Q's for ladies with MFI issues

heathergirl67 · September 2011

We recently got Kruger test results back that gave my husband a value of 0% morphology. I've been doing some research and I have some questions for other ladies who have MFI issues:

1. Did your husband see a urologist? Do you think it's worth it? I read that if a man has a vericocele it can cause IF issues. Vericoceles can often be repaired and many of those men are able to impregnate their partners naturally thereafter. But MH doesn't have any veriocele symptoms, could it be asymptomatic?

2. Are you doing/ have you heard of the Sperm Chromatin Assay test? The SCA tests sperm for their DNA fragmentation. According to a study (https://humrep.oxfordjournals.org/content/15/8/1717.short) and the internet (https://en.wikipedia.org/wiki/DNA_fragmentation) men with more than 30% damage on the SCA have virtually no chance of impregnating their partners, even with IVF w/ ICSI. I asked my RE about it and he said that that is false. I will be seeking a second opinion, but I'm wondering if you've heard or read anything about it?

wither16 · September 2011

My DH has 3 MFI factors. We did go to the Uro, we thought if there was a cause, it would at least save us the $$ for ICSI. (we were IVFers no matter what though)

I believe that there are several different things that could cause the MFI, including the vericocele you spoke about. I think it's worth it just to get an expert opinion. They will most likely do another set of bw if they didn't pull all the testosterone panels, etc. Luckily, my RE is connected to the Uro- so they knew exactly what blood panels to pull for the Uro- we walked in with SA results, blood panels and then the Uro did a physical exam.

Our situation was unexplained, but it was nice to know we had tried everything.

Good luck!!!

Delta04 · September 2011

Hey there - my DH went to a urologist and I think it is well worth it if for nothing else than to try to see what is causing the problem. There could be a number of underlying causes for sperm issues.

My DH had varicocele surgery but unfortunately, the results did not improve too much. It is very important to know that the surgery does not guarantee better results. Also, my DH never had any sypmtoms. He did, however, have a pretty bad hernia at birth, which required surgery and he had another hernia surgery about 7 years ago.

We are not sure whether those surgeries - particulary the one he had as a newborn - were the culprit; so he has an idiopathic dx. He also had the sperm dna fragmentation test as well as the Y chromosome deletion (sp)....or something like that. So sorry, it has been so long ago.

If I were you, I would have him consult one. GL.

Edwina.McDunnough · September 2011

I wrote a response regarding SCSA on this post and this one, also there is an entry on Dr Scher's blog. It's a controversial test because it can indicate DS unnecessarily.

GL.

Mitzi Bishi · September 2011

1. Yes, my DH went to a urologist in connection with my RE. Ours didn't give us tons of new info or at least things to do with the discoveries. My DH learned he has low numbers all around, a grade II varicocle, and he had a bacterial infection, which he was treated for twice. I also requested meds, because to me it sounded pointless to treat just him given our circumstances.

I have read that bacterial infections are sometimes the root of unexplained IF and some doctors Px a heavy dose of meds in an attempt to 'clean things out'.

2. I should know, but honestly I'm not sure if my DH was tested for this, although I believe he was. We had an unsuccessful IVF-ICSI cycle and nothing to freeze.

Unfortunately the varicocle surgery and ICSI don't guarantee success. I hope you fall on the lucky side if you go either route.

Another thing that might interest you is I've heard that there is something that can be done (I don't know if this is just a European thing or available in the US) that relaxes the DNA coil below the head so they can be better separated if there are fragmentation issues. I posted an article about it a couple months back... let me see if I can find it...

MsGMChick · September 2011

1. Yes, MH sees an IF Uro. I would highly recommend a uro especially if you can find one who specializes in IF. Vericoceles can sometimes be the cause of MFI but not always. MH had an US to rule any out and he did not have one. We did discover he had low testosterone and that's what's causing his low numbers (including 0% morph like YH). Our Uro gave us two choices- IVF with ICSI or try Clomid for a while to see if it helps him. Our goal is having the clomid help enough to go back to IUIs (as of now we have a 5% chance of conceiving with IUIs on our own without IVF with ICSI). In a few months we'll get a repeat SA done and BW to see if it's helping him and then adjust from there. If not, or if we still don't get pregnant, we'll do IVF next summer. Has YH had bloodwork? What was his testosterone/fsh/lh levels?

2. I have heard of DNA fragmentation tests but he hasn't had one before.

heathergirl67 · September 2011

My husband has had bloodwork done. All of his hormone levels come back normal. He even had a SA that came back normal. It wasn't until we had the Kruger SA done that we discovered he had 0% morphology. So far, that's the only issue we can find with either of us. But it's a biggie.

Thank you for all of the replies! I swear, you ladies are so informative. Collectively we could teach a class about IF. From the links you've provided it's looking like SCSA is pretty much good for indicating whether or not we'd need ICSI. We already know that we do, so it's useless for that. I'm getting the impression that even if the test results come out bad, it still only cuts our chances of achieving a viable pregnancy with my husband's sperm by about half, based on my maternal age (27). I think even if we got that result we would go ahead with IVF. So it's looking like the SCSA might not be necessary. I am going to a new RE for our IVF, so I'll be sure to ask his/her advice on this beforehand, too.

MsGMChick · September 2011

Has he had a second SA with Kruger Morphology to confirm? Flukes do happen.

heathergirl67 · September 2011

MsGMChick:
Has he had a second SA with Kruger Morphology to confirm? Flukes do happen.

No, but that's a good idea. I'm actually prone to think that the first SA was the fluke because his number of total sperm then was 109million, whereas afterward his counts were 45million, 5million (post-wash), 10million (post-wash), and 10million (post-wash). But I will have him ask the urologist if he recommends a second Kruger when he goes in for his appointment. I should just go with him, since I'm the one who knows all the questions to ask. I've explained it to him three times, but I'm still pretty sure he doesn't know why he's going in. Confused

sbrowns08 · September 2011

My husband has a uro who specializes in MFI. He was diagnosed with a Stage 2 varicocele. We tried 3 IUIs first at the recommendation of the uro. Post wash counts kinda stunk, so we went ahead with surgery. It was painful with a terribly long recovery. We did an IUI and 4 months post and 5 months post surgery. Numbers didn't improve. It wasn't until 6 months later that we finally had better numbers (just this week).

I guess what I'm trying to say is that after all of this, we wish we had gone right directly to IVF and skipped the IUIs and surgery. I would recommend seeing the uro, because you never know if there are any issues that need to be addressed.

GL!

KDR1979 · September 2011

My DH also has 0% morph. We did see a uro that specializes in mfi. I think it is worth it. A varicocele or hormonal issue could be fixed. DH takes l-carnitine 500mg, antioxidants, Switched to boxers, etc...so far no improvement for us. My RE also does not believe in sperm dna/fragmentation test. my RE is still very Optimistic that ICsi will work for us. Good luck!

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