Are we missing a MFI issue?

hollymichael

DH's S/A showed normal count and motility, but on the low end. Morph was low, but just slightly low.

Through all these IVF's, we have never heard that his sperm was a problem. They also let us into a guarantee program so it must have looked ok.

Our fert rates have been:

• OE IVF 4/5
• OE IVF 2/4
• DE IVF 3/5
• DE IVF 3/5

Other than our first cycle, these seem low to me, especially for DE cycles. We have been using frozen for the DE cycles.

Thoughts? Are they missing something?

Off to walk the dog, but will return shortly.

vanessagorc

Hum, I can share with you what DH's uro tells us (and i won't even charge u his crazy rate

With ICSI, it's a crude assessment of the sperm...so there is a margin of error.  If the sperm is really poor quality, they can't even force the fert.  But more often than not, the reason for no fert...is the egg. 

With frozen sperm, you can pretty much expect a lower fert rate.  Sperm is damaged during the defrost.  At Cornell, they REALLY want to avoid frozen sperm at all costs if possible (obviously unless using DS).  They really heavily advocate for a fresh sample if possible.  So id expect fert rates to be a bit lower w frozen.

PS- i assumed u are ICSI-ing

AND GOOD LUCK HOLLY!!!!!!!!!

baze2

Seems a little low. Are you doing ICSI? If so, maybe that is as good as it gets. However, if not that would greatly improve I think!.

I have been following your cycles as I am coming up on DE cycle #1 and only.. followed by FET...It is so scary to me!

Muah and don't loose hope my friend..

 

mdluv21

You are doing ICSI right? We have lots of MFI issues but my RE does it on everyone because it is too much to risk them not doing their job.

Our fert. rate wasn't fantastic even with ICSI but it wasn't terrible either...and my DH has terrible motility/morph issues.

hollymichael

vanessagorc:

Hum, I can share with you what DH's uro tells us (and i won't even charge u his crazy rate

With ICSI, it's a crude assessment of the sperm...so there is a margin of error.  If the sperm is really poor quality, they can't even force the fert.  But more often than not, the reason for no fert...is the egg. 

With frozen sperm, you can pretty much expect a lower fert rate.  Sperm is damaged during the defrost.  At Cornell, they REALLY want to avoid frozen sperm at all costs if possible (obviously unless using DS).  They really heavily advocate for a fresh sample if possible.  So id expect fert rates to be a bit lower w frozen.

PS- i assumed u are ICSI-ing

AND GOOD LUCK HOLLY!!!!!!!!!

Yes, we are doing ICSI. Hmmm. That is interesting about the frozen sperm. I figured it wasn't an issue since they were ok with it and we are in a guarantee program, but it sounds like it could be a problem.

vanessagorc

hollymichael:

vanessagorc:

Hum, I can share with you what DH's uro tells us (and i won't even charge u his crazy rate

With ICSI, it's a crude assessment of the sperm...so there is a margin of error.  If the sperm is really poor quality, they can't even force the fert.  But more often than not, the reason for no fert...is the egg. 

With frozen sperm, you can pretty much expect a lower fert rate.  Sperm is damaged during the defrost.  At Cornell, they REALLY want to avoid frozen sperm at all costs if possible (obviously unless using DS).  They really heavily advocate for a fresh sample if possible.  So id expect fert rates to be a bit lower w frozen.

PS- i assumed u are ICSI-ing

AND GOOD LUCK HOLLY!!!!!!!!!

Yes, we are doing ICSI. Hmmm. That is interesting about the frozen sperm. I figured it wasn't an issue since they were ok with it and we are in a guarantee program, but it sounds like it could be a problem.

I do think it could be a contributor.  Especially since u are sharing a cycle, and are dealing w less eggs.  Since you had 5 mature, I know you want them all to fert! 

Since your fert rate isn't too bad, it seems like ur DH's swimmers are ok...but maybe the freeze and thaw is less than ideal for them?

Also keep in mind our uro sees the worst MFI cases in the country...so he really doesn't want to deal w their frozen sperm...too risky.  Ur DH's seems great, so the clinic may not feel it is such a big deal.  But it's worth asking IMO.

njohnson1972

Holly, I was wondering the same thing today when I saw your fert rate.  We only had mild MFI - mostly lower count (but still decent) and lower motility.  If our only issue had been MFI, we would have been candidates for IUI.  But given my issues, we pretty much needed IVF.

And even with my crappy eggs, I always had great fert rates (always ICSI):

4/4, 4/5, 6/6

We always had fresh sperm.

I think it is something I would bring up with your RE.  Have you heard how the other couple's eggs fertilized?  

Also, how do the decide who gets what eggs?  I assume they are being fairly divided among the couples.

hollymichael

njohnson1972:

Holly, I was wondering the same thing today when I saw your fert rate.  We only had mild MFI - mostly lower count (but still decent) and lower motility.  If our only issue had been MFI, we would have been candidates for IUI.  But given my issues, we pretty much needed IVF.

And even with my crappy eggs, I always had great fert rates (always ICSI):

4/4, 4/5, 6/6

We always had fresh sperm.

I think it is something I would bring up with your RE.  Have you heard how the other couple's eggs fertilized?  

Also, how do the decide who gets what eggs?  I assume they are being fairly divided among the couples.

They divide the mature eggs, but they say they can't really tell the quality at the time they divide them. I don't know the fert rate for the other couples first cycle, but I do know that only one of the three recipients got pregnant. Also, I am sending you a PM.

hollymichael

vanessagorc:

hollymichael:

vanessagorc:

Hum, I can share with you what DH's uro tells us (and i won't even charge u his crazy rate

With ICSI, it's a crude assessment of the sperm...so there is a margin of error.  If the sperm is really poor quality, they can't even force the fert.  But more often than not, the reason for no fert...is the egg. 

With frozen sperm, you can pretty much expect a lower fert rate.  Sperm is damaged during the defrost.  At Cornell, they REALLY want to avoid frozen sperm at all costs if possible (obviously unless using DS).  They really heavily advocate for a fresh sample if possible.  So id expect fert rates to be a bit lower w frozen.

PS- i assumed u are ICSI-ing

AND GOOD LUCK HOLLY!!!!!!!!!

Yes, we are doing ICSI. Hmmm. That is interesting about the frozen sperm. I figured it wasn't an issue since they were ok with it and we are in a guarantee program, but it sounds like it could be a problem.

I do think it could be a contributor.  Especially since u are sharing a cycle, and are dealing w less eggs.  Since you had 5 mature, I know you want them all to fert! 

Since your fert rate isn't too bad, it seems like ur DH's swimmers are ok...but maybe the freeze and thaw is less than ideal for them?

Also keep in mind our uro sees the worst MFI cases in the country...so he really doesn't want to deal w their frozen sperm...too risky.  Ur DH's seems great, so the clinic may not feel it is such a big deal.  But it's worth asking IMO.

I am definitely going to bring it up when I talk to him. Thanks!

theworms

you've got some great advice cutie

i really hope this is your sticky BFP and you don't need any of it

i do think trying fresh sperm may help

GL

ladychicago

hollymichael:

vanessagorc:

hollymichael:

vanessagorc:

Hum, I can share with you what DH's uro tells us (and i won't even charge u his crazy rate

With ICSI, it's a crude assessment of the sperm...so there is a margin of error.  If the sperm is really poor quality, they can't even force the fert.  But more often than not, the reason for no fert...is the egg. 

With frozen sperm, you can pretty much expect a lower fert rate.  Sperm is damaged during the defrost.  At Cornell, they REALLY want to avoid frozen sperm at all costs if possible (obviously unless using DS).  They really heavily advocate for a fresh sample if possible.  So id expect fert rates to be a bit lower w frozen.

PS- i assumed u are ICSI-ing

AND GOOD LUCK HOLLY!!!!!!!!!

Yes, we are doing ICSI. Hmmm. That is interesting about the frozen sperm. I figured it wasn't an issue since they were ok with it and we are in a guarantee program, but it sounds like it could be a problem.

I do think it could be a contributor.  Especially since u are sharing a cycle, and are dealing w less eggs.  Since you had 5 mature, I know you want them all to fert! 

Since your fert rate isn't too bad, it seems like ur DH's swimmers are ok...but maybe the freeze and thaw is less than ideal for them?

Also keep in mind our uro sees the worst MFI cases in the country...so he really doesn't want to deal w their frozen sperm...too risky.  Ur DH's seems great, so the clinic may not feel it is such a big deal.  But it's worth asking IMO.

I am definitely going to bring it up when I talk to him. Thanks!

Hey honey! I definitely think it is worth asking about, but I also don't want you to worry too much. Our only diagnosis is MFI (low count, borderline morph and motility), and we have almost always used frozen sperm because DH's job simply doesn't allow for on demand sample production. we have done limited fert IVF twice and had 100% ICSI fert rates both times with frozen samples. I know it is all very person dependent, and maybe your DH's sperm doesn't hold up as well, but our clinic has never batted an eye at our need to use frozen sperm. Like I said, definitely worth an ask, but i am not sure it would be a deal breaker, you know?

Fingers crossed for you lady!

kthappy76

Wish I had some sage advice for you, I'm sorry you even have to worry about this.  These fert rates don't look that bad to me, but the total number of eggs you are getting from a donor seems really low.  I've always heard that egg quality is more important than sperm generally, ICSI gets around most sperm issues.  GL hon!

hollymichael

kthappy76:

Wish I had some sage advice for you, I'm sorry you even have to worry about this.  These fert rates don't look that bad to me, but the total number of eggs you are getting from a donor seems really low.  I've always heard that egg quality is more important than sperm generally, ICSI gets around most sperm issues.  GL hon!

We are in a 3:1 shared cycle, so that is part of the reason for the low number of eggs. There were actually 14 mature eggs split between 3 recipients. Still, I think 14 (and the 15 our donor produced last time) are on the low side for a donor egg cycle. I would have expected something in the high teens/low 20's which would be more on par for what they have listed in their stats.

GL to you too!

JM1977

They do seem a little low but probably not a huge part of the equation.  Has your DH had the DNA fragmentation test done?  My DH had terrible results on that which then predicted very poor fertilization (1/6 for our OE cycle and 2/12 - or something like that - on our DE cycle with his sperm).  I think your fertilization rate is fairly common, although I know it's discouraging.

I agree though that I would have expected a few more mature eggs - more like 7-8 per couple based on their stats like you said.

hollymichael

JM1977:

They do seem a little low but probably not a huge part of the equation.  Has your DH had the DNA fragmentation test done?  My DH had terrible results on that which then predicted very poor fertilization (1/6 for our OE cycle and 2/12 - or something like that - on our DE cycle with his sperm).  I think your fertilization rate is fairly common, although I know it's discouraging.

I agree though that I would have expected a few more mature eggs - more like 7-8 per couple based on their stats like you said.

He has not, but I think I will ask my RE about it. Did SG recommend it? Or, did you have it done when you were at CCRM?

kthappy76

hollymichael:

kthappy76:

Wish I had some sage advice for you, I'm sorry you even have to worry about this.  These fert rates don't look that bad to me, but the total number of eggs you are getting from a donor seems really low.  I've always heard that egg quality is more important than sperm generally, ICSI gets around most sperm issues.  GL hon!

We are in a 3:1 shared cycle, so that is part of the reason for the low number of eggs. There were actually 14 mature eggs split between 3 recipients. Still, I think 14 (and the 15 our donor produced last time) are on the low side for a donor egg cycle. I would have expected something in the high teens/low 20's which would be more on par for what they have listed in their stats.

GL to you too!

Ah, I forgot that part.  Do you know the total fert vs. retrieved?  Maybe you just got unlucky and got the few that didn't fert.  If only nine of the 14 fertilized, then I would definitely be concerned.