# Sperm Morphology?????



## Jac 25 (Mar 28, 2006)

Hi,

We're starting out on the trail and our GP has told us that we need IVF to concecive as my husband has 0% motility. We have an appointment on May 2nd at AGRC but in the meantime it also looks like there is a problem with the sperm morphology. I can find loads of info on the internet about motility but nothing on morphology and I know that there are different "defects" head vs tail etc and it would really help if someone explain it all or point me in the right direction. I want to find out as much as possible for our appointment on the 2nd. In the meantime we're getting another test done this week that goes into all the morphology - the ones the GP did didn't include all the info. It's all so confusing and I still can't quite believe we're doing this

1. the different types and which you can overcome - which are complete non starters...

2. the relevance of the %ages. I know you only need one healthy sperm but how do clinics look at this - do they use quotas i.e. minimum 5% before they treat you

3. Treatment options - Is there anything that can help?

Any advice gratefully accepted!  
Thanks
Jacqui


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## Fran (Eva04) (Nov 18, 2004)

i am not sure i can entirely answer your specific questions. but we had 2 NHS tests done which showed 100% abnormal morphology. We then had a private test done which showed 35% normal (which IS normal!). I would advise that if your partner has only had one test done to have another done. We thought the results of this particular NHS hospital were very suspect. The ones we had done at ARGC were roughly about 10% normal in the end. The difficulty is that ARGC use the Kruger strict test to measure morphology and the others used WHO. Kruger strict test is indeed much stricter than WHO with 13% and above being considered normal and WHO with 35% being normal. Just thought if you didn't know that then useful to know. With 10% normal at ARGC we were then offered the choice of going for IUI. 

At the time of our initial appointment at ARGC (ie before the 35% normal result had been done) they advised us on the basis of having 100% abnormal nmorphology. He said it would be very unusual for them not to be able to find a sperm normal looking enough to use for ICSI. They will spend alot longer looking for one - but generally if your count is ok there should be a few. If this proved to be impossible - then they would possibly look at TESE (i think?). Though we never got that far - so can't explain the procedure. From what i understand, they cut the tails of the sperm and just us the main body to inject into an egg - so they will just look for the best. 

The one thing that seemed to help DH was keeping his 'area' cool as much as possible. Not wearing boxers where possible, no baths, cooler shower, no hot jacuzzi. He also took some vits - but i can't remember exactly what - i know that one was pycnogel (sp?) which is apparently good for morphology and L'argentine. You should have a look at the Zita West book or internet as she recommends vits. 

Hope this helps.


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## Jac 25 (Mar 28, 2006)

Thanks - actually we saw Jane Knight at the Zita West clinic yesterday and it was her that picked up on the morphology problem so we're going for the WHO test on Sat. No doubt here will be a lot more as we progress. Thanks for explaining about the ARGC.....it's such a minefield! I feel reassured as I was worrying it was curtains for us! I guess it's just a waiting game and you have to be patient!
Good luck with your bump!
Jacqui


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## Fran (Eva04) (Nov 18, 2004)

No worries. We thought it was curtains too. But it would be very unlikely that they can't find decent sperm - they'll trawl through the sample until they find them - that's what you pay for. However with sperm tests at hospital they take a very small extract from that sample to look at.


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## peaches41 (Mar 4, 2006)

Hi Jac,

I would put NO faith in SA test that used WHO criteria. My dp's SA according to WHO parameters= 30% normal forms. But a Kruger strict morphology test [repeated a few times] showed only 1-2% normal forms. _For IUI they like 5& of normal forms using Kruger test. Anything other is too crude._

I have read that pycnogenol [you can get it from holland & barrett] is good for sperm morpholgy. Dp uses it, also vit C & E @ 1,000mg each plus Wellman vits [from Boots] plus selenium. Eating organic, reducing booze may help.

Sperm takes 3 months to develop so you may not see the results of your efforts for a few months

Also, I read an article on acupunture. It was it yesterday's Daily Mirror. The claim was that the sperm count doubled. It's perhaps worth looking into. He also advised men to eat an organic bacon sandwich on granary bread each morning! Dunno why!!

Love peaches xxxx


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## LindaJane (Jan 4, 2004)

Morphology is to do with size and shape.  All men will have a certain percentage of the "wrong" size or shape sperm in any sample the key is what percentage.  Less than 15% abnormal forms is classed as a problem.  DPs were between 2-5% in the three samples he did.  Although millions of sperm are produced a high percentage of abnormal ones means a large reduction in the chances of a perfect sperm actually reaching the egg.  Some abnormal ones might get there but of course might not be able to "get in"!  

Our clinic advised us that poor morphology is an increasing problem they are seeing and they dont really know why.  It could be to do with a greater proportion of men trying for children later or environmental/lifestyle factors.  

I researched it quite a bit and found Marylin Glenville's advice useful.  We switched to mainly organic diet (especially fruit & veg) and took all the recommended vits and cut down the beer.  DP also took 180mg pycnogenol as there some indications that this might help - I contacted one manufacturer about this and they said that they had not researched it fully themselves but they had had some feedback that this was the case from studies done somewhere else.  They therefore dont claim that it does do anything - sensible in these times.

In the end we had ICSI where the embryologist was able to select the best possible sperm from the sample.  They were delighted with DPs sample at EC saying that it was good - who knows whether that was down to the vits etc but they cant have been bad for us! Some clinics may have a certain % for morphology for IVF due to success rates for fertilisation - the sperm and eggs are left to get on with it.  At some point they must say that ICSI which involves selecting the best sperm and then injecting the sperm into the egg is the way to go but I dont know exactly what that point is - they only ever told us that ICSI was the way to go for us.

Good luck for your journey

LindaJane


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## Jac 25 (Mar 28, 2006)

Hi,

Thanks for your advice. I'm going to get DH some pycongenol as it keeps cropping up and we've done the diet and vits thing...time will tell if it helps. 

Can I ask you two more questions? I'm intrigued to know if your clinic set any % criteria for ICSI? e.g. 3% normal.  Also, did the clinic say your Dp's morphology had improved or was it count/motility? We're still waiting for our appointment at the clinic and more SA results and it's agonising waiting to know if we can go ahead with ICSI....

Jacqui


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## jan27 (Aug 19, 2005)

Hope this helps

Dh has a low sperm count varying from nil to 5 million max, not much said about morphology though until yesterday when we had our proper fertility appointment for icsi.  His sperm test shows only 2 normal sperm, yes thats right, 2!  However we are continuing with tx but dh will bank some sperm everytime i go up for scans to make sure there is enough for the big day in case there isnt any!

We have noticed though that his count is lower the longer it is before tests, ie both yesterday and the nil count were whwn we had abstained for 5 days, the best one was three days, so we shall aim for this next time (whether we feel like it or not!).

Good luck
Jan27


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## pinkpear (Feb 8, 2006)

hi DH  used , vit c folic acid, selenium and lycopene and zinc  and DH abnormal's went from 96% to 76% and just as we had opted for fertility treatment found ourselves pregnant naturally. there is hope for all, as i was told we would never be able to conceive naturally again.
pinkpear


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## Jac 25 (Mar 28, 2006)

Wow that's amazing. Congratulations!


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## jola (May 18, 2006)

Hi people - I'm new here. 
DH and I are at the very beginning of this - we have been trying for two years, and finally got around to going to the Dr - my ovulation test came out fine, but DH has only 9% normal morphology, good count but below average motility. Our GP has referred us to the fertility clinic, but we don't really know what is going on - and our GP is reluctant to say much - I think he is worried about telling us stuff that is outside his filed of expertise. I'd be grateful for any advice from those who have gone through this. From my internet research it looks as though we are looking at IVF with ICSI. 

But I have no idea how long we will wait for an appointment, or what we might be offered on the NHS. I'm 34, DH is 36 - so we don't have a huge amount off time - should we just go private? We don't have much money, but we are lucky in that we could borrow some. 

Is it right that the problem with morphology is that the sperm cannot penetrate the egg rather than that the genetic information is damaged? In other words, I am worried about the chances of birth defects. Its very hard to find information about this on-line - it seems that the medical profession is very anxious to keep people calm - which makes sense of course - but I would like to be told straightforwardly what the situation is.

Also - I think it is most likely not to do with lifestyle - is that right? 

Thanks!
Jola


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## Jac 25 (Mar 28, 2006)

Hi Jola

I'm afraid I can't help you on your NHS question as we weren't eligible....all I can tell you is that our appointment came through within twelve weeks and we were able to start tx straight away...which was a bit of a shock as we thought we would have to wait a bit....some people on here have gone private whilst they waited for their NHS appointment to come through. 

The one thing i've learnt is that each sperm test will be different and the morphology/motility goes up and down. Also, the tests we did with the GP were really unreliable. Our's showed 0% motility but this has improved to about 35% and the morphology has gone down since our first tests! When comparing %ages it also depends which criteria the lab are using. Apparently the WHO are revising their guidelines and it's likey they will move to the Kruger guidelines. The difference between the two tests is that any borderline sperm are dyed and analysed more closely which means the normal rate will be lower - as the WHO test would have counted these as normal. With Kruger we were told that about 15% normal morphology is normal. Either way 9% isn't as bad as it first seems! Honestly!

DH went on to see an urologist just to make sure there was nothing we could do (the clinic didn't ask us to do this but we wanted to make sure we had explored every avenue) - there are lots of causes that are unrelated to lifestyle. They didn't find anything and the advice we were given was to leave it as further exploration could do more harm than good. 

We saw an embryologist and yes you are right about the shape - they have different defects head and/or tail - and this means they can't penetrate the egg. BUT the good news is that of the 9% that are normal and with a normal count for ICSI they will have plenty of healthy/normal sperm to choose from and it won't be a problem. I was really worried about it, just like you, but when we had our appointment they were really adamant that it wasn't a problem and this was really reassuring. I asked if there were problems with the natural selection process effectively being bypassed by ICSI and again they just said they choose the very best sperm of the normal sperm from the sample and they only need 10 or so...just because some are defective it doesn't mean the others are all bad too......to be honest I was so gobsmacked that we were told to start next cycle that I didn't take much in!

The embryologist was very pro lifestyle changes to give us healthy DNA and really believed that lifestyle could be a factor for DH (no booze being the main one) but the urologist was really dismissive of it all - as were the clinic. However, we decided to do everything we could just to give it the best possible chance. It hasn't been long enough to see if his SA has improved with all changes. 

Sorry to waffle on but I was in your shoes not so long ago and I wanted to reassure you that it will be OK and that it's not as bad as you first think. 

good luck with it all
Jacqui


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## jola (May 18, 2006)

Thanks Jacqui - that's helpful and reassuring. Can you tell me why you were not eligible? Sorry if that is a cheeky question. I'm worried about that too of course - when I look up the NHS guidelines on this sort of thing they don't say anything at all about the criteria for eligibility. At least, I couldn't find anything - any pointers appreciated! I'm the kind of person whose mind jumps ahead fifty stages - I'm thinking that if we are not eligible for NHS treatment I would want to try egg sharing - but I know you have to be 35 or under, so I'm anxious to move fast. I also know they don't do it in Scotland, where I live, so it would take a little planning...I can't help myself doing this - it drives DH a bit nuts, but it does actually help me to have thought through all the possible outcomes.

We have had two SAs from our GP - both came back the same - I am pretty sure its the WHO guidelines they are using. After the first DH stopped alcohol, but i guess there wasn't enough time between the two to make a difference anyway. But I agree with you - we might as well do everything we can! I have looked around a lot for causes - can't find anything consistent - I think its just 'one of those things'. Which is good in a way - at least he can't torture himself with the thought that it is his fault! 

Good luck with your treatment!
Jola


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## Fran (Eva04) (Nov 18, 2004)

Jola
Your morphology is ok - and the NHS all use the WHO guidelines. My GP friend got pregnant with her DH having 12% morphology - but as we all know sperm tests change from month to month. If you make changes to your diet & lifestyle you might not want to re-test for another 3 months as this is how long it takes for sperm to regenerate. 
If i am being honest I would only use the NHS for IUI or clomid. The reason for this is that our GP initially told us that the waiting lists are long and that the NHS don't monitor treatment very well. We decided to go with the most expensive clinic in the country purely because you get daily individual treatment. When I was going through stimming injections i had a blood test every day and scans a few times a week. This showed that i was responding badly to the medication and I wasn't growing many follicles. Almost daily my medication was changed which is why they could 'save' the cycle and why i got a positive outcome. I am absolutely sure that had i have been on the NHS that i would have been kept on the same dose and ended up with nothing. Also, the embryologists at ARGC are absolutely amazing and they can make or break the success of treatment. 
I sound quite anti NHS - and I guess I am. They told us on 2 occasions that our morphology was 100% abnormal - yet one month later we had a test through a urologist Dr Ralph which showed a completely normal sample so not sure that the NHS sample was large or how much time they spent on looking for good sperm - as in the end there were plenty there on every subsequent occassion! 
Sorry a bit of a biased opinion!
Lol Ex


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## jola (May 18, 2006)

Hi Eva - thanks. I am a fan of the NHS in some ways - I once fell off my bike on my way home (at midnight) and cut my face open quite badly. I got rushed to hospital and was stitched up by a plastic surgeon - practically no scars at all now! But I believe they are not good on this sort of thing. The worst thing at the moment is having _no idea_ when we will get an initial appointment. I'll wait and see what happens I guess.

I like your signature quote!
Jola


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