Male fertility - causes of low morphology?

[metric]

I had a sperm count done after 29 days of abstenance that showed low morphology of 1%. The count was done by an outside lab that has no connection to our fertility doctor. Our doctor considers 5% to 13% to be low-normal or something, which means their 1% isn't even on his graph.

Anyway he is pushing IVF ICII, which I agree is the best course of action in our situation, IF I really have 1% morphology. However I'm scared that morphology has something to do with the abstenance or some lab varience or other non-permanent factor. Nutrition is supposed to (depending on who you listen to) make a difference, but is there really going to be a difference from 1%? One percent to me is "barely not zero", doubled is still barely not zero.

He is very reluctant to repeat the sperm count as during preparation for ICII the sperm will be analysed again. The thing is I don't want my wife going through 8 weeks of pre-IVF, not to mention the financial costs, only to have them come out and say, "Well your sperm turned out to be 8% morphology, we really could have tried IUI first."

Does that make sense? I can't seem to find any information on the cause of low morphology. Does long abstenance have any effect? Is 1% hopeless (or at the bottom of hopeless right next to zero)? Is there really no point in getting retested?

[Tootles23]

I am surprised that they only did one SA- most times places want 2-3 SA's b/c they can vary. My DH had 3 SA's spaced out by a few months and all 3 had different amounts of morphology (the last being 0% but we won't go there). Was your SA a Krueger's strict morphology? We had very strict instructions that the period of abstinence could only be a certain number of days (not more than 5, not less than 3 I think?) All sorts of things can affect morphology- illness, hormones, genetics,etc. The volume also affects the seriousness of the morphology- for instance 1% of 120 mil is a lot different than 1 % of 5 mil. I have heard of people getting PG without IVF with only 1 or 0% morphology. IMO, I would make sure to get at least 1 more SA with less than a 29 day time frame before pursuing IVF with ICSI.

[cincynana]

You really should get 3 SA's, all 1 month apart to see the whole picture. Most urologists will do it that way. And you shouldn't abstain for more than 5 days, so that really could skew your results. I would most definitely get at least 2 more. In the meantime, lifestyle changes can also help (no alcohol, a good diet, vitamins, etc)

Good luck!

[kittywitty]

I agree with the pp's. I was an andrologist and after 29 days, I would push for a couple more SA's after ~2 days abstinence. That is optimal (or was a couple of years ago when I was in the field).

[joyakshi]

did you abstain for 29 consecutive days? I've heard that the sperm "go bad" if they aren't "cleared out" regularly. They say to ejaculate at least 5 days before a sperm test and abstain the three days before.

[Kristin0105]

Acupuncture is supposed to help with morphology. You might want to try that first. Cheaper than IVF also said to improve success rate for IUI, IVF cycles. So your wife might want to check that out as well. There are also supplements that can help. Off the top of my head Coenzyme Q10, Pycnogenol, L-Argenine, L-carnitine. The Infertility Cure by Randine Lewis has a list of supplements for men and women, with the appropriate amounts.