# IUI with Low Morphology



## Cazmania

Hi Ladies

We are considering going the IUI route after 16 unsuccessful natural cycles. My hubby has been diagnosed with low morphology (2% on Kruger scale and 12% on the WHO scale).

Is anyone else trying this or has anyone here tried IUI for low morphology and been successful?

I should also add that he has extremely high sperm count ranging from 400 million to 600 million.

Any advice would be great 

Thanks


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## HappyAuntie

Hi Caz - we're in a similar situation. My DH has 1% morphology and extremely high count (300-500 million). Our RE was confident that IUI with injectables would work for us, because the high count compensates for the low morphology - if you do the math, DH has more normal-shaped sperm in one sample than most men with normal morph and normal count have. We got pregnant on our third IUI but miscarried (most likely due to my age, 37 at the time). We did two more IUIs before moving on to IVF. 

You didn't give your age, or whether or not you'd be using clomid or femara or injectables along with the IUI... those factors will have a significant influence on your chances of success. Because of my age it's harder for us to get pregnant in the first place and we're more likely to miscarry once we do get pregnant. But anyone < 35 shouldn't have those issues to contend with. And IUI without some sort of drugs to get you to ovulate more than one egg isn't likely to have any benefit to it at all....

Good luck to you! It's scary at first, to be told he has such low morphology. But it's less of a hindrance than you might think, especially given his super high count. :thumbup:


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## Cazmania

Happy Auntie

Thank you so much for your response. It helps so much to hear from someone who is in the same situation and been there and done that, so to speak.

Firstly, I am so sorry to hear about your struggles to get pregnant. I totally took this for granted with my first son . . . it just happened so easy. Now we are going on 16 months with not even a hint of a BFP. 

I am turning 31 in the next few weeks. Have gone through 2 FS for testing this year alone and both results were very good on my part and I am textbook fertile and as previously mentioned, the problem seems to lie with my hubby - although deep down I believe there must be something else going on too. 

I am petrified of needles so was hoping to do this with as little or no meds at all, but now, having read your response, perhaps I could take some meds that come in pill form to make me produce more than one egg . . . . more targets. I am really nervous to go down the assisted conception route, but am willing to do whatever it takes at this point (yes, prob injectables too). 

Do you think I could get away without too many needles? I know it sounds pathetic, but I am just so scared of them and I cant help it. 

How are you finding the IVF procedure?


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## HappyAuntie

Thank you. Yeah, we never expected to find ourselves here, either. We got pregnant the first two times on our own and within the first two months of trying, and then after our recurrent mc testing we couldn't get pregnant again. :shrug:

Clomid and femara are both oral medications that will produce multiple eggs. Clomid has some nasty side effects (can't be used for more than 3-6 cycles because it thins the uterine lining which actually makes implantation less likely and it creates hostile CM) but I think femara doesn't. Injectables (follistim and gonal-f) have none of the side effects and allow the dr to have more control over how many eggs are being produced (because they can tweak the dosages mid-cycle), but they're more expensive than the oral meds. I don't have any experience with the oral meds but tons of women on here do and could answer more of your questions.

The injections are intimidating before you get started, but honestly, they are no big deal at all. They're a tiny sub-cutaneous shot - it goes into your belly, and the needle is so small you almost don't even feel it.

IVF has been kind of the same - the thought of it, the anticipation, is worse than the process itself. Once you get started and just take it one shot at a time, it's manageable.


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## Cazmania

Once again, thanks for all this information.

I have now done my research on the two and found numerous case studies online where they confirm that IUI without any intervention doesn't increase your chances anymore than trying naturally.

From what you have said, I think I would be inclined to try IUI with Femara and possible a trigger shot so they can time it as best they can and maybe opt for two inseminations. Did you do multiple inseminations, or just one each time? Do they do it from one semen sample or would my hubby have to supply two? 

You have given me the inspiration to go ahead and do this and I will be calling the RE tomorrow am to try get an appointment this week and hopefully I will be starting IUI in November. It would be a lovely Christmas present to be pregnant by the end of the year.

Where are you in your IVF journey now?


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## HappyAuntie

I just did one insemination each time, 36 hours after the trigger. My insurance wouldn't cover multiple insems. But the reason they don't cover it is because multiple insems haven't been proven to increase pregnancy rates (over a single insem). Multiple insems require separate samples, so it increases costs as well - each sample has to be washed, where they take the sample and spin it down to remove the dead sperm and remove all the semen from the sample (the prostaglandins in the semen cause cramping if injected directly into the uterus). I know some REs do multiple insems, though. Talk to yours about it and see what he thinks. 

As for IVF, this is our third fresh cycle. We got pregnant on the first one and miscarried, then didn't get pregnant on the second or on our one frozen cycle. Right now I'm in between retrieval and transfer - I had the egg retrieval on Friday and transfer will be on Wednesday. So far this cycle is going fantastic, though - my RE changed my protocol this time (what drugs he uses and for how long) and we got more eggs on this one than we got on the first two fresh cycles combined! It's scary to be hopeful after everything we've been through, but we're really hopeful this time....


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## Cazmania

Unfortunately my insurance doesnt cover anything, so we are looking at the most effective and cost effective way of trying to achieve a pregnancy.
I called yesterday and have my appointment on Friday, so hopefully we will discuss dates for November - yay. If I didnt use the trigger, should I just use OPKs or OPKs and the CBFM? 

Thats great news about more eggs. Isnt it just awful, how something so natural can be so difficult? Are you nervous for your egg transfer? How many rounds of IVF are you going to try?


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## HappyAuntie

Cazmania said:


> Unfortunately my insurance doesnt cover anything, so we are looking at the most effective and cost effective way of trying to achieve a pregnancy.
> I called yesterday and have my appointment on Friday, so hopefully we will discuss dates for November - yay. If I didnt use the trigger, should I just use OPKs or OPKs and the CBFM?

That's really a question you should ask your RE. And be up front with him about the cost factor - they're used to that, and he should be willing to work with you to stay within your budget. 



Cazmania said:


> Are you nervous for your egg transfer? How many rounds of IVF are you going to try?

Nope - transfer is painless. And this is likely our last round of IVF.


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## Cazmania

Well, fingers crossed for you that this is THE one. How many embryos are you transferring?


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## HappyAuntie

well, the plan is to transfer two, but that could change when we get there. You don't know how many embryos you have left or what their quality is like until you get there that morning, and that info can affect your transfer strategy - for example, if they're all really crappy looking embyros, the dr will recommend you transfer more of them because you're less likely to get pregnant with crappy looking embryos. It's ridiculously complicated and scary (the unknown aspect). But you talk about it with your dr once you get there and they see how the embryos look... the dr has specific guidelines on how many it's appropriate to transfer based on the quality and on the age of the woman providing the eggs, you talk about your risk tolerance for multiples and how many you're comfortable transferring, and together with your dr you decide how many you should transfer. That decision is honestly the hardest part of the entire process for me. I really hate it.


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## Cazmania

As its your last shot, you should go with a high number. Increase your chances *wink*. I hope you have some good healthy strong embryos to transfer.

It sounds like you need to be a really strong person to be able to go through all of this. What a process indeed!


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