Abnormal Semen Analysis. Thoughts?

skier8390

Hi everyone!

My husband (35) and I (33) are a same-sex male couple about to begin our IVF journey with donor eggs+surrogate. We thought everything would go well and that there wouldn’t be any issues. Unfortunately that isn’t the case as my husband got his results back and he did have an abnormal semen analysis:

Concentration: 114 million (normal > 15 million)
Motile: 74% (normal > 40%)
Normal Morphology: 3% (normal >=4)

Everything else looked normal but those are the three main factors I’ve learned contribute to male fertility and normal morphology being that low definitely sounds like it will be an issue when it comes to fertilizing eggs. I’ve read online a ton of conflicting info and our doctor hasn’t talked to us yet which is making this even harder.

Can anyone help provide any insight for us or share their personal experiences?

Thanks for your help!

skier8390

Just wanted to update that we were told that our clinical team isn’t worried about it, (our doc literally signed off on the results the same day we gave the specimen). They’ll be using ICSI (which they made it sound like that was very common to do anyway for their clinic).

inthewoods23

I know you have your answer but still wanted to chime in with my personal experience.

When my husband had his semen analysis, his concentration and motility were normal (although possibly even lower than your husband's), and his morphology was only 1%. My OB stated they consider it a "yellow flag" as they really don't know how many men out there have no issues with conceiving but have extremely low morphology. We did IUIs which were all unsuccessful. When we moved to IVF they also used ICSI for the procedure. This basically takes the issue of low morphology out of the equation since they inject 1 single normal shaped sperm into the egg. For us the majority of the mature eggs did fertilize so I wouldn't worry too much knowing they will be doing ICSI!

And FWIW, skipping way ahead in my timeline dealing with infertility, we discovered IVF wasn't necessary as we were able to conceive naturally for reasons that IVF wouldn't fix (implantation problem). I will say it may be beneficial for your husband to take a multivitamin prior to your IVF. It really doesn't help with morphology, but it can improve the concentration and motility for healthier sperm.

Good luck!

skier8390

Thanks inthewoods23! That was very reassuring to read and lines up with what our clinical team was saying. We will proceed using his sperm then. My husband has started taking a multivitamin and we’re both trying to eat healthier and exercise (not just for fertility’s sake but also to be healthy parents for our child).

00kim00

Just looking mathematically, I wouldn't be concerned. With their normal ranges, 15 million sperm, with 40% motile and 4% good morphology leaves 240,000 "good" sperm in that sample size. Your concentration and motile percentage is so much higher, even with the slightly lower percentage of good morphology, you actually end up with more than 10 times more "good" sperm overall in that sample size: 115 million x .74 x .03= more than 2.5 million. They might be trying to upsell you on the ICSI (it does cost more). You could look into/consider if rescue ICSI is something you'd prefer. That gives some time for natural fertilization, but then they'll do ICSI if needed for any egg that wasn't fertilized

skier8390

Thanks for the response 00kim00! It helps when you put it in that perspective! I’ll also keep the ICSI cost in mind.

blacksnoww

In this article, they say morphology is only one of the variables, and the rest of parameters are ok. Good luck with ICSI. 

ivfmeerut

I understand this is a challenging situation. It's important to consult with your fertility specialist for a detailed analysis and personalized guidance. Low morphology might affect fertilization, but there are options like ICSI to address it. Stay hopeful and proactive in seeking professional advice.