My husband and I have been unable to conceive for 2 years. All my tests came back normal and my husband's sperm analysis came back abnormal with a count of 5 million; motility of 12%; and morphology of 1 %. My doctor has advised icsi.
Will the morphology abnormality affect my chance for a baby. I know that with icsi a majority of the eggs will fertilize, but will the abnormal sperm morphology impact the chance for a good embryo and ultimate implanation and pregnancy.
When performing ICSI, the embryologist will do their best to choose a normal looking sperm. This does not guarantee the genetic normalacy of the sperm. Conversely, perfectly normal looking sperm may be geneticaly abnormal. The correlation between abnormal genetics and abnormal morphology is not absolute.
When morphology is poor (i.e. <4%), fewer embryos develop to the point where they are capable of implantation (blastocyst stage). Of the ones that do implant, there is a slightly higher first semester miscarriage rate. That being said, once a fetus makes it past the first trimester, development appears normal and there is NO higher chance of congenital abnormalities (birth defects).
So, to answer your question, yes, poor morphology will lower your chances of pregnancy, and to a lesser degree, a term pregnancy.
Thank you for responding. Given my husband's SA, are we wasting our time pursing icsi, or do you think we still have a good chance. We need to decide how to best utilize our resources.
I think, with ICSI, your chances are still reasonable, provided you have enough eggs to compensate for the effect of the sperm. In my opinion, you will need at least 10 if you are going to transfer at the blastocyst stage. I would recommend this because when the sperm morphology is low, if pays to wait it out to see which ones develop into good blastocsts.
Thank you again for responding. One last question.
Assuming there are embryos which make it to 5 day blast, does this mean that we have overcome any sperm issues? Does this mean we would be okay transferring 2 good blasts? We do not wish to deal with selective reduction, but also do not want to transfer less than would be wise.
From all the available data, it would appear that there is no higher miscarriage rate from ICSI derived embryos. Yes, I would suggest transferring 2 good quality blastocysts.
Dr.Smith, Me and my wife have been married for 3 years now and trying for a baby since almost a year. I recently went for a semen analysis and scrotal Ultrasound. following were the result: Concentration:10.0 X 10 Million/ml Total count: 24.0 X 10 Million Motility 25 Morphology: 11 and TZI of 1.95.
In such a case, do u see there is a possibility of conceiving naturally? or should we go for IVF/ICSI?
Most of the tests conducted on my wife has been found to be normal.
Any information is greatly appreciated. Thanks, Steve
Semen parameters do go up an down, so there are "good" sperm days and "bad" sperm days. However, based on what you provided, even on a "good" sperm day, it is unlikey (notice I didn't say impossible) that you would be able to conceive through intercourse. You've been trying for a year and that has not been working. The next option would be IUI, but I think that's probably a waste of time and money too. Bottom line, yeah, go straight to IVF/ICSI. That's where you have the best chance.
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