Low morphology IUI OR ICSI?

Hi

i am new to this thread and also to the fertility issues! We found out 2 months ago that my DH had abmormal sperms with only 12% normal in the 1st SA and 5% normal in the 2nd SA. The fertility specialist said ICSI was THE option for us and we agreed to what she said. In the meanwhile our parents ( hyper by this stage ) took a second opinion and said ICSI is too invasive and to definitely try IUI before jumping into ICSI....

now we are sooo damn confused. we were all set mentally emtionally for ICSI and with this new info everything seems to have come to a standstill.....

we might be soon starting off an IUI cycle ...looks like...



any hopeful responses?

I think you need further information before making a decision. For instance, Sydney IVF consider between 2-5% normal morphology to be normal, whereas some clinics using a different grading system consider anything over 15% to be normal.

If his motility, volume and count is all good, then I can't see why ICSI would be required as that is generally a technique used for men with poor motility and/or count, and a single sperm is injected directly into the egg.

Speak to your fertility specialist further so that you can better understand his/her recommendation, or if you can't do so with them perhaps start anew with another specialist. Good luck.

thanks for your reply slyder

Dh's motility is on the borderline and everything else is good. our FS dosent seem to be giving us good info about everything. when we said we had a second opinion and tht IUI was recomended she immediately said yes thts alright if you want to do it,and she started off all the paperwork for that .
that made us wonder....why did she not suggest IUI in the first place if she had no problems with it???

This is just my opinion by know means am I am expert on this. To me normal forms of 5% is very low and pregnancy rates naturally would be unlikely (although not impossible) you are also looking at a higher chance of m/c as 95% are not normal and if one of these abnormal sperm does fertilize the egg then you can almost guarantee m/c (one of mine and my DH problems)
A normal form of 12% I would also say is low but you would have a higher chance of achieving a successful pregnancy (meaning live healthy baby) I guess one of the problems is how do you know without testing from month to month how good your DH sperm will be as it changes so easily from each sample, every few months when new swimmers are made. Also normal forms alone can not tell you alot as you need to know the count as well as how many are swimming in the right direction. You can have normal forms which are not motile so not moving at all and obviously this is not going to help you achieve a pregnancy. Also what I have only just discovered was a normal form of 20% you might have a forward progression of 50% so not all of thos 20% have a chance of reaching the egg as 50% of those are not moving IYKWIM!

Before making any decisions get lots of opinions if you can. I think the chances of IUI been successful is about 10-15% per cycle where as for an ICSI cycle depending on age of course and egg/sperm quaility can be as high as 25-40% per cycle so some FS do tend to recommend IVF/ICSI over IUI. It really depends on who you see.

We are starting IVF soon not sure of just plan IVF or ICSI and we wont know until the day. IUI has never been mentioned although I do only have one functioning tube which is why I gather its probably not an option for us. Ultimately its yours and your DH decision as to if you want to go for IUI which does have a lower success rate but is much more affordable and much less invasive then IVF/ICSI. IUI would be well worth it over ICSI if you are sucessful but unfortunately you can not guarantee when success will occur. Wishing you all the best and hope you achieve your BFP very soon.

Has your DH done anything to try and improve his sperm like menvite, ceasing coffee etc? Maybe some sperm diets will help his normal forms increase dramatically just a thought. Also with IUI they wash the sperm (not sure how they do this) so they are getting a much higher normal form sample when they do the IUI procedure so perhaps IUI is the way to go to start with seeing as they will wash the swimmers and place in as good as sample as possible certainly a much better sample then you would get at home.

Again best of luck.

Thought I would add an ex friend of mine DH has all his SA normal form between 2-5% normal forms. With drastic lifestyle changes and menevite, zinc and some other stuff I don't know he took his wife had IUI and fell pregnant first attempt. The sample they used for the IUI was around 11-12% (I'll have to go find her old email I am sure I kept it) they have a healthy boy now and after ttc again for 18months are likely to head in that dirction again. She pushed for IUI over IVF which was recommended and it most definately paid off.

hi mildez

thankyou for your post and thanks for you wishes!

we tried to take more opinions but soon realised the more opinions we took the more confusing it becomes. every specialist has a different opinion. one specialist said...SA shows bacterial infection,so dh needs antibiotics and with that the problem will be solved. so then we stopped taking more opinions and decided to do IUI as it is less invasive. we know the chances are low. but we atleast want to give it a go. i am seeing the nurse tomorrow for instruction on how to take the injections.....now thts scary !!!
i have got dh on menevit....although it is giving him constipation...he;s not complaining of it...!!!and he's cut down on alcohol ,dosent smoke so thts sorted.
we'll see what's in stroe for us !!! your friends story really gave me more hope..

thanks again....