Morphology Issues?

hmz819 · November 2011

Hi Ladies:

I have been lurking on this board for a while and I have a question. My DH had a SA and his results weren't normal. His motoility is 40% which I don't think is horrible but morphology is only 4%. We can't get an appointment with an RE until next year. DH does have an appointment with the urologist on Tues but is there anything that they can do to help morphology?

With these numbers could I still get pregnant without IUI or IVF? (Assuming that I have no issues?) (I know this is a loaded question and no one can say 100% but I am just wondering what the general consensus is or whtat others in our situation have been told).

limpetfan · November 2011

4% morph is obviously not ideal, but it's not horrible, either. Our RE always tells us they don't get really concerned over morphology until it's 1% or less. It will probably qualify you for IVF-ICSI, though.

As far as I know, there isn't very much you can do about morphology except to make sure your DH is taking a multivitamin daily. Also, my DH has 3% morph, and our RE told us there's no reason it would inhibit being able to get pregnant naturally. I think it's more an issue when your diagnosis is poor morphology + something else.

Hope that helps!

MsGMChick · November 2011

Morph is one if the least studied issues right now and everyone has a differing opinion. This one's just mine... Morph is important because it dictates a lot. With amorphous tails - swimming straight is an issue, with amorphous mid section- it won't be able to explode and release the enzymes properly, with amorphous heads- it has trouble penetrating the egg at all. That being said, so much depends on other factor, too, like count and motility. You said the motility was 40%, what was the count? The example stands like this.. If you have 100 million total in a sample, then 40% is motile- now you have 40 million, then 4% are structured correctly- now you have 1.6 million total motile normal sperm. That seems low but it's pretty good because most REs when doing IUI, etc only look at the motility and they'd see your 40 million.

Um, my long winded explanation boils down to this.. lol

Our IF urologist explained that 0-4% is pretty much IVF/ICSI needed, 5-10% would be great IUI candidates and over 10% would been keep trying the old fashion way. You fall on the line. Your RE will probably tell you you can try a few IUIs but may end up pushing for IVF.

As a girl TTTC, I can tell you we have 0-2% morph depending on the day and I've managed to get pregnant twice. Once with a m/c at 6 weeks and one chemical pregnancy. Now, were those m/c a result of amorphous sperm? Our uro thinks they could be but we will never know. I very well could have just been unlucky or it could have resulted from the endo we didn't know I had til last week. Unfortunately, you just have to keep trying and do what's right for you and YH.

lady_chance_99 · November 2011

love2travel1:

I think that 40% motility is bordeline. I believe normal is supposed to be at least 50% motile. That paired with the 4% morph, I would think that your RE would recommend IUI. Is it possible you could get pregnant without IUI? Absolutely, but I think youre best chance would be IUI.

This. This is exactly what my RE did- saw his issues and recommended IUI. We are doing a Metformin only, cycle this month (due to surprise ovulation) but from here forward it will be IUI... GL to you

lady_chance_99 · November 2011

love2travel1:

I think that 40% motility is bordeline. I believe normal is supposed to be at least 50% motile. That paired with the 4% morph, I would think that your RE would recommend IUI. Is it possible you could get pregnant without IUI? Absolutely, but I think youre best chance would be IUI.

This. This is exactly what my RE did- saw his issues and recommended IUI. We are doing a Metformin only, cycle this month (due to surprise ovulation) but from here forward it will be IUI... GL to you

jessican08 · November 2011

The PPs have all given great advice.

This isn't what you want to hear but my DH has only 1% morphology - we tried 6 IUIs but never got a BFP so we're moving on to IVF w/ ICSI in January. I have endo as well so who knows if the IUIs didn't work as a result of that, the poor morph or both reasons.

Having said that, I definitely wouldn't discount trying IUI first, especially with 4% morph which is borderline "bad" depending on which guidelines they're going by. I hope the urologist has some good info for you both. GL!!!

Blueyed228 · November 2011

My H has 4% morph as well and on IUI #2 I did get pregnant (it was a c/p).

My RE said morphology is the least important of the 3. But that is not to minimize morph issues. He thinks IUI's are fine for now because they deposit the sperm right in your uterus and cut down on the swimming that needs to be done.

But every RE is different and like PP said, there are so many different opinions on morph and other factors play a role in success rates with that percentage as well.

Best of luck to you

hmz819 · November 2011

Thank you for all your answers. I was not suprised to hear IUI/IVF is the best option. I just want to know what we are dealing with so we can move forward. Hopefully we will get more answers soon.

maggie2324 · November 2011

Hi, I agree with the other ladies. I just wanted to add that you can try Pycnogenol. It's a supplement that may help with morphology. MH is on it, but we're doing so many things at once, I'll have no idea what worked and what didn't (assuming something works!)

If you're not in a huge hurry to start IUI/IVF, you may want to give that a shot for a few months.

We're at 0% morphology, so we are not candidates for IUI (unless things improve). If you're OOP, I wouldn't recommend spending the $ on IUI unless you can get the numbers a little higher.

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