Fertility Network UK
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Sperm morphology

Wondering if anyone knows much about this. All but one of our 6 embryos we have had have been very poor quality (stopped at day 3!) and we have one good one in the freezer.

We just received our report from our clinic from this last round and I was really surprised that hubbys sperm morphology was only 4% - that seems to be at the very bottom of normal and borderline needing ICSI. We have never been told we need this. Count and motility are fine.

Of course I’ve googled and it says sperm with poor morphology can still fertilise an egg and if a sperm with poor morphology fertilises an egg, it can lead to poor embryo quality and development.

Our embryos that have been poor have had severe fragmentation at day 3 and the one good one is great with none.

Wondering if this might be another layer to our issues?

Anyone worked on improving morphology?

18 Replies
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Hi, we didn’t work on improving my OH morphology but his was just below the 4% so they did icsi for us. His count was ok not high but above the threshold but the motility was lower too. We got really good eggs up to day 3 then by day 5 only ever had one or two good ones even though we started with like 15. Xx

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our NHS clinic up here only does icsi regardless as they feel better success rates xx

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Really? Need to talk to clinic and find out if we should opt for it. We had good fertilisation rates would just be whether it’s useful to pick the “best looking” actual sperm.

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Our private clinic suggested DNA fragmentation to us as the next step for us however since going back via the nhs, our nhs consultant said why would we do that test when it costs so much, she said she would just do icsi. I've not looked into it all yet but hopefully if we get the go ahead on the nhs we will do icsi next. My OH's morphology was 5%. xx

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Yup and that's what I so does.we did ivf and Icsi split on our last fresh cycle and the icsi ones did better and morphology not an issue for us xx

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Hi Orla I assume that means you had ivf as opposed to icsi? They are able to choose the best sperm with icsi but icsi tends to have a better success rate regardless I think because the sperm is injected. I really don't know whether its more successful because of this, or because its choosing the best sperm or what. My husbands morphology was 3%. We had icsi twice and first round we got 9 eggs but ended with only 1 x 5 day blastocyst and nothing to freeze. Second time we got 4 eggs and ended up with 2 x 5 day blastocysts. I think if ivf wasn't successful for you then icsi is definitely worth a go xx

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I’m a complete one track record but maybe also investigate whether the clinic would recommend your hubbie has karotyping to check for any chromosome disorders. It’s a slim chance but that’s the reason we had poor embryo development.

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I’m definitely going to ask about karyotyping at the miscarriage clinic I think, because they keep telling me I’m young (I was 32 and 33 for the 3 ivf rounds and 2 pregnancies we have lost) and they don’t expect my eggs to be this poor.xx

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We’ve always been told (and the WHO statistics seem to back this up) that 4% morphology is actually average, anything over that is obviously great. My OH has 4% and we produced 5 good quality blastocysts with ivf xx

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Ah ok, my understanding is that 4% is the lowest of normal and if it’s 3 or less then it’s ICSI. I’ve emailed the clinic to ask about it xx

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Hi Orla

My OH has poor morphology too and out of 7 eggs collected we only had one fertilised. (However the fact we have any sperm at all is a miracle as we were told before on numerous occasions there were none)

I’ve signed hubby up to vitamins (as have I). The consultant advised particularly selenium and zinc but I think there may be others as well. I don’t know if it’ll help but worth a try!!

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Hiya. My DH also has 4% and we’ve been told this is average. Here’s the thing. He started off with 1% and we were devastated. Feared that we would even get a free go on the NHS. Then my husband took fertility vitamins religiously and stopped drinking altogether. He excersized and cut out the junk food. Within 3 months he went up to 4% morility. Sperm is naturally regenerated so see if lifestyle changes improve the sperm quality

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What was worrying my is my husband already takes all of the vitamins that are in proxeed and has done for the last 2 years - selenium, zinc, l arginine, l carnitine, etc and eats no processed food and we eat everything organic, and if it’s only at 4% with that there is little we can do to improve. Even changed 2 years ago to cotton boxers rather than snug Calvin’s. All that’s left is curt out caffeine and alcohol, neither of which he has in excess. Maybe 4 isn’t as bad as I worried at first, so I’ll have to see what the clinic says.

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I think cutting out alcohol can have a big effect x

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Hi Orla, my husband’s morphology was always between 0-5%. The doctors kept saying to us to not to worry as the other parameters were good. During IVF we had average/poor embryos and the treatment failed. For 1,5 year we worked with fertility nutritionist, he was taking a lot of supplements but the semen tests were the same. Just when we were about the start 2nd IVF, my husband became very unwell was was diagnosed with an autoimmune illness and hyperactive thyroid. His endocrinologist confirmed that thyroid hormones play a huge role in spermatogenesis and this is primary cause of his low morphology. He is on a medication now so it would be interesting to see if sperm parameters improve in a few months. This of course might be irrelevant to your situation but I thought I would reply as I kept researching the subject for years and never came across the links between morphology and thyroid function. Good luck with everything x

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Hey! We had ICSI too - my hubby is a 3. But when we first started our journey and did the initial screening his morphology was 1. That was Dec 2016. We saw a nutritionist and he stopped drinking and took lots of supplements to get it to a 3. We had a egg collection 3 weeks but had to freeze embryos due to my progesterone levels being to high. Of our 6 fertilised eggs only 3 survived and only two to blastocst. I do think poor morphology hinders fertisation. We would never have made an embryo on our own. Without ICSI. My hubby was miserable as anything but he gave up drinking for 3 months, too loads of supplements like antioxidants and he changed his diet significantly. Mostly protein and colour (veggies) he has a teaspoon of tomatoes purée daily too. I can’t say for sure this helped but he had gone from 1% to 3% and with the help of ICSI we have two little embryos on ice.. hope this helps x

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Hello, sorry to hear of your troubles. IVF is so tough :(. I would say you should push for ICSI. Myself and OH had a sperm morphology issue and we had ICSI xx

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Clinic have suggested the sperm dna fragmentation test due to the poor quality and fragmentation of embryos. Thanks for all the helpful replies!xx

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