From girl sway to secondary infertility with Mfi - please help atomic!

So I've posted before on Sway boards but long story short obgyn sent me to re bc after 3 months of light swaying I started just trying to get pregnant and it wasn't happening ... Ob thought it wouldn't hurt to see an re. I have one 2.5 year old son who my dh and I got preg with first try... I go thru all the testing first and the only thing wrong with me is random shorter (10 days) Luteal phases and a late o in general of day 19-20 but no specific reason according to re but bad luck.... Went thru two unmediated cycles - one thrown off completely by hsg and a stomach flu and second that was perfect. Good cd 21 ( was 27) numbers etc ... She thought like me I didn't give it enough time . She agreed to femara this cycle to try to get me to o earlier .... I started femara last sat cd3 and finished on wed. My husband finally had his sa which I believe he put off bc of how easy we got preg with number 1 and I just got his results and don't know what to do ... He said he'll do whatever I wish as the process is easier for him but feels as if the re is jumping the gun... However I'm in a rush now for number 2...
Sperm count 70 million
Motility 61%
Morphology -2% -yikes !
She basically said you have a couple options
1) do iui just to get more in there especially if on ur cd 12 check Monday we have more than one follicle will just up your chances ( but she said washing doesn't look at morphology? - doesn't it eliminate bad sperm???)
2) keep trying naturally but strongly suggest he freeze 1-2 samples
3) go thru this cycle and consider Icsi- she basically said textbook is this is the only protocol...
After a panic and tears I look up morphology and many readings say is it even important. She basically said if I don't freeze sperm he can have none left soon....
Is morphology important when other numbers are good???
Is iui out ?
Is it possible with #1 we just got amazingly lucky the first time ?! The re thinks so... I asked what my chances are of conceiving naturally and she wouldn't put a number to it. She also said multiple times she strongly suggests freezing a sample now while I decide .
What info / advice do any of you have with morphology? How does fr affect it??? Any vitamins or supps???

Have him take a fertility blend for men vitamin. 4% is considered normal.

Sperm morphology is poorly understood, and because the evaluation is somewhat subjective, scores can vary on the same semen sample, in the same lab, using the same scoring techniques. If sperm morphology alone is abnormal, but all the other semen parameters fall within normal limits, then male fertility may still be considered normal.

OK deep breath. Everything is ok, I promise.

70 million sperm of which 2% are normal morphology is 1.4 million sperm. That is still a lot of good sperm. We have guys in here all the time who have NO good sperm, as in zero, and they aren't making 70 million of them either. I think this may be an RE who is overreacting. Usually when a guy has 70 million sperm, everything else sort of fades into the background because you're kinda spoiled by choice - the prob. is a guy who makes 1 million sperm total and then has 2% motility. :)

Sperm health can go up and down and it may have just been an off sample, too much indulging or overheated swimmers or all sorts of things. I would put him on Cyvita and/or a fertility vitamin.

1)Washing doesn't really "wash" anything, it gets rid of the protective goo and means that all the sperm will be capacitated and ready to fertilize at the time of the IUI. I wouldn't have an IUI on this basis but that's up to you guys of course. Femara sways pink, IUI may sway a bit blue.

2)Why??? Sperm can recover in quality and freezing sperm based on one SA seems a little bit overreacting to me. unless you guys know he's having poor sperm quality due to something like chemotherapy or a virus or something (that can't get better) I would try lifestyle changes first.

3)Get a second opinion on that. For TRUE MFI ICSI is their route but I don't think you're in this boat.

4)FR - shouldn't affect morphology. I'd have you guys have him do regular release every 2-4 days for optimal number.

5)I would track down a male fertility vitamin wihtout a billion weird herbs in it. Cyvita has helped a lot of people. Home



3)

I read this aloud to my husband and he said I feel so much better. The re quickly told me Icsi was the only option and then quickly said you may want to try a little longer and I'll keep prescribing you femara if you wish for a better egg.... She has been so not aggressive so to get the "Icsi and freeze sperm like this week phone call" made me panic... I did ask about iui and she said theoretically bc you are already cd 10 from femara cycle... If you come Monday and have a good egg or two and want to trigger and iui in theory you would up your chances slightly by getting more shots closer too -and this would be in addition to ti... I don't disagree and seeing that iui is covered if the conditions look good we decided we may give it a shot as it could only get more sperm closer too. After I emailed this forum and cried and then calmed down and did a ton of reading - morphology as a single factor seems to be the most controversial of arguments on Mfi.... That also made me feel better ...
I also feel like the re had been looking for an answer for me as I told her the first time my husband and I had unprotected sex we got pregnant and she couldn't find anything wrong she is basically attributing all the missed attempts to this ...
I am going to go for my cd 12 follicle scan and decide on iui with this re. Regardless I am going to get my records and make a second opinion consult. In the meantime I am going to tell this re I want the semen analyst repeated in 30 days ( she has two labs she works with and my husband wants to try the second lab to see how close the comparison is ) and then in 30 days we will make the decision regarding next steps . I immediately asked when we should retest and she said that most likely his morphology has always been this bad and that my son is my " 1 in a million shot" she also said its not necessary to repeat This test as it is likely his issue is genetic... Both comments just struck me as too extreme considering I have a wild two year old reason to disagree -
I purchased a ton of vitamins for my husband today all of which he already started taking instantly but will check out what you mentioned .... Thank you so much for your advice!

I just want to re-reassure you again that we have seen HUGE improvements with guys who are undergoing IVF rounds and seeing their numbers and quality improve by leaps and bounds. :)

Also, I do want to mention something - is he on any kind of medication (such as antidepressants or medication for baldness, or doing something like smoking drinking a lot, using steroids) because these things can dramatically affect sperm health.

Quote:

---

Originally Posted by atomic sagebrush

I just want to re-reassure you again that we have seen HUGE improvements with guys who are undergoing IVF rounds and seeing their numbers and quality improve by leaps and bounds. :)

Also, I do want to mention something - is he on any kind of medication (such as antidepressants or medication for baldness, or doing something like smoking drinking a lot, using steroids) because these things can dramatically affect sperm health.

---

He is not on any medication - however since quitting smoking when I was pregnant with #1 he uses an electronic cigarette - could this have any affect???( it's not tobacco but nicotine and other chemicals I assume) and he doesn't drink much maybe 5 drinks a month,however he does occassionally smoke pot and always has .... I have been incredibly vocal about this being part of he problem and he feels as if it isn't enough to contribute , but I'm working on this.

I had acupuncture today and she feels similarly to you- i need a second opinion - however she reviewed my list of vitamins dh started yesterday and had me add zinc ... ( the rest include c, d , folic, l arginine, acetyl carnitine ) she also suggested non lean protein and seafood ( sure for zinc ) . And tons of water . I know a lot of these things will sway blue - I assume - however , as you always say if I can't get pregnant I can't worry about gender. The acupuncturist feels with counts that are that high all the other factors could be moving targets.... And lifestyle could make a huge difference . I m a little mad the re didn't push for the sa at he beginning of testing and my dh also put it off blaming my thyroid issues and now we are months in but what's done is done ...
We reviewed our plan based on my cd 12 follie scan tomorrow . We bd yesterday and are planning to tonight. Follie scan at 815. If conditions look good for an iui / trigger we are going to give it a shot even if it is just 1 more slight way to up chances besides its covered .Re was willing to go his route on the phone Friday but suggested we decide after scan. In addition to scan what should be rule for bd?? Some reading I have done said more frequent intercourse ups chances of better sperm in sample however , I worry hat we need a larger sample should we go thru the iui.
Obviously I'll listen to re opinion but I always like to run it by a bigger group.
If we never conceived I would head advice of re and strongly consider going right to Ivf ... But I feel as though we need to try something else first before we go to such an extreme measure .

Update! Had my cd 12 scan today and as mentioned took femara from cd 3-7. My lining was still thinish - but didn't give me # , just said my concerned , however I have 1 nice follie on left ( 16mm) and two smaller ones on right (12 ish and 13-14) she has me going back on wed for a repeat scan . She said she wasn't even planning on triggering bc I ovulate on my own but if I want her to , to guarantee timing she will. She also seemed less worked up about the morph results. She said she believes it's 99% of our problem but that is bc she can't find anything else wrong . She did say that there isn't a specific standout abnormality which makes her less worried it's a Dna issue and that unfortunately it can't penetrate the egg. She said he has good counts and in theory getting the counts up would get more of the good sperm # up. She said that she'll do iui if we want ( however said if I just have 1 mature follie she would still suggest just timed intercourse for this cycle ) and if I have 2 it may be worth it to do iui to "up the ante" . She said iui will probably only increase my chances 2-3% a cycle. My husband and I felt if we can get 2 eggs , it would be worth the extra percent being that it's covered by insurance . What are all your thoughts? Wouldn't it get more closer too?? Sorta giving me an advantage. The re feels that bc our motility is fine they are getting there , they just can't penetrate the egg. In regards to the morphology, she said he can see a urologist ( which he will) taking supplements can't hurt and she even said being that he isn't a heavy smoker she doubts it's from that as smoking effects motility most. If she were me she would try naturally or with iui for another 4-6 months ( I'm not comfortable waiting that long but agreed to 2-3... Before she would even discuss ivf however she did say if we et to the point of ivf there is no reason to not do Icsi - and I agree. I do feel a little better and am still going to get another opinion.
What are your thoughts on this cycle and iui??? Do you think we should throw in pre seed for attempts ? She also said she would do 3 good attempts day before ovulation day of and day after ... Which I would think sway boy - but currently we are doing every 3 days or so in btw fertile window.
My other concern is my lining - will it "catch up" to my maturing eggs? She didn't seem so concerned and said by wed she expected it to be thicker ?

Update - had a scan Thursday am and the 16 mm follie took the lead and the two in the right seemed not to be maturing . The 16 mm was now 17.8 which she said is a little slower growing but my lining and estrogen level were in line . Going tomorrow to hopefully confirm ovulation on its way. If so femara would of loved up the o by 2-3 days only.. On another note I requested a copy of my husband's sa and the total count was not 70 million it was 268 million ... 70 mill concentration and motility was 68% however the morph was 2% and the note was Kruger strict mostly tapered heads ... From the research I did tapered heads appear a lot in varicoceles and he will now see a urologist but I'm hoping we have enough with a strong egg this go ! I would have to believe that the count overrides the morph in this case? Thoughts?

Quote:

---

Originally Posted by Tmommy725

He is not on any medication - however since quitting smoking when I was pregnant with #1 he uses an electronic cigarette - could this have any affect???( it's not tobacco but nicotine and other chemicals I assume) and he doesn't drink much maybe 5 drinks a month,however he does occassionally smoke pot and always has .... I have been incredibly vocal about this being part of he problem and he feels as if it isn't enough to contribute , but I'm working on this.

I had acupuncture today and she feels similarly to you- i need a second opinion - however she reviewed my list of vitamins dh started yesterday and had me add zinc ... ( the rest include c, d , folic, l arginine, acetyl carnitine ) she also suggested non lean protein and seafood ( sure for zinc ) . And tons of water . I know a lot of these things will sway blue - I assume - however , as you always say if I can't get pregnant I can't worry about gender. The acupuncturist feels with counts that are that high all the other factors could be moving targets.... And lifestyle could make a huge difference . I m a little mad the re didn't push for the sa at he beginning of testing and my dh also put it off blaming my thyroid issues and now we are months in but what's done is done ...
We reviewed our plan based on my cd 12 follie scan tomorrow . We bd yesterday and are planning to tonight. Follie scan at 815. If conditions look good for an iui / trigger we are going to give it a shot even if it is just 1 more slight way to up chances besides its covered .Re was willing to go his route on the phone Friday but suggested we decide after scan. In addition to scan what should be rule for bd?? Some reading I have done said more frequent intercourse ups chances of better sperm in sample however , I worry hat we need a larger sample should we go thru the iui.
Obviously I'll listen to re opinion but I always like to run it by a bigger group.
If we never conceived I would head advice of re and strongly consider going right to Ivf ... But I feel as though we need to try something else first before we go to such an extreme measure .

---

Oh gosh this one sneaked past me, I"m sorry.

My suspicion is that yes the e-cig and the "special T" are not helping, that's for sure. But he still has 70 million sperm and his morphology is not that bad really.

I believe strongly that it's really US for whom the nutrients matter most and DH they are a lot less important.

What I would have you guys do is either have him do regular release eveyr 2-4 days for best sperm healht and count, AND/OR have unprotected sex every 4 days plus one more attempt at positive OPK OR at trigger shot. If you're doing the IUI then that would be your attempt at the trigger shot (so you wouldn't have an actual attempt, just the IUI)

Quote:

---

Originally Posted by Tmommy725

Update - had a scan Thursday am and the 16 mm follie took the lead and the two in the right seemed not to be maturing . The 16 mm was now 17.8 which she said is a little slower growing but my lining and estrogen level were in line . Going tomorrow to hopefully confirm ovulation on its way. If so femara would of loved up the o by 2-3 days only.. On another note I requested a copy of my husband's sa and the total count was not 70 million it was 268 million ... 70 mill concentration and motility was 68% however the morph was 2% and the note was Kruger strict mostly tapered heads ... From the research I did tapered heads appear a lot in varicoceles and he will now see a urologist but I'm hoping we have enough with a strong egg this go ! I would have to believe that the count overrides the morph in this case? Thoughts?

---

Honest to goodness Facepalm.

I hate to be negative about a person who I know nothign about but is this RE trying to get money out of people or something??? That is NUTS to take a guy with a sperm count of 268 million who has already conceived a child, and tell them their only chance is ICSI. I have literally NEVER EVER heard of that in going on 10 years advising people with both natural and IVF conceptions. I feel it's really out of line and now that she's done a 180 it feels very much like she ~may be~ trying to scare people into IVF and then if they don't bite treating them with other methods. I really am at a loss but just please rest assured that I think you guys are totally fine to proceed naturally and I would not be surprised if you get pregnant in short order. :)

I am so sorry I don't know how I missed these posts?!?

Most IVF uses ICSI anyway. it's not at all unusual and if you were to do PGD (for gender) you would have to.

IUI is really not very successful and I think you'll have better results with intercourse anyway. A lot has to go right for an IUI to work out and many times the batch is put in too soon or too late and it ends up being the natural BD rounds that get ya preggo anyway.

It takes fully fertile couples doing nothing to sway, 3-6 months ON AVERAGE to get pregnant. I think it is utterly beyond the pale for a doctor to look at someone who has been TTC for 3 months and advise these courses of action. I am honestly speechless.

I would wait AT LEAST 3 months before looking into IVF *unless you want to do it for gender selection with PGD and I am in solid agreement that 4-6 months is MUCH more reasonable. You really haven't even begun to try yet.

I would probably not have you do 3 attempts around trigger, I'd do what I laid out in the post above there. I really think this is a tempest in a teapot and I hate to see anyone throw out the baby with the bath water just yet, because I think the odds are very good you will conceive within the next 3 months. BUT if you are ready to pull the trigger and conceive, I advise SMEP as it's the best of the best way to get pregnant. Sperm Meets Egg Plan