natural start: CANCELLED due to high progesterone
IVF#4: 2001 September, Edmonton: short protocol with BCP: CANCELLED due to high progresteron & cyst
Change clinic

IVF #5: 2012 March-April Hungary: stimulation starts march 28, 300 Menopur
mixed protocol: BCP for months, CD3: Menopur 300& lupron for 8 days
ER : April 8th , 4 eggs retrieved, all were mature and fertilized with ICSI and AH
ET : April 11th, 1 A quality 8 cell, and 1 A quality 4 cell embryo transferred, no frosties.
BFP on the HPT at 7dp3dt: happy 37th birthday to me :D
Beta: , 12dp3dt: 150, 2nd Beta, 15dp3dt: 550
Anna has arrived on 21st December after being induced at 39 week. She is 6 lb 9 oz, 20" , and has blue eyes, and long dark brown hair and just perfect !

#11 cheers

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Posted 08 August 2012 - 07:42 AM

We also wasted a lot of money on IUIs. I personally haven't heard/read of too many couples succeeding naturally with severe morphology issues. That's not to say it can't happen but the odds are lower. Our RE gave us a <2% chance.

If you can afford it I would go straight to IVF with ICSI. ICSI greatly increases the chances as the embryologist chooses the best looking sperm to fertilize the egg. There are other procedures which may help if the sperm aren't normal - PICSI and calcium ionophore. However these procedures are generally only used when there is 100% abnormal sperm heads.

I wish you lots of luck! The whole process is hard emotionally, physically and financially. All the best.

Been ttc for 4 years
Dx: low morphology
1st IVF with ICSI: bfp but ended in a m/c at 5 weeks
Had initial consult with our new clinic - all screening bloodwork results are good; dna frag is high end of normal; karyotyping results are normal for dh.
February 26th called with my day 1.  Will start lupron on day 21 to down regulate.  Here we go again, hang on for the ride!! March 30th first puregon shot (day 3)
ER on April 11th - 34 eggs (ouch!)
Fertilization update - 30 mature eggs and all fertilized (holy cow!). Praying they keep growing!
April 16 - day 5 ET of 2 embryos
April 26 - BETA BFP!!!
7 week scan - 2 babies measuring on track with two good heartbeats!!! We are team PINK! Our miracle baby girls are here and we are in heaven!






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