Intro and question about SA results, poor morphology

g8rmama_16 · March 2016

I have been on the TTGP board for a few months and my husband and I have been TTC for 6 months. We are both 35 and this would be our first. This is my first time participating on the Infertility board. I have had some minor testing done just to check my day 3 and day 21 levels, all were normal. So far, I seem to have a normal cycle. I made an appointment with am RE for later this month to make sure everything else checks out ok.
So, for my question...Last week my husband went for a SA and the results came back with poor morphology (4%). That "isolated severe" in the MD notes has me all kinds of concerned. Unfortunately, he didn't get a chance to talk to his doctor yet to break down the results. The only thing the nurse that called him with the results said was to come back in 5 weeks for a repeat test. I know one test is just a snapshot and his results might change, but I just don't have a good grasp on how serious this is or if I shouldn't worry about it yet. He also got blood work done, we will have those results tomorrow.
I have done some research and can't find very much conclusive information on morphology and it's impact on natural conception. Some people say it doesn't matter, some think it does. Most studies I read were about the impact of morphology on IVF and IUI. Is morphology only a factor when using IVF or IUI? Should I anticipate my next step to be IVF with ICSI?
If anyone here is dealing with MFI or might be able to break down this test and could help me decipher his results, I would greatly appreciate it. There are some other areas that are outside of the normal range (viscosity, round cells), but I don't know if they are cause for concern or not.
Sorry for all of the questions. Thank you in advance for your insight and help!
FWIW this is after 7 days of abstinence.

Image: https://us.v-cdn.net/5020794/uploads/editor/ep/eplu18i6aeha.jpg

tvh1982 · March 2016

Hi! and welcome.
Sorry you found yourself on this board, it's a good place to be, but I'd rather met everyone on a 'happier' board.

i don't have any tips or advice for you, but I saw that @sammyl1221 has asked about the same topic, and she got some responses. Have a look there.

GL on your journey!

dragonfaerie · March 2016

Hi there! Sorry you have to be on the board with us, but this is a great resource. I can't address your results specifically, but here's what I know:
Morphology covers how the sperm look which includes them having the acrosomal (spelling?) cap. If most of the sperm don't have that cap, they can't get into the egg which makes conceiving naturally or through IUI difficult. If you have really good motility and count, then IUI might still work, but unfortunately IVF with ICSI may be the way to go for your best chances. Your doc will be able to tell you what they think is best based on all of your other numbers. We had tried two rounds of IUI that both ended up cancelled and my doc basically said he didn't want to waste our money and break our hearts just to keep trying when our odds were less than 3% with IUI. Some people will end up doing 5 or 6 rounds of IUI before moving to IVF.

oxinfree · March 2016

Hey there! Haven't read through what the other ladies said but they're both very knowledgable and I'm sure they gave great info.

My DH actually had 1% morphology for years. He was just retested this year and it was 6% so it can change! Make sure your DH is avoiding the "sperm killers" such as saunas/steams, bike riding etc, and get him on a supplement. My DH has been taking a really good multi-vitamin and I guess look for Selenium and Folic Acid (not just for the ladies!).

Morph is important, but if he has a high overall count, its less important for natural conception, as nature will weed those out anyways. 4% isn't the worst, it's right on the cusp, but I'm sure worrisome nonetheless. Best bet is to chat with your doc about it. When we had 1% we definitely ruled out IUI and went straight to IVF... We'd give IUI a chance now at 6% however with endometriosis now confirmed, our best bet is IVF. So it'll depend on what your diagnosis (if anything) is as well.

Best of luck to you! Sorry you find yourself here, but these ladies are all amazing resources!

g8rmama_16 · March 2016

Thank you all so much! I guess now I just wait until my appointment and his retest...

BrightenMySky · March 2016

You are right that there is some dispute about how important morphology is. We had been trying for just over a year, did a SA, and then got a similar morphology diagnosis. Our RE wanted to go to IUI with Clomid--I ovulate, but the idea with the Clomid is to increase the number of eggs to increase the chances that a normal sperm will find its way to an egg.

/pregnancy & loss mentioned/
We did have success with IUI #3. Unfortunately, that ended in a loss due to a genetic issue where 2 sperm make their way into 1 egg...kind of ironic given we have MFI, huh? I was concerned that the morphology issue could be a risk factor for this kind of genetic flaw, but my RE said he thinks it is very unlikely. So we're going to go for 3 more of the same and then onto IVF, if needed.

g8rmama_16 · March 2016

@BrightenMySky The clomid makes sense. I see on the MD notes that he recommends medicated super ovulation with IUI.
That is crazy that you had two sperm in one egg! I didn't even know that was a thing!

BrightenMySky · March 2016

@HeyBooHey the way it was explained to me, it's super aggressive sperm or an egg that doesn't close down after one sperm makes it in (or some combo). But to me, just pure irony. It results in 3 copies of every chromosome, which I think has close to zero chance of live birth.

juliehollz13 · March 2016

Hi, our RE actually thinks anything above 3% is great, 4% is optimal. DH has morphology of 2% but since his count and motility is good she's not worried. Don't google too much about it. Some websites say that 2-6% is normal and some say it has to be above 15%. dont freak out until you talk to your RE.

P.S. our RE is also recommending IUI at least to try because the sperm washing will improve the numbers as well.

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