OK, most of the ladies have seen my boring spiels about this before, so anyone who has feel free to ignore. Kell, the way I see it (now) is that most of us have something that's not quite 100% with our bodies. Some of us are diabetic, have irritable bowel syndrome or eczema or any number of other oddities about our bodies. In my case, and your DH's case, we have dodgy sperm. It doesn't make him less of a man, it just means that those particular cells aren't spot on - not that they're incapable of doing their job. It doesn't mean your DH is less of a bloke, or "firing blanks" or any of that other nonsense.
I'd be interested to know what his sperm problems are specifically, but in my case I have a good count (over 250 million) but 98% or so are malformed (morphology). On my first SA I also had low motility and a couple of other issues, but for some reason the 2nd and 3rd tests came back better each time - the 3rd showing the same morphology issues but everything else was normal. Bear in mind, they say anything better than 7-8% (approx) normal morphology is considered the lower end of OK for blokes, which is quite amazing. Even normally fertile men might only have 20% normal shaped sperm.
In the case of a low count (which is more common these days than it once was), it's all about quality over quantity and lots of blokes with low counts can still father kids naturally, it might just take a bit longer. Back in the dark ages (pre 1980's!) people just had to keep plugging away until they got there, and many did. I could probably do the job naturally so they tell me, but who wants to wait 5 years on principle?
For the best course of action to be ICSI, it just means that a fairly significant number have one or more defects, but more than likely there are perfectly normal ones in there too, as there were with me. So with ICSI, the fertility scientist simply hunts through the sample, finds a number of normal ones and injects them into the egg (one sperm per egg). With straight IVF, they can find enough normal ones to throw them all together and leave them to party. ICSI can also overcome issues with limited or no motility (tail defects), or sperm which cannot move effectively due to other defects, because they are placed exactly where they need to be. They say that these days with ICSI, as long as you have some sperm (and by that I mean only one or more single sperm), then you have a chance at pregnancy, genetic and other factors notwithstanding.
I can't speak for your DH, but I know I was pretty ****ed off to start with. I am healthy, very active, healthy weight, eat well and so on, and yet you see enormous chubbers at the shops sporting 6 kids. It's stupid, but that's life sometimes. With infertile couples, research suggests 40% owes to the woman, 40% to the man (or a combination of both), and 20% unexplained. They also say approximately 1 in 6 couples experience infertility in varying degrees. But with infertility no-one tends to advertise it, so that couple in their 30's who say they aren't having kids until they've travelled some more, may have actually been trying for some time. You just don't know. No-one I know (apart from those I've told) would look at me and think "yeah, he's a dead ringer for dodgy sperm".
Please ask any questions you or DH want to ask, and let me know if there's anything I haven't covered.
ETA: ICSI success rates are the same as straight IVF. So there's no less chance, theoretically, for ICSI than with IVF.
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