Talking through each component of the sperm analysis with us, the cheery doc checked off each box with a smile: volume, concentration, total number, motility. All good, until we came to the last box. Morphology? Low, but nothing a good concentration and total number can't make up for. Okay then! Just keep trying!
I didn't leave the office and immediately study and research the results as I would ordinarily have done; there was a summer's evening to enjoy and pink champagne to be drunk and sushi to be eaten and goodbyes to be said. I asked Gilles to email me a copy to pore over during my sure-to-be-sleepless jetlagged nights, and that's what I did in the wee hours of this morning, before getting up to put on my doctor's cap and scour the internet for more information. What I've found does not bring me comfort.
The results showed the percentage of sperm with normal morphology was 2%. The minimum reference level stated on the lab report was 4%, but a little research shows me that this is the absolute bottom limit of abnormal with capacity to conceive, albeit reduced and impaired capacity, and that the minimum "normal" level is 14%. (This is based on the Kruger methodology, which is newer and apparently stricter than that of the WHO.) "Severe teratozoospermia," the report noted – but "not a diagnosis of sterility," it hastened to add, perhaps having predicted a personally invested reader's oncoming panic attack.
I haven't yet found many sources discussing low morphology in great detail, and the stuff on the discussion boards (which I always read with an eyebrow fully raised) runs the gamut from "no big deal" to "no baby other than through IVF/ICSI." Our own doctor's opinion falls into the former category, especially since I "got pregnant once before," as she reminded me yet again, like a couple ill-fated weeks of incubating a totally empty gestational sac is a good indicator of the capacity of my husband's sperm.
I suppose I should give the highest weight to her opinion and keep hold of her takeaway message: it's fine, just keep trying. But it's always good to "collaborate" (thank you, Tami!), so to that end, my trusted friends, do any of you have any experience with or resources on low morphology, a.k.a. teratozoospermia, a.k.a monster sperm syndrome? No doubt I'll be back in the medical library as soon as I'm able, but in the meantime I'd love to hear your stories or to check out any referrals to reliable online sources.
I thank you for it.
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| borrowed ethically from source |
Mmmhhhh.... Where do I begin... Our problem is male factor infertility.... But in our case everything was bad... Motlity, mobility, volume and ofcourse morphology.... My gyno upon seeing the results sent us immediately with an RE, as he said our only chances to conceive were through IVF/ICSI.... He also refer my husband to an Urologist and he took some vitamins and antibiotics for a while, but the results didn't change....
ReplyDeleteWe finally started the IVF road. First round I got pregnant but lost it.... Second round, the doctor told us the sperm results were so bad he had to use "an additional filter/microscope" to determine the sperms with the best morphology.... As a result of that round we have our baby :-)
Now, we just did a FET cycle, with the 2 embryos left from the previous cycle and we are waiting for our 2nd baby....
In my experience, it takes one good sperm to do the job! :-)
Ahhhh I am so happy to hear that! I have been thinking about you and wondering how that FET went. What wonderful news! Sending you very many congratulations.
DeleteHey girl. I don't have any experience but I know Em at Follow Every Rainbow just posted about it. Her DH took vitamins/oils and according to her last post, seems to have helped a bit. http://followeveryrainbow-emhart.blogspot.com/ in case you don't have her blog already.
ReplyDeleteI hope you get the answers you're looking for. Try to enjoy your English class and your vacation--don't play doctor too much!
My husband's morphology was 4% (he also had a high/normal count and everything else was fine). My RE said that average is 8% (14% is the Kruger criterion but it is EXTREMELY strict). He also said he had seen everything work at 1% or less since it just takes one.
ReplyDeleteWe did 3 IUIs with Clomid, but none worked. We ended up having to do IVF with ICSI.
The 2 vitamins my RE recommended for men are L-Carnitine and CoQ10 although I don't know if they affect morphology specifically. We never retested morphology after the first test.
Good luck with the monster's!
Ok, the title and the picture made me die.
ReplyDeleteI don't know too much about it - but I have heard stuff about vitamins, etc. helping with that.
Our problem seemed to be with Morphology and with progressive motility (although as you know now we don't know what the flip was going on there). All I can say is I have had Kitt on Wellman conception multi-vit and also on omega 3-6-9 fish oil caps. I have no idea if that is what has made the difference or if it is a fluke but it cant hurt right? Also, if this is the only test you have had done, you need another as one bad test can be a fluke. Was it done on or off site? An on site one is much more accurate.
ReplyDeleteOh, and he also gave up regular alcohol consumption.
DeleteOn-site (but the lab's only ten minutes away). I'll look into a second test.
DeleteI don't know anything about it but I would do just what you did and scour the internet for any chance any and everything. This is at least a place to start. The doc didn't mention anything that could be done to improve it? Acupuncture and herbs? Does he use his cell phone a lot or carry it in his pocket?
ReplyDeletehttp://www.ncbi.nlm.nih.gov/pubmed/17482179
No, I didn't ask anything, since it was presented to us as a non-issue. You can be sure I'm now making a list of such questions. Can you believe Gilles does not have a cell phone?
DeleteAlas, our infertility rested soley on my shoulders. However I applaud you for COLLABORATING efforts. :) And please dont forget to enjoy your trip m'dear.
ReplyDeleteOur issue is Morphology. Three SA's were completed. The first analysis was done through referral from my OB. Morphology was 0-10%. My OB suggested my husband go to a Urologist. The 2nd SA had 0% morphology. Then the urologist suggested my husband cut out alcohol and caffeine completely for 6 weeks and retest. The 3rd SA had 1% morphology. He then referred us to our RE and said IVF with ICSI is about best chance. As far as the research goes, it seems the jury is still out on morphology. Yes, it only takes 1 normally shaped fast swimmer to fertilize an egg. The urologist told us that it's hard to know about how important morphology is because SA's are only completed on men who are struggling to get pregnant. It is possible there are millions of men who's morphology is below the 14% criteria that have no trouble getting pregnant. However, of all the tests my husband and I have had done, morphology is the only # that came out as abnormal. We TTC for 1 year on our own while timing sex and tracking ovulation. We have 3 failed IUI's with Clomid (2 with Ovidril trigger) and after 1 1/2 years I have not been pregnant once. So it seems to me that morphology means something. Here is a fact sheet on morphology from ASRM...http://www.asrm.org/uploadedFiles/ASRM_Content/Resources/Patient_Resources/Fact_Sheets_and_Info_Booklets/SpermShape.pdf
ReplyDeleteYou know, it drives me nuts when doctors gloss over borderline test results with the presumption that it will all be okay. I fully believe that full information helps temper expectations as well as aiding the planning process.
ReplyDeleteI don't have any direct experience with SA results, but I will ask a few of my friends who have experience with it and get back to you. Please try to enjoy your trip and stay away from Google as much as possible. I know, easier said than done, but information can be totally skewed.
ReplyDelete14 percent is the OLD number! 4 percent is what they look for now.
ReplyDeletehttp://infertilityblog.blogspot.com/2010/07/sperm-morphology-new-guidelines.html
And having one previous pregnancy is a good indicator that the sperm can get to the egg. I know it sucks to get bad news but try not to stress too much. I had my husband start taking Fertile Aid for Men. We haven's had a new test since then but I'll let you know if it helps any. Our problem is motility so it's a bit different. Would you mind sharing the other numbers?
Sperm results seem to fluctuate widely. So I wouldn't take one result as gospel. I agree with Em get him on every supplement you can lay your hands on and in a few months (if need be) have another test to see if there are any changes.
ReplyDeleteMy hubs had issues with his Sa, low count ... Well low everything, 1% morph. Bad! Ivf was reccomended, but I don't want to do it bc of the costs (I ended up doing it and we ended up with new problems.... Yay us!). Anyway, because I so did not want to do ivf... I looked up every possible vitamin known to help. After 4 months, none of it worked. He ended up going to a urologist who found he had varioceles . He had a minor surgery and after 3 months, his numbers more than doubled morphology is normal now. Problem with male factor is... It takes 3 months to make a sperm. Who knew? So what you do today, you will see the results in 3 months. It's a real pain in the ass! I'd reccomend, knowing what I know now... Him going to see a urologist sooner rather than later. Try can do a simple ultrasound to see if veins overheating the boys are the issue. Hope this helps.
ReplyDeleteFirst, get a second SA. If you're still concerned about morph after that, have Gilles go to a urologist, but only one who specializes in male fertility. Vitamins and supplements may help, but I don't know of any specifically for morphology. Most of what I've heard, though--and this is based on others' experiences and on forums (babycenter has one specifically for male infertility: http://community.babycenter.com/groups/a4079615/male_factor_infertility_mfi_information_and_support_group) since we don't even have enough sperm to look at morphology yet--is that it's the least important of all factors that could affect your chances of pregnancy.
ReplyDeleteEnjoy your trip and your class!! And try not to worry about it too much just yet. :)
Daryl from above posted that morphology "is the least important of all factors the could affect your chances of pregnancy", but this is false information. The least research has been conducted on morphology so they don't exactly know the importance of morphology in fertility. Morphology is also unique because there are different types of issues...the heads could be shaped round instead of oval, there could be no tails, multiple tails, etc. So we also don't know whether low morphology with sperm that has two tails does not affect fertility or if it's only when the head is not shaped normally. There is still a lot of research to be done and a lot of unanswered questions.
ReplyDeleteThank you, my dears, for sharing your personal experiences, for passing along the links, and most of all for your always greatly appreciated support. The latter is what will buoy me the most as we dig deeper into this issue. Hugs to all of you from holiday-land.
ReplyDeleteWe tried for a year.. did 6 IUIs. Nothing. The RE that did our last 2 IUIs did a sperm analysis, that previously had come up 'fine' prior to the IUIs at the general dr (not the RE). Turns out the hubs had poor sperm morphology. Of course for 1 year we assumed it was me, mainly because hubs had a 9 year old daughter. They said his morphology was 1.5% and that it was basically a waste to do IUIs, or try naturally, and that we really needed to do IVF w/ICSI to have the best chance. We went to an independent urologist for a second test (both under Kruger strict) and that guy said 2% so I figured it was bad (I was a bit suspicious of the IVF place since they're selling IVF!) We did one IVF w/ICSI- I did awesome- 28 great eggs, all fertilized and on day 3- the embryos were seeming ok but different cell stages. On day 5 transfer day- big shocker- all the embryos looked crappy. Dr. said most likely this is a sperm issue... devastated. but they stuck 2 in and one became my 2.5 year old son who seems great to me! Oddly- on my son's 2nd birthday last October, I found I was pregnant. Not expected! And then I miscarried and it was a trisomy. That sucked balls.
ReplyDeleteAs you probably read in my archives, my husband had two SA- everything else was great but the morphology was 4% the first time, 2% the second time. After my fibroid/endo/cyst surgery last year we had three IUIs with Clomid with no luck. My doctor in CT seems to think that it has to do with my husband's sperm (I guess they don't check morphology when they do the wash for IUIs because the doctors kept telling me that he was giving great samples), so we have moved to IL and will hopefully save up some money to do IVF with ICSI soon.
ReplyDeleteThanks for following my blog- I look forward to following your journey as well!