SA Analysis - thoughts?

lavril

Okay sorry just one more post for tonight..

We got my DH's SA back today.  Below are the results:

73 mil total
55%   motility
4.5% normal shaped (is this morph?)

 Should I be freaking out here?  The total is good.  She said the motility is fine, but the "normal shaped" was a little on the low side.  They like to see closer to 14? 

 To me that sound crazy low.  They said we could do TI or IUI, whichever we preferred, so they didn't seem too concerned.  Should I be?!?

Carolee

Do you know what criteria they used?  (Kruger's Strict or WHO)  For the Kruger's, anything less than 4% morphology (yes, this is shape) causes severely impaired fertility, while anything above 14% is considered normal.  According to WHO, anything above 4% is normal.  I'm assuming they used Kruger's because you said they told you they like to see 14.  Morphology is our issue - DH has done 2 SAs and on the first one he had 2% normal sperm and only 1% on the second.  FWIW, I did get pregnant after 1 of the 4 IUIs we did, but I m/c.  Our RE recommended IVF after the first SA, but we decided to try IUI first because it was partially covered by insurance.  You might not have to take that step because your DH's number is higher.  Good luck!

lavril

Thanks for the info Carolee.  I didn't realize there were two scales.  I will ask tomorrow when I go in for my u/s.  I *think* she said it was on the very low side of normal, and that they could see anywhere between 0-14 (a student of mine walked in right when she was telling me this on the phone so I was distracted).  She did say the RE would let us do either TI or IUI -  which made me think it wasn't horrible.  But then I googled it.......

Carolee

lavril:

Thanks for the info Carolee.  I didn't realize there were two scales.  I will ask tomorrow when I go in for my u/s.  I *think* she said it was on the very low side of normal, and that they could see anywhere between 0-14 (a student of mine walked in right when she was telling me this on the phone so I was distracted).  She did say the RE would let us do either TI or IUI -  which made me think it wasn't horrible.  But then I googled it.......

Yeah, google is NOT your friend on this subject...trust me, I've been there too.  I hope you get a little more information tomorrow.  I would think if it was really bad, your RE would try to convince you to go with a more aggressive procedure like IVF.  I would ask how much doing IUI over TI would increase your chances, and go from there.

lavril

Carolee:

lavril:

Thanks for the info Carolee.  I didn't realize there were two scales.  I will ask tomorrow when I go in for my u/s.  I *think* she said it was on the very low side of normal, and that they could see anywhere between 0-14 (a student of mine walked in right when she was telling me this on the phone so I was distracted).  She did say the RE would let us do either TI or IUI -  which made me think it wasn't horrible.  But then I googled it.......

Yeah, google is NOT your friend on this subject...trust me, I've been there too.  I hope you get a little more information tomorrow.  I would think if it was really bad, your RE would try to convince you to go with a more aggressive procedure like IVF.  I would ask how much doing IUI over TI would increase your chances, and go from there.

Okay - good idea.  I will ask tomorrow.  I guess my actual RE is going to do the u/s?? I scheduled my appt w/ him so I should have time to ask.  Honestly, I'm still a bit freaked out by all this.

My DH has a job interview tomorrow so I haven't shared the results w/ him yet (don't want him to worry), but tonight he decided to have a beer w/ dinner and I almost went off on him (something to the effect of - what the h*ll are you doing to your sperm?!?).   Oye, this is going to be a long journey.

Carolee

It's difficult for sure.  My DH is still having a hard time dealing, and it's been more than 6 months since we found out.  He keeps thinking he can improve it (although the 2nd analysis was worse and RE says there really isn't much that my DH can do) so I think he's having trouble grasping that what he's done hasn't worked and we still have to do IVF.  I hope you're able to talk to your RE in detail tomorrow and find out some more information.  Keep us updated!

buckeyebaby814

I have no advice to offer but just wanted to say I hope your appointment goes well.  My husband's morph was low too, but one thing I heard (from the girls on 3T) was that of the different things that a SA checks, morph is the least important.  I'm not saying it's not important, but apparently it's the least.

lavril

Carolee:

It's difficult for sure.  My DH is still having a hard time dealing, and it's been more than 6 months since we found out.  He keeps thinking he can improve it (although the 2nd analysis was worse and RE says there really isn't much that my DH can do) so I think he's having trouble grasping that what he's done hasn't worked and we still have to do IVF.  I hope you're able to talk to your RE in detail tomorrow and find out some more information.  Keep us updated!

Aww, I'm sorry.  That must be so rough.  I can't imagine my DH would take any news well either.   The nurse said he can take vitamins, antioxidants and stop drinking (and smoking if he did that), but the number would generally only budge a percent or so.  I'll defn keep you posted as I get more info.

damabo80

Is this in conjunction with the clomid challenge? If so, if you have one follie, I'd do TI and save the $$ for IUI when you're on better drugs that don't inhibit your lining.

If you have 2+ good follies, then I'd do IUI and hope I had good lining,

heathergirl67

Morph is our issue, too. The new criteria (as of this year) is that anything at 4% or over is considered normal. However ours was at 0% and then 1%. Turns out that morph is very important. Like your husband, mine had a good count and good motility. So when I got our results I didn't really think there was any point in doing IUI's because they can obviously get to the egg. They just can't penetrate it when they get there. After learning of our diagnosis we went straight to IVF w/ICSI. I would recommend that your husband gets checked out by a urologist, though. Sometimes a vericocele can damage morphology. They can correct that surgically and sometimes morphology will improve. Since your husband's numbers are so on the borderline even a 1% or 2% difference would be huge. GL!

lavril

Thank you ladies for all the info!!  My RE has put him an antioxidant combo and a multivitamin.  He didn't take the news too well, but not sure any guy really would. 

Heather - My RE didn't mention anything about a urologist.  Do they deal with that kind of thing often?  How do they test for vericocele?  Did your RE recommend anything else for him? 

Damabo- yes with clomid challenge.  I'll keep that in mind!  Thanks.

Buckeye - thanks!  I've been thinking about intro'ing over there too.

lavril

Carolee:

Do you know what criteria they used?  (Kruger's Strict or WHO)  For the Kruger's, anything less than 4% morphology (yes, this is shape) causes severely impaired fertility, while anything above 14% is considered normal.  According to WHO, anything above 4% is normal.  I'm assuming they used Kruger's because you said they told you they like to see 14.  Morphology is our issue - DH has done 2 SAs and on the first one he had 2% normal sperm and only 1% on the second.  FWIW, I did get pregnant after 1 of the 4 IUIs we did, but I m/c.  Our RE recommended IVF after the first SA, but we decided to try IUI first because it was partially covered by insurance.  You might not have to take that step because your DH's number is higher.  Good luck!

I asked about this and they said they were using Kruger's - so we're borderline at the bottom of the scale.   They said we could do either TI or IUI - we're going to do TI this month and see how the rest of the testing turns out.

heathergirl67

Do they deal with that kind of thing often?

Yep! We did see a urologist that specialized in reproductive issues, but I'm 99% sure that any urologist can diagnose and treat a vericocele. It's not an uncommon problem.

 

How do they test for vericocele?

They do a basic physical, ask a bunch of questions, and basically poke around his junk a lot. (Payback, if you ask me! ) If they suspect a problem they may u/s the area.

 

Did your RE recommend anything else for him?

Nope. They asked if he smoked or drank. He told the doc that he doesn't smoke and will maybe have two beers over the course of the football game. Also, he told him that he rides mountain bikes once a week. The doc said that none of those were a big deal. After looking him over and seeing his hormone level bloodwork the urologist just said that there's nothing "causing" his morphology issue. It's just how he was born and nothing will really fix it. Which is a bummer, but I'm glad we know. GL!