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SA MORPHOLOGY: POST YOUR DOCTOR's COMMENT HERE

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?
 
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?
 
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 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!
 
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!!
 
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.
 
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 :)
 
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!
 
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!!
 
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.
 
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:
 
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.
 
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
 
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.
 
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.
 
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!
 
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!!
 
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!!
 

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