With your volume, counts and motility so high, the morph shouldn't be as big as a deal, at least according to the urologist that we saw. What criteria was the morph measured on? That too can make a big difference. Our urologist said that morph measurement is somewhat controversial and doesn't really make a difference when everything else is at or above normal.
Here is a blog written by a RE. I pulled out some of the morph info (sorry this is so long) All of his entries are in purple.
http://infertilityblog.blogspot.com/Abnormal Sperm Can Fertilize Eggs and Make Babies
How do I know that? Because it happens every day at the NYU Fertility Center.
If we have a man with good counts, good motility and low morphology, we do not recommend IVF with ICSI. We will treat him as if there is not a problem (because we don’t think there is one) and allow the couple to do insemination. If they do go on to IVF, we do not perform ICSI, and the eggs fertilize just fine. Of course, we would not follow this plan if the counts or motility were very low. And we at times have exceptions.
Other clinics do things differently. Sometimes its because other places have found that they need to do ICSI to get good fertilization rates in their patients with low morphology. I can’t speak for the techniques of other offices, but you should know things are done differently in different places. As with all of my entries, don’t change any of your treatment plans without speaking to your doctor first.
Sperm Morphology Mythology
This week I saw a couple who were told the reason they were not getting pregnant was “bad morphology”. The sperm, they were told, could not penetrate the egg because of the abnormal shape of the sperm. Because of this, they would need to go directly to in vitro fertilization with ICSI. This was in spite of the fact that they were young, had normal hormone levels and open tubes. I’ll tell you what I told them.
When we test sperm (the semen analysis) we look at a few different parameters. First is the volume, which should be 2cc or higher. Second is the count. This is the number of sperm per cc, so it’s technically a measure of the sperm concentration. This should be 20 million per cc or higher. The average is around 35 million. Next is the motility: the percentage of sperm moving. Should be 50%, most normal samples are not much higher. And then there is the morphology: the percentage of sperm normally shaped. This should be 14% or higher. The average is 2-6%, but why?
The original guidelines for sperm parameters, from the WHO, stated normal morphology should be 30%. Then about 20 years ago, Dr. Kruger came out and said we really need to be looking more carefully at sperm shapes. If we are really careful we will see that there are more abnormal sperm than we think, and the cutoff should be 14%. He called his classification "strict criteria". He also said that by being more careful we could better identify the men who are infertile due to badly shaped sperm. This all sounded well so the andrologists (the people who do your sperm test) started looking harder, and harder, and harder. They now deduct for every sperm that does not look perfect. So over the past 20 years, the andrologists have been getting pickier and pickier, and now a man is lucky if his morphology is over 5%, and almost everyone is less than 14%.
Obviously this has all gone too far. We are telling almost all men that their sperm is abnormal, and that just can’t be. The fact is we do not know what a normal sperm looks like. More on this next time.
My dh has (hopefully had!) 0% morph (100% head defects) as well as below normal counts and motility. He had an embolization and now just needs to do a f/u SA.
As for something that can help, I have my dh taking pycnogenol. He takes 200mg a day, plus zinc and a multi-vit.
this would be great.
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