# SA MORPHOLOGY: POST YOUR DOCTOR's COMMENT HERE



## Snowglobe21

Hi all, I'm just trying to create a centralized thread for morphology as it seems to be one of the least understood SA issues. I'm interested to hear about your hubbies SA results and what the doctors said in particular about the morphology in relation to them. I've heard so many different things, but think its good to hear perspective from other people. This is what I have read from the WHO 2010 SA guidelines sent to fertility labs. So please post all the results if you like! I've read the gradient of how many percent are below and above each number and can help you out with count or motility numbers if you'd like. 

50% have less than 15% morph and 50% have more than 15% morph
25% have less than 9% morph and 75% have more than 9% morph
10% have less than 5.5% morph and 90% have more than 5.5% morph
5% have less than 4% morph and 95% have more than 4% morph. 

This is why WHO lowered the standard from 14% to 4%. If 50% of fertile men who fathered children had less than 14%, that couldn't exactly be a minimum standard. 
__________________________

My fiancee's results: 

Count: 204 million (50% have less than 255 million, 50% have more and DH missed part of sample so assuming its about 255-300 million)
Rapid Progressive Motility: 61% (75% have less)
Total Motility: 65% (50% have less)
Vitality: 87% (90% have less) 
Morphology: 4% (5% have less)


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## cooch

I have been told by 2 different fertility specialists that the norm these days is 4%. One of the specialists would definitely tell us the truth- I trust him.

The NHS professor we saw stated that they don't count morphology at all as there is a question over how important it is to conception, as the WHO lowered the level to 4% as men with such low levels were fathering children.

Plus you need to take into consideration the volume and other factors. So you could have a low morphology of 4% but if your volume is pretty high then it kinda evens things out!

By the looks of your fiance's results there is little to worry about. His count is incredible as is his motility. The fact that there is only 4% morphology has to be measured against the count etc.


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## DancinEmr

Thank you for posting this thread. I also have questions and concerns about my husband's morphology results. The results are as follows...

Total Sperm-173 million
Motility-68%
Morphology-4% Kruger

The Dr. said that we would mostly likely need IVF to conceive. The results have been really hard on us and it makes it harder reading such conflicting info out there.

I would love to hear about more people's results.


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## Snowglobe21

HI Dancing EMR. Did a fertility doctor say that to you or your GP? I had my GP say that, but he had no idea what Kruger was and was basing it off prior WHO criteria and though the majority of sperm were supposed to be normal.


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## Snowglobe21

Here are three studies showing the low significance of morphology if the range if even 3% or greater normal forms. Hopes this helps some people out. I have read the full studies, but just posted the abstracts or conclusions for simplicity. 

"Prospective and retrospective studies were conducted to evaluate sperm morphology using strict criteria for predicting fertilization capacity in males. Severely impaired male fertility potential was measured by a result of <4% (denotes percentage sperm having normal morphology) and scores of > 14% indicated normal fertilization potential. There were no statistically significant differences found in pregnancy rates in partners of men with normal morphology of <4% vs. those with 14% or greater (x2 analysis): the prospective study showed a 41 % pregnancy rate in <4% group vs. 29% rate in > 14% 
group @ - 0.44 NS); the retrospective analysis showed a 50% pregnancy rate in the group with <4% morphology scores vs. 67% in > 14% group @ - 0.45 NS). When only the men with normal motile 
density (> 10 x 106/ml) were evaluated, a statistical difference was found in the retrospective study between the group with morphology results > 14% (93%) 
vs. the group <4% (40%). However, the 56% success rate in the men with < 10 x 106/ml sperm and normal morphology <4% reduces the significance of the diagnosis of sperm morphology using the new strict criteria."

Source: EVALUATION OF SPERM MORPHOLOGY USING 
KRUGER&#8217;S STRICT CRITERIA 
J. H. CHECK, H. G. ADELSON, B. R. SCHUBERT, 
and A. BOLLENDORF

(Done in 1996)
__________________

This is another study classifying the minimum as 3%. (I'm a university student so have access to library database to read the studies)

In this study, the semen analysis results of a fertile population were compared with those from a subfertile population, in order to establish normal cut-off values for the standard semen parameters with the aid of receiver operating characteristic (ROC) curve analysis. The fertile group comprised healthy males (n = 107) without any history of fertility problems, the partners of whom had had a spontaneous pregnancy within one year of unprotected intercourse and were pregnant at the time of the male's inclusion into the study. A total of 103 males from couples attending the infertility clinic, and with an initial sperm count of <20×106/ml were recruited to form the subfertile population. The best discriminating parameter between the two populations was sperm morphology evaluated according to WHO criteria at a cut-off point of 31% normal spermatozoa. The other cut-off values were at 8% for the acrosome index, 45% for motility, and 4% normal spermatozoa for strict criteria. Recalculating the ROC curve cut-off values based on an assumed 50% prevalence of subfertility in an assisted reproductive setting, the cut-off points were reduced to 21% and 3% normal spermatozoa for WHO and strict criteria respectively. For motility, the new cut-off value was at 20% motile spermatozoa, for motility quality at 3.5 (on a scale of 1&#8211;6), the acrosome index at 3% normal acrosomes, and the teratozoospermia index at 2.09.

(Done in 2000)

Roelof Menkveld1, Wai Yee Wong2,3, Carl J. Lombard4, Alex M.M. Wetzels2, Chris M.G. Thomas2,5, Hans M.W.M. Merkus2 and Régine P.M. Steegers-Theunissen2,3,6

____________

Study of Sperm Morphology in Fertile Pakistani Men
Mohammad Owais Ahmad, Saadat Ali Khan, M. Amjad Hameed**, Umar Ali Khan** 
Departments of Physiology *Foundation University Medical College and **Islamic International Medical College, Rawlapindi. Pakistan 
Pak J Physiol 2007;3(2) 

Background: The aim of this study was to determine the sperm morphology of proven fertile 
males and to compare the same with that of infertile males. Method: This study was carried out at 
International Medical College Rawalpindi and its attached Railway hospital and Islamabad Clinic 
Serving Infertile Couples Islamabad, from June 2005 to July 2006. 50 healthy fertile males were 
selected and their semen morphology was determined according to Tygerberg&#8217;s strict criteria, 
while another 50 infertile males were recruited as controls Results: Proven fertile group showed 
significantly higher morphologically normal forms of sperms (3.04 ± 1.63) than the infertile 
group (0.92+-0.72). Conclusion: Sperm morphology assessed by strict criteria is of value in the in-vivo situation to identify a group with greater chance of having an infertility problem and strict criteria sperm morphology analysis should be used to minimize variations in intra and inter-individual and inter-laboratory sperm morphology assessment. 

Conclusion: Around 3% normal morphology was the average for the fertile group. The range found in the fertile men was only 0-8%. The maximum morph found was 8%. CRAZY!

________

WEBSITE WITH MORPH AND CONCENTRATION SPECIFIC INFO:

Chart comparing monthly probability of natural conception in comparison to sperm morphology. First chart I've seen with this info. https://metrovanurology.com/content...ability of Pregnancy Using the Semen Analysis

Figure: Morphology and Pregnancy. The main thing to note is that there is a gradual but small decreae in the probability of conception as morphology declines. It should be noted that the effect of morphology on the probability of conception is relatively minor compared to that of concentration. Modified from Bonde et al. Relation between semen quality and fertility: a population-based study of 430 first pregnancy planners. Lancet 1998. Specifically, the old WHO morphology criteria have been changed to the Kruger Strict criteria for illustrative purposes.

"Very commonly, the only 'abnormality' on a semen analysis report will be the morphology - the concentration and all other parameters will be 'within reference range'. This is known as isolated teratospermia. Most patients are alarmed at this. While a decrease in morphology can be associated with a decreased probability of conception, this is one instance in which there is probably no effect on the chances of conception and the morphology can be safely ignored." -Quoted from website.


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## Armywife84

Both my FS's dismissed 4% morphology as average. They're more concerned about my DH's low count and motility. 

DancinEmr- How long have you guys been trying? Are there any female factors too? Because you should still be able to conceive with your DH's count and motility. 

I wouldn't listen to the doctor in going with IVF (unless you have a female factor). If you wouldn't to go with alternative treatments, I'd go for an IUI..because there's no issues with motility. We're going to eventually do IVF due to my DH's low motility. I get my info from my FS, online, and here.


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## Snowglobe21

Good luck with your last month in the year Armywife! I'm on hold till my cycle resumes...whenever that will be. Haven't seen AF since October.


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## DancinEmr

Hello everyone and thanks for all of the information. Morphology is so confusing I am glad to hear information that gives me hope. My hubby took the sperm analysis at a FS office, and the FS sent the results and the report to my Gynecologist's office. My Gynecologist gave us the report that said 4% morphology Kruger-Abnormal, refer for IVF.
I am still hopeful, as I have heard that 4% is the new normal and we have no female factors that we know of. 
Good luck to everyone and I wish you all the best!


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## mjemma

Thanks for posting this. My DH's SA was 4% which the FS said was on the low side but wasn't a major problem. His next one was 7% and they said there was no problem. It's so difficult when there is so much conflicting information. After 19 months TTC and various issues, tests and ops, my conclusion on most factors is that they just don't know!


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## korink26

My DH had S/A done and has 4% for morph....my Dr. called and said everything came back normal and no worries. I didn't even realize until I got onto evil google that 4% is as low as normal can be, so now I've worried since. 
In May I did get PG after only 6 months of trying, but I did miscarry. But, at least I got PG so it's possible!
I called my Dr. last week because now 7 cycles later I'm still have not gotten PG again and she confirmed again she is not worried at all about the 4% morph because his count and motility were ok. Idk, I think it may just take us all a little longer, but it seems possible!!


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## Snowglobe21

Hi Korinkj and mjemma. 

Are there any female factors involved with you too? I have a feeling morphology amplifies female factors as it is already slightly more difficult with a lower morphology so female factors really influence it. From my perusal of the boards, it seems that once female factors are corrected the 4% morph is normal. I can't help but wonder how many dad's that I see have a morph number in that range, but had no idea of it because they concieved right away with a wife free of endo or pcos.


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## cooch

That's an interesting take on it Snowglobe. My blocked tube may not be able to be opened and my endo may come back. So I'm looking at DH's count rather than morphology and crossing my fingers big time x


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## Snowglobe21

Hi Cooch! 

What count numbers are you working with?


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## mjemma

Snowglobe21 said:


> Hi Korinkj and mjemma.
> 
> Are there any female factors involved with you too? I have a feeling morphology amplifies female factors as it is already slightly more difficult with a lower morphology so female factors really influence it. From my perusal of the boards, it seems that once female factors are corrected the 4% morph is normal. I can't help but wonder how many dad's that I see have a morph number in that range, but had no idea of it because they concieved right away with a wife free of endo or pcos.

Yes, I have PCOS and complications from a cyst removal but am now on a low GI diet and agnus castus to regulate my hormones and having another lap in February to sort out any scar tissue so for the first time in months I'm feeling really positive that we will be able to TTC naturally eventually. 

I think you're right, that most people have no idea what their morphology is as they never have to get to all that.


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## cooch

The count in 50's and 60's. 50% for motility and we've had 5% and 7% for morpho x


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## korink26

Yes, I've thought a lot of times that probably a lot of men have counts like ours, but their wives were maybe lucky fertile myrtle's so it was never a problem.
I don't know of any female problems, I haven't had a whole lot of testing done though either. She did a blood test which I'm not sure what it checked, I think thyroid and protein levels? Those came back ok, she also did an ultrasound (checking for I'm not sure) and that came back fine as well.
I temp and have a lower temp and seem to spot a couple days before AF comes and my LP is only about 11 days to begin with so I think it's possible I'm not having really good ovulation, even though I am ovulating. This is my first month trying clomid, and I guess if we still have no luck with that, then we know something is really going on with us.
I pray that Clomid does the trick for us though.....
*Snowglobe* this is such a great thread, thank you for all the time you put into it! I've searched Morphology a lot of times and haven't found anything so informative and hopeful!


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## Snowglobe21

That's great morphology Cooch! You have nothing to worry about their at least.


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## Snowglobe21

Hi Korink. Did your cycles go back to normal right after your miscarriage. I stopped bleeding after 20 days on October 20th and have no sign of a period since except black discharge. Also, from what you've said everything sounds great and hopefully your BFP comes soon and the morph is just slowing it, not an inhibitor which I don't think it is. Also, would u mind sharing what count and motility your working with?

Good luck to mjemma with clomid!


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## cooch

Snowglobe21 said:


> That's great morphology Cooch! You have nothing to worry about their at least.

Fingers x'd x


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## Snowglobe21

Also, for anyone interested in where their count/motility/morph stands. This is the link to the WHO 2010 guidelines book. Over 200 pages of the techniques used and everything you need to know about SA analysis LOL. Page 225 is the chart I refer to frequently. Also, if anyone has a study they find on the internet they want read about, but can't access it because you have to pay or something. Just send me the title of the study and I will use my academic account to find any info you might want off of it. 

https://whqlibdoc.who.int/publications/2010/9789241547789_eng.pdf


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## korink26

Snowglobe21 said:


> Hi Korink. Did your cycles go back to normal right after your miscarriage. I stopped bleeding after 20 days on October 20th and have no sign of a period since except black discharge. Also, from what you've said everything sounds great and hopefully your BFP comes soon and the morph is just slowing it, not an inhibitor which I don't think it is. Also, would u mind sharing what count and motility your working with?
> 
> Good luck to mjemma with clomid!

I had a D&C done, so I'm not sure if you had that or if you miscarried naturally? I had the D&C and really hardly bled at all....and then AF came 4 weeks and 1 day later. 1st cycle after was odd, but since then I've been fairly regular. 
As far as the other numbers, we never got a report, but my husband called and wrote crappy notes! Maybe you'll be able to understand what's what?
His notes are:
Volume: 3.7
Motility: 70 (he has concentration written by this also?)
PH: 7.8
Sperm Count: 207
Morph: 4

**Also, do you have any problems that you know of? With your cycles varying so much, have they done tests for you? Have you tried Clomid at all to help regulate your cycles?


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## Snowglobe21

Haha wow, his SA sounds pretty similar to my own fiancee's except for your DH has 5% higher motility. We also started to TTC around October/November 2010 when I came off the pill. In regards to my problems, I don't have any diagnosed problems as of yet, but have just had blood tests and ultrasounds done which have shown nothing. That being said, my cycles were 45 days regular before they stopped altogether after getting cysts. I then went on the pill for a year and since coming off, they have been completely irregular and random with no hope of charting anything. I tried to get clomid to regulate it, but my family doctor discouraged going on it saying irregular cycles were "normal" and that the human body is not a robot. My fiancee was pretty ticked by her lack of concern. That said, I have an ultrasound and abdominal scan again tomorrow, the first after my miscarriage so maybe they'll see something then. 

My fiancee got a referral to a FS due to his 4% morph but we have to wait until Feb/March for that so I'm sure I'll get more testing then. Also, yes my miscarriage was natural. I took a preg test and got a positive, then started bleeding a few days later. About 4 days into the bleeding I had prior blood tests scheduled and they detected 4.9 HCG and called saying I had been pregnant because I never told my doctor that I got a positive pregnancy test. Just was gonna leave it since I had got a period so figured it might have been wrong. Well turned out it wasn't as I expelled a [TMI warning] small sac and then wouldn't stop bleeding.

Have you asked your doctor about your 11 day luteal phase?


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## korink26

I was thinking their SA's seemed very similar!!!! Actually a lot of our situation seems similar....How long were you TTC when you got pregnant? I worry sometimes that because of his Morph we miscarried (not blaming him in anyway, I also worry I have crappy ovulation/eggs). I was 8 wks when I miscarried, but was only measuring about 6W4D.
That's curious that yours referred you to a FS but mine said everything is A-ok....sometimes I think she's too laid back. She says my LP is fine...idk really any of my worries I bring up to her she dismisses. She was really good though about letting me take the next step with clomid. 
As for yours, that's really discouraging that she thinks it's normal to have such long/irregular cycles. I suppose they're the Dr. though.....I'd think they'd want to try a cheaper route (clomid) before they put you straight to a FS. I'll be thinking of you tomorrow. It would be great to find something out, as long as it's treatable. At least you have a direction then, and a plan of action! Let me know how it goes!


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## Snowglobe21

korink26 said:


> I was thinking their SA's seemed very similar!!!! Actually a lot of our situation seems similar....How long were you TTC when you got pregnant? I worry sometimes that because of his Morph we miscarried (not blaming him in anyway, I also worry I have crappy ovulation/eggs). I was 8 wks when I miscarried, but was only measuring about 6W4D.
> That's curious that yours referred you to a FS but mine said everything is A-ok....sometimes I think she's too laid back. She says my LP is fine...idk really any of my worries I bring up to her she dismisses. She was really good though about letting me take the next step with clomid.
> As for yours, that's really discouraging that she thinks it's normal to have such long/irregular cycles. I suppose they're the Dr. though.....I'd think they'd want to try a cheaper route (clomid) before they put you straight to a FS. I'll be thinking of you tomorrow. It would be great to find something out, as long as it's treatable. At least you have a direction then, and a plan of action! Let me know how it goes!

I know! It seems we are in very similar situations in many ways! I will definetely be paying extra attention to your TTC journey as the circumstances seem fairly similar although you seem to be better off than me cycle wise lol. Hopefully, I can get to your stage of regularity with clomid. I know what you mean about worrying doctors are lax. My doctor wouldnt refer us to an FS or do further testing on me or give me clomid which lead my fiancee to really question her and she shut him down telling him to "take me to hawaii" and stop rushing, "we're young and have a wedding coming up" and the best, "told him he must be an engineer because he expected everything to go like clockwork and my body doesnt work like that". I think he was right though about pushing her for treating me. I hope clomid works out for you! When can you test? 

Also, your husbands SA sheet must have said greater or equal to 4 is normal for your doctor to dismiss it. my fiancee's form said >5% is normal and he got 4% lol so at the bottom it said "low morphology, may need IVF with ICSIS if consistently below 4%". Funny how 1% more would have meant a normal result and natural conception would be possible, but his 1% lower meant we need ICSI, not even IUI... Now that doesn't make much sense because his morph was 4, not lower. And WHO guidelines reccomend 4, not 5 as the cut off. I figure this clinic that did his SA must use the 10% percentile of fertile men as the cut-off rather than the 5% percentile that many others use. The first time my fiancee went to his family doctor to get the results, I was in the midst of miscarrying so he thought everything would be fine. Man, the morph was a nasty shock! especially seeing 4%. Of course he had no idea 15% was the norm at the time so he thought that was crazy bad when really it isn't as bad as it looks. His doctor didn't know about the new Kruger though and I think if he saw anything below 50%, we would have been referred lol. My fiancee tried to explain it to him, but doctors don't like being told stuff so he was shut down pretty quick and just referred him. 

We were TTC about 11 months when I got pregnant so took us a while longer. That being said, I probably only had 6-8 cycles in that time. Also, there was no charting or known ovulation times. We just did it every day, or every other day, 3-4 times each day and hoped for the best! I wish the old-fashioned way would just work for us :(. I hate this technical stuff. 

Oh in regards to worrying about whether your MC was from morphology, I am fairly convinced that doesn't affect it, but that DNA fragmentation of sperm does which is a seperate test that costs about $400 and isn't done on a SA. The degree of fragmentation can affect miscarriage rates. 0-15% is normal 15-30% is abnormal, but chance of conception and live birth still possible and over 30% makes even conception impossible. So you know at least your not over 30%. I have read many studies on DNA fragmentation and although it is higher in people with lower morph, it is much higher when 2 or 3 semen parameters are abnormal and not just one. I wouldn't worry to much about it.

Thanks for the good luck and good thoughts!


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## korink26

I would have been pretty upset that the Dr. really seemed to not take your fiancee seriously! I swear they have never had to struggle to conceive, or they would be a little more understanding/empathetic. I really really urge you to push more for the clomid, depending what you find out tomorrow.
Yeah, I wish I could have seen the sheet from my husband's results. All they did was call and say everything was normal, some on the lower end of normal. So then I made husband call back and ask what they meant about lower end of normal. then they just kind of read the results to him real quick and he wrote stuff down. they said 4 and higher is normal. If I would have realized right away how low his Morph was I think I would have asked for a follow up, because a lot of people have said I can't base anything off just 1 result. Then again if his next one put him at a lower Morph. that would suck more! :dohh:
I ssssoooo wish we could have done it the old fashion way. I REALLY did not want to resort to meds, but it just wasn't happening for us and he'll be 30 in Feb. and I just turned 28 so time isn't on our side. 
I'm CD 11 right now, and I will test around CD30 if AF doesn't show first. I don't know how clomid will affect my cycle so I'll have no idea when I'm actually late?!
Anyway, good luck tomorrow, let me know how it goes!!


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## Snowglobe21

Yeah, exactly eh. Well it seems only morph is the lower end of normal on his results. Everything else is exactly on the average of fertile men. I wish I could try to push more for clomid, but my doctor was so rudely insistent that I need to try for another year. Well, good thing we have our referral from a different doc lol. Ugh, I know what you mean about being scared for the morph going lower on a second test....My fiancee is booked for a redo in February. I really hope its better or at least the same at minimum! 

He used to hottub almost every day so he cut that out and is taking tons of different vitamins that "may" improve morphology so hopefully that helps. Honestly, I don't think the vitamins and stuff really make a huge difference, they just make people feel like their doing something when it is mostly out of their control. It all depends on what part of the semen they sample for morph. The way the test works, they look at 200 sperm and make a percentile of it. Usually they do 2 different batches of 200 and then average the results according to the WHO guidelines. So in one result, our DH's could have had 2% and then 6% in the other for an average of 4%. Not sure if our lab's followed the WHO procedure as they don't have too, but this could have been.


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## korink26

What vitamins is he taking? I've tried looking up what could help but haven't found much?
Hope you get all good news today :)


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## Snowglobe21

Hi Korink26, hope your having a great day! Looks like you'll be getting pretty busy around Christmas Day/Eve if your ovulation patterns stay around the same. That's exciting! 

Won't be getting any news today, but went for the ultrasound and they asked lots of questions and took tons of pictures (way more than usual so not sure what that means or if its because I went to a different place and they are more thorough). Just did the blood tests this afternoon. Not sure where you are from, but here in Canada, they can't unfortunately say anything at the ultrasound. They'll send the results to my doctor and go from there. I expect the usual, "oh its normal"....I kinda hope not and she can say something different. Unfortunately, I am going down to California for a few weeks over Christmas so won't get any results until I am back in mid-January so everything is on hold till then! 

As for the vitamins, he is on

1000 IU Vitamin E
1000 mg Vitamin C 
200 mcg or mg (I mix them up) of grape seed extract
50 mg Selenium
50 mg Zinc
1,000 IU Vitamin D 
300 mg Coenzyme Q10 

and a multi-vitamin taken 3 times a day that has tons of stuff. So much money on these things so I hope its not a waste! I have read tons of conflicting studies. Some say they work, some say they don't lol so we will find out! We are also BD'ing 3-4 times each day right now (have no idea if that helps or not. You'd think that would increase the numbers too, but no studies have been done.). Sadly, its probably a waste because I don't think I've ovulated in a few months but oh well. It makes him feel productive and I'm not complaining! 

Keep me updated on your clomid cycle and how it goes! I am very interested and hoping for the best for you!


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## Lisa92881

Wow Snowglobe!! Great thread, how nice of you to put so much work into it!! :)

I'm going to dig out my hubby's SA paperwork later....when he's not sitting right by me wondering what I'm doing. :winkwink: My dr said they were a bit low, but when I started researching, the #'s didn't seem too low. At my next appt I said to her, "His numbers are a little low, but nothing overly concerning, right??" and she agreed. So I don't really know what to think, haha. Right now the major issue is that I don't ovulate, so we're working on fixing that "problem" and not stressing about his swimmers too much. :) Anyway, I'll post the details later to get your take on them!!


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## Snowglobe21

No problem Lisa! Thought I might as well put up some of the stuff I've seen to help since I've been badgering others with questions. Please do put up your hubs results and I'll try to help you out! Also, good luck with your clomid cycle! Keep up posted on here how it goes!

Also: For those in the UK, here is an NHS website saying IVF was only affected by less than 2% morphology. They use 4% as lower reference value in line with 2010 WHO guidelines. They noted their SA sheets only changed October 2011. This may be why some still have the 15% expectation.

https://www.cmft.nhs.uk/saint-marys/our-services/andrology/reference-ranges-for-semen-analysis.aspx
____________

Here is a study done of the semen characteristics of men who preserved their semen before undergoing cancer treatments for various types of male cancers. It is important to note that these values should be seen as an average of a population and that the cancer generally did not affect their semen samples as it is only affected after undergoing treatment. Once again, the chart shown in this link is of their semen values taken before any treatments that would dramatically affect the values, although the various cancer's may have slightly suppressed them. Their kruger morphology average was 3.5% with a range of 0-11%. All other values can also be seen as averages of normal fertile men except in the case of the testicular cancer group where the cancer had already affected the concentration prior to treatment. Once again, this is another study showing how low male morphology is when using the kruger method. Note: This study is not about a group of males with proven fertility status or having achieved a pregnancy. The sample is based around cancer diagnosis, not fertile males as all of my other posted studies have shown.

Here's the link:

https://www.brazjurol.com.br/march_april_2009/Bonetti_ing_190_198.htm

(Please refer to Table 1)
___________________

Reference values for morphology from the Andrology Lab in Oslo Norway. They found the 10th percentile of fertile Norwegian men's sperm to be 4%. (90% have higher, but 10% of fertile men have equal too or lower). The 5% value which is the usual cut-off for SA tests was 3%. 

https://www.andrologyjournal.org/cgi/content/full/27/1/66/TBL5

_____

Also, I caution people new to looking at morphology research to only look at studies or websites updated in the last 2 years maximum. WHO only changed the criteria in 2010 so there is a lot of old information floating around the web, less stringent techniques and misinformation. There is one particular doctor who I have noticed posting on the web about how 15% is the absolute minimum criteria and I laugh at how terribly wrong he is considering the statistics and multiple studies proving him wrong. I won't mention his name here for fear of lawsuit, but just be forewarned there is misinformation out there. He called someone with 10% kruger normals as "severe male factor" when that is clearly wrong. That being said, despite all my posts of 4% kruger being alright, I do believe that higher morphology correlates with time to pregnancy.


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## Lisa92881

Ok Snowglobe, analyze away.... :winkwink:

Total count: 48.0 million - says it should be >60
Motility: 40% - says it should be >60

Then the other part that is highlighted is "Kinetics" (the highlighted items are low) which is a 3. Are you familiar with this scale, if not I will post the full scale. 

There is no morphology listed on the labwork. :shrug:


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## Snowglobe21

Lisa92881 said:


> Ok Snowglobe, analyze away.... :winkwink:
> 
> Total count: 48.0 million - says it should be >60
> Motility: 40% - says it should be >60
> 
> Then the other part that is highlighted is "Kinetics" (the highlighted items are low) which is a 3. Are you familiar with this scale, if not I will post the full scale.
> 
> There is no morphology listed on the labwork. :shrug:

Hi Lisa! Hope your having a great day and are all ready for the Holidays.

*First of all let's start with the count of 48 million*. That's odd your sheet says greater than 60 million as WHO 2010 guidelines lowered the total acceptable amount to 39 million total. My fiancee's sheet says anything over 40 million is normal. So your clinic has considerably higher standards than the norm. That said, the count is low compared to average, BUT between 5-10% of fertile men who concieved after 1 year did have a count in that range. (Source: Page 225 chart of this link https://whqlibdoc.who.int/publications/2010/9789241547789_eng.pdf) 

*Motility: * Do you have a breakdown of the motility on the sheet? Like Rapid progressive, slow progressive, non-progressive? That was how my fiancee's was divided up and it can provide a bit more info. That being said, the cut off for motility on the majority of semen analysis's now is 40%. Thats what my fiancee's sheet says once again. 60% seems high for a minimum and I've never heard that. 60% is the average for men (50% have higher, 50% have lower). So your right on the cut-off here, but on the low end of fertile men (5% have less than 40% total motility, 95% have more). All WHO normal values use the 5th centile as the cut-off though so you would be within normal range. 

I can't help you with the kinetics at all as I have no idea what that is and have read nothing about it. If you could post the scale, I could take a look. 

You should consider trying Vitamin C and E together to try and improve the motility as well as Coenzyme Q10. I myself have no idea how well vitamins work, but its worth a shot at least! I've read studies saying these help motility. 

I'm surprised they didn't do morphology. Who did the testing? Was it in the UK with your NHS or something? Apparently, I've heard they don't consider morph anymore. Basically, from reading your SA, if you don't concieve in the next while (however long a deadline you think is appropriate), I'm sure you would be excellent candidates for IUI provided the morph is at least 4%. IUI looks for at least 10 million motile sperm post-wash for optimal success rates of about 13-20% which you guys will have. Anything less than 10 mill and rates decline. Since you have 48 million x .40 = 19,200,000 and then cut that in half since washing gets rid of about half, you are right around the 10 mill mark.


----------



## Lisa92881

Ok here is more info. The first pic is the scale used for Kinetics. The second pic is the list of what they looked at in the SA, maybe something is another word for morphology??

https://i1231.photobucket.com/albums/ee514/Lisa92881/1324494933.jpg

https://i1231.photobucket.com/albums/ee514/Lisa92881/1324494827.jpg


----------



## Lisa92881

Oh dear, sorry those pics are so obnoxiously big!! :haha:


----------



## Lisa92881

Hmm, maybe "normal sperm" 3% = morphology??? :huh:


----------



## Snowglobe21

Hi Lisa, sorry, I can't even see the pictures on my internet browser lol. It's probably my mac or the internet version isn't updated or something! But if it says Normal Forms, that would be the morphology as mine says "Kruger Normal Forms". So your hubby has 3% morphology. Depending on what you read, that can be seen as the absolute bottom of normal, nothing to worry about, or that you need IVF with ICSI. Plenty of people have concieved with that number so its not impossible. In fact, in one of the studies I posted, that was the average morph of fertile men. I wouldn't worry too much about the 3%. My fiancee got 4% and our sheet said "May need IVF with ICSI" and that 5%=normal. But who knows!

WHOOPS: I can see the pics now so Im editing this post. That is great motilty. I was worried that of the 40% they might be slow or none-forward moving, but you have the good moving sperm so thats good! 

WBC: 4-6 (is that in millions?) My DH's SA didn't have that done or it was less than 1 million, not really sure, but 4-6 may mean infection or something. You might want to ask about that. Also, does your SA have a reccomendation at the bottom for treatment or anything?

Do you have PCOS or a diagnosed reason for why your not ovulating? I suspect I don't ovulate much either as my cycles are so crazy, but nothing confirmed yet. I did get pregnant when I had my first short cycle of the year (35 days) before the cycle I got pregnant though.


----------



## Lisa92881

Yeah I guess the normal sperm 3% probably means morphology. That number seems to be ok according to my clinic. Man this is confusing! How are you able to tell that the motility is good b/c it's the good moving sperm? It's hard to tell from the pics, but the things that are in bold are the numbers that are low, and motility is bold. 

Whatever WBC is I guess is fine, because it's not in bold. :shrug:

No PCOS or any clear reason why I'm not ovulating. Bloodwork and everything has shown that my levels are normal.


----------



## DancinEmr

Hi Everybody,
I posted earlier saying that my husband had 4% morphology on his SA. The doctor said we would need IVF and we were devastated. That was about 2 months ago and we haven't gone to an RE yet. 
Anyway, my friend is a Homeopathic Doctor who specializes in infertility. I called her today because I have been worrying myself sick about the 4%. I thought I would relay some of the info she told me. Some of it you may already know...
She said that the Kruger morphology percentage keeps getting lowered and that male sperm count and quality are on a downward trend. She said it may be due to our diet or environmental toxins. She said that 4% was pretty bad...but you can still get pregnant naturally with that low of a number.
She also told me some things the male can do to improve morphology such as eating organic foods, taking an anti-oxidant supplement, taking up to 5 grams of Vitamin C per day (lower the amount if it causes indigestion), and taking 90 mg of zinc sulfate per day. She referred to studies showing that all of these things improved sperm morphology in sub fertile males. She also said that males should avoid parabins and phthalates in their bath and body products...something about them increases estrogen production in males and messes with their hormones.
I hope somebody finds this info helpful! Good luck and happy holidays to all!


----------



## korink26

Well girls, I've been reading about the vitamin "Fertility Blend" for men, so I went and bought some tonight. Says it could take 3 months to really tell a difference so we'll see. $40 a month so I hope it helps!!


----------



## Lisa92881

korink26 said:


> Well girls, I've been reading about the vitamin "Fertility Blend" for men, so I went and bought some tonight. Says it could take 3 months to really tell a difference so we'll see. $40 a month so I hope it helps!!

Ohh that sounds interesting. I have been making my husband take a multi vitamin, haha. I'm going to research fertility blend!!


----------



## dachsundmom

Hi girls,

I hope you don't mind me jumping in, but I am very curious about this kinetic scale...if you read what Wikipedia says about grading, 1 is the best...the kinetic scale is rated backwards.

I know Wiki isn't science, but I am interested in the comparison.

My DH has 30% motility and a Grade 1+. I am just trying to figure out if anything is moving and how he could have 30%, if they are immotile.:haha:

It's just too hard.:wacko:


----------



## korink26

Lisa92881 said:


> korink26 said:
> 
> 
> Well girls, I've been reading about the vitamin "Fertility Blend" for men, so I went and bought some tonight. Says it could take 3 months to really tell a difference so we'll see. $40 a month so I hope it helps!!
> 
> Ohh that sounds interesting. I have been making my husband take a multi vitamin, haha. I'm going to research fertility blend!!Click to expand...

Yeah, mine has always taken his Men's One a Day vitamins, but now I'm making him add this in! If we don't get a BFP I almost wonder if I should take a month or 2 off Clomid to give the vitamins time to work!?


----------



## Lisa92881

dachsundmom said:


> Hi girls,
> 
> I hope you don't mind me jumping in, but I am very curious about this kinetic scale...if you read what Wikipedia says about grading, 1 is the best...the kinetic scale is rated backwards.
> 
> I know Wiki isn't science, but I am interested in the comparison.
> 
> My DH has 30% motility and a Grade 1+. I am just trying to figure out if anything is moving and how he could have 30%, if they are immotile.:haha:
> 
> It's just too hard.:wacko:

I know, I don't really understand it either. Right now, I'm just trying to relax about it all, have my husband take a mulit-vitamin each day, and take comfort in the fact that my dr wasn't like, "OMG, you need to get your hubby to the dr right now, there's no way you'll ever get pregnant with an SA like this!!!" :haha:


----------



## dachsundmom

:xmas13::xmas13::xmas13::xmas13:


----------



## jenlouise

wow this thread is excellent just what ive been looking for as so confused... please could someone look at hubbys results and adavise me. quick background info. We have been TTC for over 2 years-i have mild PCO ( though normal bloods) no periods, last one was last feb-though we do have a 3 year old that we naturally conceived after 6 years. So we went to docs in nov to asked to be refereed to FS-He made hubby do SA and this is what he got in Nov:
volume. 3ml
ph. 8.0
motility. 44% motile. 9% sluggish.9% non progresive. 38 % non motile
Vitality. 85% alive 15 % dead
count. 118 million
Morphology.4% normal 

The doc said the last one was too low so made him to another SA 4 weeks later, in the mean time my hubby was taking vits and we have just got the results and we think its not too good ( doc left his results with the receptionist as he had to rush out so didnt have chance to talk through them) This is latest results....

volume.3.4 ml
motility 60% rapid. 4% sluggish.5% non progressive. 31% non-motile
count. 150 million/ml
Morphology. 2%


Now all of this is confusing though from looking everything else is better apart from the last one, which is even worse then the first time. I am due to see my doc again on Thursday as he said he wouldn't refer me to FS until this second test on hubby, though im so worried he wont refeer me as he said that morp needs to be above 5% for the NHS to accept me as we already have a 3 year old -is this right?? I know we wouldnt get IVF on NHS but i was hoping he couldn't at least refer me and maybe try me on clomid? what do you think he will say and please could someone help me on the results are they really bad??


----------



## Snowglobe21

Hi jenlouise, im writing this on my phone so I will have to be brief. I'm no doctor, but I don't think you have much to worry about with that SA. Is the number of sperm the total count, or concentration per millimeter? Also, if you haven't had a period in almost a year, my understanding is that means you haven't ovulated since last feb so no matter whether your hubby was Jim duggar or had no sperm, it wouldn't matter because there is no egg. I think clomid would really help you


----------



## MariaF

Hi ladies - I really don't mean to be rubbing it into anyone's face, but I thought it may be useful to let you know what after 24 months TTC with morphology between 6 and 8% we got our BFP.

DH had 3 SAs done and the first two showed high total count (close to 150million). But the last SA showed only 45 million with just 6% normal sperm. The FS hinted that IVF is probably the only option. 4 weeks later I got my BFP.

We did use lots of Preceed and I also used a baking soda solution for my cervix to make the mucous more sperm friendly. I don't know if this helped.


Im really sorry if my post offends anyone - I just wanted to share that although it did take us 24 months (and about 17 cycles) and we were about to start IUI followed by IVF it still happened naturally.


----------



## Snowglobe21

Hi Maria, 

First of all, congratulations! Success stories are awesome to hear. Did you have regular cycles in the time TTC or did your doctor think the morphology was solely responsible for the long time period it took?


----------



## korink26

Thanks for the encouragement Maria!


----------



## Snowglobe21

Sorry to see your BFN Korink26 :(.


----------



## korink26

Ugg...thanks snowglobe, onto the next cycle. :) Where are you in your cycle?


----------



## Snowglobe21

I'm not really sure as I haven't had a regular cycle in years lol! Could be 35 days, could come in 70 days but who knows. I got my period on December 26th finally, the first after the miscarriage so day 16 according to that. Im in a weird TTC/not TTC phase as my wedding is 7 months away so although I don't want to be massive at the wedding, I don't want to be wasting time now either as it has been a long haul already so I'm having unprotected sex now and then, but having mixed feeling about it as somedays I feel I could get pregnant easily and others I feel it will be tough. I know, I sound stupid and prob don't make sense, but I can't exactly explain it. My fiancee is getting nervous for his second SA, feb 6th. We'll see then how the supplements work...

What did your doctor say about your clomid cycle? Is he optimistic about the higher cycle dosage?


----------



## Snowglobe21

I'm not really sure as I haven't had a regular cycle in years lol! Could be 35 days, could come in 70 days but who knows. I got my period on December 26th finally, the first after the miscarriage so day 16 according to that. Im in a weird TTC/not TTC phase as my wedding is 7 months away so although I don't want to be massive at the wedding, I don't want to be wasting time now either as it has been a long haul already so I'm having unprotected sex now and then, but having mixed feeling about it as somedays I feel I could get pregnant easily and others I feel it will be tough. I know, I sound stupid and prob don't make sense, but I can't exactly explain it. My fiancee is getting nervous for his second SA, feb 6th. We'll see then how the supplements work...


----------



## korink26

My Dr. always is 100% optimistic, even when she shouldn't be so I don't always trust her enthusiasm. 
I can't wait to hear how his second s/a goes--you'll have to let me know. DH is going on his 2nd month of the fertilaid vitamins, wish we could do a SA to see how he is.
I totally get your predicament. If we just could see into the future and know how long it would take us to get PG. Ugg...


----------



## Skoer1360

:hi: my DH finally got an SA but I really don't know what anything means :( I've looked online but there's so much descrepancy between what's okay and what's not :nope: I posted this in another thread, but haven't gotten a hit yet so I thought I would post here :flower:

Volume: 2mL
Count: 17mill (Is this per mL? If so his count would be 34mill, right?)
Motility: 56%
-forward motion: 2.5%
-total motile: 19% (How can he have 19% motility with 56% overall motility?)
Morphology: 34%
-round cell: 1 (I really don't know what this means)
Ph: 8
Viscosity: 1 (this either)

Is this horrible/not horrible? The dr said his numbers were low in volume and motility but I don't know what part of it and (of course) she's on vacation until next week :dohh:

:wacko: this is all so confusing

Thanks so much in advance! xx :flower:


----------



## Snowglobe21

Hi Skoer! 

I wish I could help you in regards to the count question, but I'd need to see the sheet. Can you upload a picture of it so I might be able to help you? if it says concentration besides the 17 mil its prob per mil, but if it says "total count", then 17 mil is prob the complete amount. 

I'm confused with your motility as well. At first I was gonna say, 56% is right on the average for motility, but only 2.5% forward motion isn't good and the total motile number is confusing. 

As for your morphology, it looks like you got the old WHO methods done for that and you are above the 30% threshold which is awesome news as it means you have normal sperm which is good if you go for IUI. I would reccommend getting a kruger analysis though. Anything over 4% on kruger is normal so don't worry if his morph is way lower if you do kruger. 

Sorry I couldn't be much more help, but his SA seems very different in format than my fiancee's was. Basically too conclude, if the 17 mil is per mL, then you have a chance of concieving naturally according to the WHO as the minimum number of normal is 15mL/ml according to the new 2010 guidelines. This means, 5% of men who concieved within one year of unprotected intercourse had a baby with a concentration of that number. With supplements or holding off sex everyday, you could prob increase the count over the 39 million mark which is the minimum total count needed according to the WHO. That being said, hundreds of women on these internet forums have found luck with all kinds of differing numbers. 

Best of luck and baby dust. 

snowglobe


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## Skoer1360

Thanks so much for your reply! :) I don't have the sheet, all of this info was relayed to me over the telephone but I think it's per mL because she said it was low but not too low.. :shrug: I double checked about the total motile part because I was wondering if it was total immotile (which I think would make sense) but she definitely said motile :wacko: I'll just have to wait and call her when she gets back next tuesday.


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## sugarpuff

i don't know the full details of my DH's SA (this is from almost 4 years ago now when were ttc first time around) but he had a count of 9 million, 9% morphology and 25% motility

combined with the pretty rubbish SA i also have severe endo. it took two years ttc but we managed with me on letrozole (we had been referred and were due to start ivf with icsi though !). i think that they'll ask for another SA in a couple of weeks as we are currently 15 months into our second ttc journey, will be interesting to see how it is now


----------



## korink26

Skoer they only read my DH the results over the phone too, and we requested the report but never got one. I've asked about it since, but sounds like they don't have it? His notes are pretty crappy so I'm not even 100% positive what's what.


----------



## heavenly

Hey guys :flower:

This is OH's SA from 2 years ago, he is going to be retested next week. My FS said we would have to go down the ICSI route because of the morphology but I keep reading conflicting things about it. Any thoughts?

Volume - 2.5mls
Appearance - Normal
Total Count - 43 millions/ml
Motility - 47% motile (moderate forward progression)
Morphology - 94% abnormal forms
pH - 8.0


----------



## Snowglobe21

Hi heavenly, 

Is the total count 43 million or is that per mL making total count 86 mil?


----------



## Snowglobe21

Reason im asking is because your morph is totally fine according to WHO guidelines released October 2010 so if he took his test before that, that is why they prob said 6% is bad. Now anything over 4-5% is considered normal and the average is 14%. Id say if 43 mill is the total count, that is more likely the problem with the low morph not helping, but not being the absolutes reason your not concieving.


----------



## heavenly

Snowglobe21 said:


> Hi heavenly,
> 
> Is the total count 43 million or is that per mL making total count 86 mil?




Snowglobe21 said:


> Reason im asking is because your morph is totally fine according to WHO guidelines released October 2010 so if he took his test before that, that is why they prob said 6% is bad. Now anything over 4-5% is considered normal and the average is 14%. Id say if 43 mill is the total count, that is more likely the problem with the low morph not helping, but not being the absolutes reason your not concieving.

Hi Snowglobe21, thank you so much for replying. :hugs:

The report says 

Total Count - 43 millions/ml

My FS said that was fine - but I get confused, does that make it any clearer?

Thank you for filling me in re morphology, yes his test was pre October 2010. He will be taking another test next week. If we have to go down the IVF/ICSI route, I need all the up to date info I can get. He is taking Wellman Conception tablets.


----------



## jenbridges

lol, yeah that is clear I guess. I just get so confused with how these tests say total count put then the number/ml. that always makes it sound like its per millileter haha. Either way, anything over 39 million in total nowadays is good so whether its 43 or 86, it doesn't really matter as both numbers are in the good category. I'd say you have nothing too worry about with your husbands sperm. Of fertile men, 10% of them had fewer abnormal forms than your husband. To clarify, 1/10 men who concieved a baby within less than a year had less 5.5% or less normal sperms. You can find that in the 2010 guidelines I posted around page 225.


----------



## jenbridges

Thank you snowglobe for posting all this info. I posted a freak out threat earlier before seeing all this and your sources and stuff are great. If you need help maintaing this thread, let me know! Hope you don't mind me answering your question for you heavenly!


----------



## heavenly

jenbridges said:


> lol, yeah that is clear I guess. I just get so confused with how these tests say total count put then the number/ml. that always makes it sound like its per millileter haha.

I know what you mean! lol

Actually it does say on the Normal Values at the bottom of the report that the sperm count should be between

20-150 millions *per ml*

The results at the top of the report said 43 millions/ml so I assume that it is 86 million?

Oh who knows!!! #-o


----------



## loopy013

Hi ladies,

What an amazing thread! My DH has low morphology too and its soo frustrating with all the conflicting advice.

My DH's morphology is 2% the NHS circled 'fertility treatment needed' on the referral form but there is a 6 month wait just to see the consultant to discuss our results. So we went to a private fertility clinic open evening and spoke to one of the people there. He was unconcerned with the 2% morphology reading and said that he takes it with a pinch of salt! Especially as we have been pregnant before even though it was 10+ years ago he said that male fertility doesn't decline in that time like womens.

So he either thinks there may be a problem with me or we would be under the 'unexplained fertility' group also. I'm so confused with it all the NHS and the private clinic seem to say different things. I've had my AMH blood test done last week so jsut waiting on the results of that and we have our first consultation at the private clinic a week on wednesday so I'm hoping I'll find out more information then.

I was happy going ahead with fertility treatement when I thought that we had a male factor issue but now he's said unexplained fertility I can help but worry that we should give it longer? Having said that we've been TTC for 18 months now and I don't want to put it off nay longer. I'm 30 and my DH is 32 soon also we've also wanted more than one child so I want it to happen sooner rather than later so that it isn't too late for us to try for a second.

Surely 2% morphology is going to have a effect on us getting pregnant though? Why else would they bother to measure it? I hope I'll have some more answers soon x


----------



## Snowglobe21

Hi Loopy, thanks for posting! That is reassuring news that you managed to concieve once with 2%. How long were you two trying for your first?


----------



## lucylou7

loopy013 said:


> Hi ladies,
> 
> What an amazing thread! My DH has low morphology too and its soo frustrating with all the conflicting advice.
> 
> My DH's morphology is 2% the NHS circled 'fertility treatment needed' on the referral form but there is a 6 month wait just to see the consultant to discuss our results. So we went to a private fertility clinic open evening and spoke to one of the people there. He was unconcerned with the 2% morphology reading and said that he takes it with a pinch of salt! Especially as we have been pregnant before even though it was 10+ years ago he said that male fertility doesn't decline in that time like womens.
> 
> So he either thinks there may be a problem with me or we would be under the 'unexplained fertility' group also. I'm so confused with it all the NHS and the private clinic seem to say different things. I've had my AMH blood test done last week so jsut waiting on the results of that and we have our first consultation at the private clinic a week on wednesday so I'm hoping I'll find out more information then.
> 
> I was happy going ahead with fertility treatement when I thought that we had a male factor issue but now he's said unexplained fertility I can help but worry that we should give it longer? Having said that we've been TTC for 18 months now and I don't want to put it off nay longer. I'm 30 and my DH is 32 soon also we've also wanted more than one child so I want it to happen sooner rather than later so that it isn't too late for us to try for a second.
> 
> Surely 2% morphology is going to have a effect on us getting pregnant though? Why else would they bother to measure it? I hope I'll have some more answers soon x

#

Hi Loopy hope you dont mind me asking aswell how long did you TTC for your first? we are TTC and have been for 15 months and my OH has 2% morphology.. i dont get it as first FS said there was no problem with OH SA and second time they were like his morphology was a little low.. i just dont know any more.. they have said we are un explained and our best option is IVF what have they said about you ? thanks Lucy x


----------



## loopy013

Hi both,

Really sorry if I wasn't very clear with my first post. To clarify me and DH got pregnant (over 10 years ago) and we only had unprotected sex ONCE!!!
This is why we are so confused now, there is no way of knowing what morphology my DH had all those years ago. We've been TTC for 18 months now and when I spoke to the guy at the clinic he said that if my DH could get me pregnant all those years ago without any trouble then he doesn't think the morphology is a problem. He said that male fertility hardly changes throughout the years. So he thinks the problem is either with me (I'm still going through tests) or we are unexplained fertility.

I never thought we would have trouble conceiving because of how quickly it happened before so I postponed us starting a family as I thought is would happen straight away. Now we're getting really worried and so I think we'll be doing IVF/ICSI split. I had my AMH blood test done last week so should get the results this week, I just hope it isnt really low and means that my fertility has taken a nose dive! We've got our 1st consultation on 15th Feb so I'll be asking all the questions under the sun about morphology I'll let you know what they say.

Like all of you on this thread all over levels of DH's SA are fine, its just the morphology that is the issue x


----------



## Snowglobe21

Wow, lucky first try eh! Yeah, isolated low morphology is really odd. I almost think they should just through the Kruger method out the window because it seems so conflicted. Every study seems to show something different! 

That's funny your fertility specialist appointment is on the 15th as ours is too now! I'll post everything that is said there. Also, DH did his second SA this morning at 8AM. We abstained one extra day, but that hopefully won't lower the morphology. We are going to wait until the FS appointment for the results though, rather than having him go into his family doctor who knows nothing about SA's and misread the first one quite significantly.


----------



## CrazyCatLady

Well I'd just like to add a little encouragement here and say that I got pregnant a few months after my husband was diagnosed with 3% morphology (he did have a high count and good motility). But I don't believe low morph is the end all diagnoses.


----------



## charbaby

First semen analysis Results

viscosity: liquid
ph:8.1
volume:1.8ml
total count : 82.5 x 10^9/L
rapid motility : 44%
sluggish motility :2%
non-progressive motility : 3%
immotile : 51%
normal forms:2%


2nd semen results

viscosity: Gel
ph: 8.5
volume: 1.8
total count: 71.0 x 10^9/L
rapid motility: 56%
sluggish motility: 0%
non-progressive motility: 15%
Immotile: 29%
normal forms: 2.5%

over all i think these results are better than the previous ones? 
What do you think?


----------



## charbaby

anyone?


----------



## Snowglobe21

Hi charbaby, yes, the motility looks significantly better so thats good! As for the morph, I would probably say it hasn't really changed from the last sample, as .5% isn't really a huge difference so its probably just chance that it was a bit higher. That said, I've read many blogs with people pregnant with 2% morphology so that shouldn't really rule you out. Everything else besides morph is normal which is good. 

Do you have any problems prohibiting you from conceiving?


----------



## tigerlilly

Hi ladies. Dh's first sa came back at 5% normal forms and the 2nd at 3%!

First test results

elapsed time between sample and analysis 80 mins (dh delivered sample within 30 mins of production)

volume - 3ml
total density - 142.7 millions / ml

appearance - normal
liquefaction - incomplete
consistency - viscous

PH - 8.1

motility
rapid 49%
slow 3%
non- progressive motility 7%
immotile 39%

agglutination o%
spermMAR -- %

Morphology 

normal sperm 5%

sperm with defects 95%

head defects 95%

neck/midpiece defects 5%

Tail Defects 10%

Conclusion: Teratozoospermia


----------



## Snowglobe21

Thank you crazycatlady for the words of encouragement! Congratulations to you!

Tigerlilly: what did your doctor say about the results?


----------



## charbaby

Snowglobe21 said:


> Hi charbaby, yes, the motility looks significantly better so thats good! As for the morph, I would probably say it hasn't really changed from the last sample, as .5% isn't really a huge difference so its probably just chance that it was a bit higher. That said, I've read many blogs with people pregnant with 2% morphology so that shouldn't really rule you out. Everything else besides morph is normal which is good.
> 
> Do you have any problems prohibiting you from conceiving?

Hiya thanks, and yeah i have pcos so we think thats all thats stopping us x


----------



## tigerlilly

Snowglobe21 said:


> Thank you crazycatlady for the words of encouragement! Congratulations to you!
> 
> Tigerlilly: what did your doctor say about the results?

we had to have a second test which was worse then the first, i'm trying to find the result but not sure where they are. We're waiting for my results and a referal.


----------



## tigerlilly

CrazyCatLady said:


> Well I'd just like to add a little encouragement here and say that I got pregnant a few months after my husband was diagnosed with 3% morphology (he did have a high count and good motility). But I don't believe low morph is the end all diagnoses.

:happydance::happydance:congratulations:happydance::happydance:


----------



## sookebunny

Semen Analysis 
Hrs Old 2.0 0-2h h 
Please note reference range changes.

Liquefaction NORMAL 
Viscosity NORMAL 
Volume 3.0 =>1.5 mL 
Appearance NORMAL 
Kinetics GOOD 
Motility 65 =>40 % 
Total Sperm Count 104 =>15 giga/L 

Semen Morphology 
Normal Forms A 3 =>4 % 
Abnormal Forms A 97 <96 % 
Pathologist Comments Reviewed by Dr. E. Zayed
Increased abnormal forms.

can any help me morphology. We are trying to have a bay normal.


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## sookebunny

I meant to have a baby normally.


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## charbaby

sookebunny, my partners s/a results are on here somewhere, he had 2% normal forms and the 2nd s/a he had 2.5% normal, his count was around 80 million and 70 million. I had my f/s appointment yesterday and they said his sperm was great and the normal forms would only mater when sperm amount was under 20 million. Hope this helps x


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## sookebunny

Thank you that makes me feel way better. SO I talk to the FS again on friday..


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## sookebunny

so my dr is putting me on Clomid.


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## Snowglobe21

BFP MENTION...

Morphology is a useless indicator. Just found out I am pregnant again and husbands last SA was 3% morph and I just got diagnosed with PCOS last month and was told we would need clomid with IUI. Sorry I have to mention a BFP in this section, but I know when I was browsing the forums and came across people with certain problems, I always wanted to know their outcome to judge how serious the issue was.


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## LuluSS

Hi everyone - I don't think my DH has low morphology. I think the lab used the WHO criteria because his was 38%. I THINK. His SA results are a lot different then everyone elses.

Volume: 3ml
Total count: 144.8 million
Rapid moving: 23% (I guess this is motility)
Slow moving: 17% (So I guess his total motility is 40%)
Normal Cells: 38% (I am guessing this is morphology)

They never said anything about progression or forward moving. So not sure how many of those there are. 

DH received these results over the phone.


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## korink26

Ssooo happy for you snow!!! You give us all hope <3


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## charbaby

LuluSS said:


> Hi everyone - I don't think my DH has low morphology. I think the lab used the WHO criteria because his was 38%. I THINK. His SA results are a lot different then everyone elses.
> 
> Volume: 3ml
> Total count: 144.8 million
> Rapid moving: 23% (I guess this is motility)
> Slow moving: 17% (So I guess his total motility is 40%)
> Normal Cells: 38% (I am guessing this is morphology)
> 
> They never said anything about progression or forward moving. So not sure how many of those there are.
> 
> DH received these results over the phone.

I think rapid moving (23%) would be the sperm that swims in a straight line and fast. The slow moving (17%) would be the sperm that don't really get anywhere. so gives you a total of 40% motile and 60% immotile They like to see at least 50% viable from what i have learnt. But if you have 38% normal forms thats great my o/h only had 2/2.5 % xx


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## Posey

Hi ladies. Well, I'm new to this thread, I'm just trying to find people who are 'going through' a smiliar tale or who understand these things.

I'm 27, DH is 29. We've been ttc for only 6 months, but decided to do a semen analysis because we're rushed in ttc (my mom passed away in the summer, so did my biological dad, and now my other dad's cancer has returned... needless to say, we're feeling under the gun to start our family here). Anyways, results were shocking/devastating to us.

Interpreted after 2 hours.
Volume: 1.0
Kinetics: fair
Motility: 40% (so borderline...)
Count: 80

Everything else normal until...

Morphology
Normal forms: 0%
Abnormal forms: 100%
Increased normal forms. Aggulation present. Consider sperm antibodies.

SO, my boss, who is a family doctor, took one look at that and told me I may never be able to have my husband's kids, even with fertility treatments.

I am praying praying praying that's not true?! Does anyone have any experience/knowledge to help me understand? Obviously, 100% abnormal sperm is terrible... does this mean I'll never get pregnant? Also, sperm antibodies maybe present... so his body makes antibodies to kill his own :spermy:. And then aggulation, so they don't swim, they just make scrambled eggs.

He's going to repeat the sample in a few weeks. We're going to see a fertility specialist hopefully soon. I just pray something can be done for him/us?

Thank you for your help :flower:


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## AndreaFlorida

Volume (amount of semen in the cup) --- 1.5 normal range 2-5

PH, semen -----------------------8.0 normal range 7.2-9

WBC concentration.............................<1.0 normal range 0-1.0 mil/mL

Liquefaction............................................ it was normal less than 60 minutes

Viscosity..............................................2 + normal range 1-2...so not so good

Sperm Motility (the ones that move well).......38.8% normal range 50-90% (not good at all)

Viability (how long they live)........................76% normal range 50-90% (very normal)

Sperm Concentration .................................67.5 MILLION --normal range 20-120 mil/mL

Sperm morph (normal sperm..good tails, heads, etc).4.7% normal range 15-90% (very low)


A note to this is last year my husbands SA was halfway decent...those numbers from February 15th, 2011

Motility- 55%
Count- 78.8 Million
Morphology- 36 %

In saying that my husband went from a morphology of 36% down to 4.7% 

AFTER A DEPLOYMENT.....so who knows where to go from here :(


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## LuluSS

charbaby said:


> LuluSS said:
> 
> 
> Hi everyone - I don't think my DH has low morphology. I think the lab used the WHO criteria because his was 38%. I THINK. His SA results are a lot different then everyone elses.
> 
> Volume: 3ml
> Total count: 144.8 million
> Rapid moving: 23% (I guess this is motility)
> Slow moving: 17% (So I guess his total motility is 40%)
> Normal Cells: 38% (I am guessing this is morphology)
> 
> They never said anything about progression or forward moving. So not sure how many of those there are.
> 
> DH received these results over the phone.
> 
> I think rapid moving (23%) would be the sperm that swims in a straight line and fast. The slow moving (17%) would be the sperm that don't really get anywhere. so gives you a total of 40% motile and 60% immotile They like to see at least 50% viable from what i have learnt. But if you have 38% normal forms thats great my o/h only had 2/2.5 % xxClick to expand...

Oh ok great! Now I feel better. I was thinking rapid moving was the total amount of sperm that were moving fast...in no general direction.


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## heavenly

Could someone interpret for me, just got OH's results back, he had this test done 3 years ago. His volume has gone down but the total count, motility and morphology have all improved.

Volume - 1.0mls (bit concerned about that, should be 2-6ml)
Appearance - Normal
Total Count - 58 million/ml
Motility - 60% good forward progression
Morphology - 92% abnormal forms


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## Posey

heavenly said:


> Could someone interpret for me, just got OH's results back, he had this test done 3 years ago. His volume has gone down but the total count, motility and morphology have all improved.
> 
> Volume - 1.0mls (bit concerned about that, should be 2-6ml)
> Appearance - Normal
> Total Count - 58 million/ml
> Motility - 60% good forward progression
> Morphology - 92% abnormal forms

From my (limited) understanding, this is a fantastic S/A result :) Don't worry about the volume I don't think. His counts are great.


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## heavenly

Thank you! He had an SA done 3 years ago and his count and motility has shot up with this latest test! He has given up smoking and has been taking Wellman Conception for quite a few months now, so maybe that helped! x


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## AndreaFlorida

That means you only have 8% normally shaped sperm...such as tails in tact, heads normal.....its not the greatest but I've heard of people with 2% getting pregnant I talked to a lady today so it is possible...especially since the count are good and the motility are great for you! I have faith you can get pregnant just might take longer than usual since the morphology is a lower than norm. I wouldn't worry about the volume....that should be fine. I wish you the best in all of your TTC journies hun!


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## heavenly

Well, me being 46, we are running out of time for it to happen naturally, probably looking at IVF.

Best wishes to you too AndreaFlorida. xx


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## Posey

Hi everyone... I'm sorry to bother and ask again, I just haven't got a response... maybe nobody knows :) My hubby's S/A was terrible, showed up 0% normal morphology forms, 100% abnormal. 40% motility. count was at 80. Does anyone know if this means we'll never conceive, even with treatments?! Sorry, I'm just panicking. We'll hopefully see the fertility doctor soon. Any input would be so greatly appreciated. :flower:


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## charbaby

Posey said:


> Hi everyone... I'm sorry to bother and ask again, I just haven't got a response... maybe nobody knows :) My hubby's S/A was terrible, showed up 0% normal morphology forms, 100% abnormal. 40% motility. count was at 80. Does anyone know if this means we'll never conceive, even with treatments?! Sorry, I'm just panicking. We'll hopefully see the fertility doctor soon. Any input would be so greatly appreciated. :flower:

Hiya posey Sorry i don't no about 0% morph, but best of luck xx


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## Moorebetter

Semen Volume 1.6 mls 
Sperm Count (conc.) 58 million/ml 
Total Sperm Count 92.8 million 
Total Percent Motility 64 % 
Percent Rapid Progressive Motility 60 % 
Rate of Forward Progression 3+ 
Motile Sperm Count (conc.) 37 million/ml 
Total Motile Sperm 59.2 million 
Round Cells <1 million/ml

just got these today at the bottom it reads, 

Evaluation: Subnormal
Comments: Sample considered subnormal due to reduced sample volume.

any help would be great


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## dreaminghopin

Great thread ladies

My dh's most recent sperm report:
Volume 2.7mls
Concentration per mil 33 million
Motility 50% (rapid progressive 48%)
morph 2%

Although no expert it does seem that morph isn't too much of an issue if you have a high count. I wish there was a study that would evaluate the likelihood of pregnancy in relation to functioning sperm. Although the recent WHO guideline state that for example 5% of males got their partners pregnant with 3% morph... I imagine those males would have had very high counts. Likewise the males who got their Partners pregnant with a count of 15 mill sperm would have probably had excellent morph. 

Despite our pretty rubbish numbers, we did conceive in dec 2011 but sadly miscarried.


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## Conceive81

Hi Ladies,

Not sure if this thread is still active, but here goes:

Volume = 2.0 (reference range >2.0)
Sperm Concentration = 161.4 million (reference range >20 million)
Total Sperm Concentration = 322.7 million (reference range >40 million)
Motility = 90 million (reference range >40 million)
Viscosity = 1 -normal
WBC = 2-4 per hpf (refrence range < 1 million/ml)
Activity = 3 (ref range 1-sluggish, 4 very active)
Progression = 36 (ref range >25%)
PH = 7.6 (ref range 7.2-7.8)

Strict Morphology:

% of Normal = 1 (ref range >14%)
Large = 0
Small = 36
Taper = 7
Amorphous = 28
Duplicate Head = 0
Acrosomal Deficiency = 0
Vacuole = 28
Neck/Midpiece Defect = 0
Cytoplacsmic Mass = 0
Tail defect = 0
Other = 0

Notes:

In the initial testing a small number of immotile cells were present. Many of the motile sperm cells progressed well but some also showed mostly fine Lateral Head Displacement. These findings are reflected in a good 90% motility and a good progression score of 36%. Morphologically only 1% of the sperm cells were normal with the presence of spermatogonia.

It has been our experience that when a majority of the sperm cells show only one or two vacuoles and/or small size, in spite of the abnormal morphology, progression score maybe around normal or above it, as is the case with this patient.


What do you all think? RE said that because of his high count and motility, the 1% doesn't necessarily mean 1%...you have to multiply that factor or something. I had IUI with injectibles last Sunday...praying for a bfp.


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## Bluenpinkmom

i would want to share my sister in law's case : 
her DH was diagnosed with male factor with 8% morphology.. though the standards are 4% her doctor still thought it was way less.. they had a hell of a doctor and though i dont want to mention his name, he claims himself to be a great OB, he works at monteray bay ivf at CA... i would not even mention but still i do cause he was that pathetic.. he straight way told them ivf also is a waste for them and he gave them ICSI as the only option. Dejected, they took a cycle off.. and baam she was pregnant that cycle.. so i swear by 4%... sorry if that was a kind of vent but just wanted to educate everyone on horrible doctors around


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## Butterfly22

My DH Morphology is 14%. Doctor is telling us IVF is probably our only option but we can try IUI 1st if we really want to. However, after research we are finding that 14% is not that bad! I just had a Lap&Dye done last month that did find issues that were fixed. Now, the only "issue" is DH morphology is 14%. We have decided to try natural and just have fun like in the beginning.

I do believe it depends on the total sperm count though. For instance 5% of 50million actually contains less normal sperm than 3% of 200million. I also read that having sex less often causes the sperm to change shape so if the SA total number is great than having sex everyday might be better for you! I am no expert though - this is only stuff I've read.


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## ChaiLatte

Hello, have read through this entire thread and see a lot of interesting info.

Here is our result:

Count: 36M per ml (86M total)
Motility: 65%
Morphology: 3%

I don't have any other details as the numbers were given over the phone.

Because of the low morphology, DH's doc had him checked for a varicoceles, but there wasn't one. But the doc did say we should be able to conceive naturally, as the other numbers are high enough to offset the low morphology.

Thoughts on this? I'm concerned because other Docs mentioned in this thread seem to say IVF is recommended if morphology is that low. 

We have no female factor issues that we know of. DH is taking FertilAid pills to see if that helps.


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## CaliDreaming

ChaiLatte said:


> Hello, have read through this entire thread and see a lot of interesting info.
> 
> Here is our result:
> 
> Count: 36M per ml (86M total)
> Motility: 65%
> Morphology: 3%
> 
> I don't have any other details as the numbers were given over the phone.
> 
> Because of the low morphology, DH's doc had him checked for a varicoceles, but there wasn't one. But the doc did say we should be able to conceive naturally, as the other numbers are high enough to offset the low morphology.
> 
> Thoughts on this? I'm concerned because other Docs mentioned in this thread seem to say IVF is recommended if morphology is that low.
> 
> We have no female factor issues that we know of. DH is taking FertilAid pills to see if that helps.

Hi ChaiLatte.

My dh got only a 0.5% on morphology and a 30% motility result on his SA. I don't remember what my dh's counts were, but I know it was well above the minimum they like to see.

My current RE did not seem concerned at all about the morphology result. She was a little concerned about the motility, which she described as "on the low end of normal". I asked her if this was the reason we were not getting pregnant, and she said no. She would have expected us to have gotten pregnant even with the low morphology and borderline motility.

I consulted a second RE, and he had a totally different opinion on my husband's sperm and wanted to send him to a urologist. In our consultation, he even asked who fathered my two year old child because he was so confident that my dh's sperm was the problem. He had told us it could take us years and years to get pregnant with those numbers. When I told him dh was the father and that it only took us eight months to conceive--(and I only have one tube open and suspected endometriosis)--he mumbled "well sperm counts can change over time"

So I have every reason to believe my current RE is right on this one, because my dh has fathered four children in his lifetime--three with his ex wife and one with me two years ago. Sperm can change over time, but it's usually a very gradual decline. 

Also, from what I can gather, there is a great deal of variations between labs in what they consider to be "normal" sperm. It's a totally subjective thing. Many REs only pay attention to morphology if the sperm is "grossly" abnormal. 

I hope this is reassuring to you!!!


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## Ruskiegirl

Mabey you ladies can help me out , We got our results today and doc was concerned with his morphology , but everything I have read said its good . He wants DH to see a urologist but is it really needed ?
https://i62.photobucket.com/albums/h91/Bmxfreestylegirl/SAM_0494_zps31702b77.jpg
https://i62.photobucket.com/albums/h91/Bmxfreestylegirl/SAM_0496_zpsf5d7e5af.jpg


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## CaliDreaming

Your doctor is basing his opinion on the OLD classification system. Under the new WHO guidelines, anything 4% and over is normal. Check out this blog from an RE who explains it all very well https://www.drlicciardi.com/2010/07/sperm-morphology-new-guidelines-announced-4-is-normal-2.html

If you do a google search for Dr. Licciardi and morphology, he has other blog posts on this same subject which explains why many REs don't put a whole lot of stock in abnormal morphology unless there are gross abnormalities. 

My dd is living proof that abnormal morphology is not usually a cause of infertility.


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## Ruskiegirl

Thank you so much hun , I thought that was what was going on . Guess I will call and talk to my doc I don't want any unnessary fee's cause my insurance doesn't cover infertility treatments at all :cry:


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## calimom029

Hi!
I'm 29, DH is 31. I have no fertility problems (all exams came back great). So today we got DH's sperm analysis results and I have to say I'm devasted with the results. His sperms have low morphology and abnormal viscosit.y All the other numbers are great and way above normal range. The only problem is the morphology and viscosity. I've read that viscosity is not a big deal... He can even take mucinex to correct it. But I'm so scared about the low morphology. DH doesn't smoke and doesn't drink. He is young and healthy... So why this?? Sorry but I just need to vent... I'm so sad :-( I called my doctor's office and the first available appointment is in 2 weeks. So while I'm wait to hear our "fate" from our doctor I'd like to know if there is anyone out there with the same problem and have some info or tips to share... Is IVF our only possible route? And about IUI?? Has anyone had the same problem and ended up getting a BFP?? 

Here is a copy of the results:

Color: Opalescent (normal= opalescent)

Volume (ml) : 4.1 (normal >1.5)

Liquefaction: complete (normal < 60 minutes)

pH: 7.6 (normal >7.2)

Viscosity: Moderate (normal= none - slight)

Sperm Concentration: 54.4 (normal >15)

Total Ejaculate: 223.04 (normal >39)

%mobile sperm: 51.5 (normal >40%)

Grade of progression: 3, 2+ (normal >2)

Agglutination: Slight (normal= none-slight)

% Normal Morphology 2.5 (normal >4)


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