My husband’s analysis came back that he has low morphology (3%). All other aspects were within the normal range.
From researching it seems to be suggested that low morphology can cause issues TTC.
After months of waiting for an appointment to discuss the results the NHS fertility nurse has advised that the sample is ‘normal’ and that morphology isn’t even considered as any sort of indicator at all of fertility.
We will therefore not be referred for IVF / ICSI as other sources had suggested.
Has anyone else encountered similar or have any understanding of the importance of morphology? According to the NHS nurse it isn’t important, but researching suggests otherwise so I’m really confused and unsure how to feel! TTC for well over a year now.
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Not sure where you’re based but it was my understanding that you should be offered IVF if you’ve had no success in a year ? I can’t comment on the morphology I’m afraid as my other half had a low count as well as low morphology but we had ICSI. It might be worth trying a different clinic to get a second opinion xx
Unfortunately in different areas there are different criteria. In some areas it’s one year, others it’s two but in Surrey where we live, it’s three which is absolutely gutting. From what I’ve heard it’s all a bit of a postcode lottery 😞
Good idea to get a second opinion. I’ll definitely look into that - thank you for the suggestion.
I hope all is looking positive for you on your journey xxx
wow 3 years!! 🤯 it’s definitely a very unfair system and really frustrating! I hope you can get some more advice but in the mean time your other half could always get started on some supplements to try and help, mine used Proceive x
My husband and I had morphology issues. There’s no definitive studies linking morphology with infertility, so we couldn’t get this tested on the NHS and got it tested privately. We went private after being told we had a one year wait for IVF, then after a year we were told it was two, then after two we were told three! The private clinic told us that ICSI was the best way to go if morphology was a concern.
In theory you can improve morphology. My husband took Proxeed Plus and we made a lot of dietary changes, he stopped drinking too, we did a lot of walking as low impact exercise, and he did see an improvement in his morphology over 3-4 months. The waiting is hard but I think taking the time to do some of these things helped out ICSI round go well. xx
Hi lovely, this was exactly our issue as well. No known issues with me and husband's semen analysis was normal except for slightly low morphology (always around 2-3%). All the doctors told us that morphology was a useless parameter and not to worry about it.
Fast forward a bit - we were 2.5 years into ttc and had had one failed IVF cycle, technically with a diagnosis of unexplained infertility, and a doctor at our IVF clinic finally suggested that my husband might want to have a sperm DNA fragmentation test done. Results came back pretty high and we finally had a clue as to why things weren't working. I strongly believe that the abnormal morphology was an indicator that there was a deeper issue with the sperm and we could have saved a lot of time, money and heartache if the morphology issue hadn’t been brushed off and someone had recommended doing more advanced sperm testing sooner.
All this to say, I would highly recommend having your partner do a DNA frag test. It's a private test not covered through the NHS, but most IVF clinics do it so if you contact your local clinic you can hopefully have it done through them.
Best of luck! xxx
PS - as conceptionimpossible says, I would also make sure you husband is following all the normal advice: he should start supplements like Impryl and Proxeed, eat well, minimal drinking, no smoking, no cycling, no saunas/ hot baths, etc
Hi soccerkt6Can I ask what they did as a solution to the high DNA frag. My husband did SOS test 2 yrs ago results from that showed high oxidised stress and he's been on impryl/proxceed since then we've had 3 more failed rounds 2 with DE and now the 6 failed in total. They have no suggested he has the COMET test which tests for DNA frag. We are waiting the results but don't know what the solution will be if he is testing high?. TIA xx
Have they done a full endocrine panel on your OH? We have a different situation, but he ended up with significant endocrine/hormone issues (thyroid, testosterone, etc.) that once sorted improved quality a lot. May be worth asking about? (Advice Caveat if numbers are off you may have to go private as NHS consider anything with in a very broad range normal - although we know that the "good range" for TTC isn't as broad as "normal.")
Hmmm not sure is it a blood test.Is that the name of it endocrine panel'? Noone at clincs mentioned that.. but they've never mentioned the COMET test before either so don't hold much weight in their ability to diagnose anything tbf , 🤣 so will get in Dr Google.
Endocrine panel is where they check a bunch of different hormones (via blood) for your OH (e.g. testosterone, thyroid, etc.) . What we found is lots of focus on female's hormones, but missed issues on male side. For us once male endocrine side was fixed sperm results improved dramatically (still crap but much better). Just a thought for investigation. It's cheap and easy to do...
Hey conceivingblee, I'm so sorry to hear about your failed cycles. 💔 Once we found out out about the high frag we went to see Dr Ramsay. He tested my husband for infections (came back clear), endocrine/hormone panel (came back normal), and also checked him for varicoceles (it turned out my husband had two, but only one was large enough to require treatment).
My husband had also previously been taking supplements and overhauled his diet, which improved things slightly but it still wasn't enough to get the DNA frag into a normal range. For us, having the varicocele embolised made a huge difference. Afterward, hubby's parameters suddenly jumped into the fertile range. The treatment for the DNA frag depends on what the underlying cause is...so more than likely you'll need to do some further testing if his results come back high, and then treat based on that. I know some men have seen improvement after discovering something simple like an infection in the urinary tract and treating with antibiotics. I highly recommend looking at Dr Ramsay's website as it has loads of information. And if your husband's results come back high, I would def book a consult with him. Speaking with him and having him run the diagnostic tests was the best money we've spent in this whole journey.
Hi. Thanks so much for your reply. It's funny as I did reach out to someone who I follow insta who'd used DR Ramsay to find out a bit more. But she never responded. She's had a baby now. So maybe that was her reason for success to.
Can I ask ball park what kind of money his testing was? We are already 35k deep in this whole shit show and feel like we are no further on. I need to move clinics really aswell as mine don't do anything proactive and have never done really but they have the monopoly in my area so I'm a bit stuck. .
Thanks for your time. I hope your journey is now more successful with a diagnosis. Xx
I've just looked back at our invoices and our initial consult (just the appointment, no tests) in August 2021 was £280. We then spent another £600 or so on the hormone panel, infection screening and ultrasound to check for varicoceles. So it wasn't a cheap visit but in the grand scheme of things it wasn't that much and, for us at least, it was really worth it. We probably should have gone to see Dr R a bit earlier than we did, but I faffed around for a few months (largely due to the cost) and wish I had just done it asap.
I'm sorry you're disappointed with your clinic as well. I know the feeling - I had to push soooo hard with ours to even get them to do really basic stuff like progesterone testing on transfer day. It often felt like they were more invested in being "right" than in doing anything and everything possible to get us a baby. And to get all that pushback while we were absolutely bleeding money into the clinic just added insult to injury...
Thanks for your wishes. We're taking a break from IVF at the mo before diving back in. I really hope you get some answers from the COMET test and can move forward armed with some new information. Let me know if you have any other questions, happy to share what I've learned so far. May 2023 be the year for us! xxx
For NHS not at all, in my experience, as you said, they didn't even test for it in my husband's case. For most private clinics they recommend supplements, dna fragmentation tests and more advanced ways of selecting the sperm for icsi.
My husband has low morphology too. We were referred to IVF after two years of TCN without success. One of the first tests our clinic did included morphology and this is how we discovered it. Our consultant explained that the jury is out on the effect of low morphology on conception and that studies suggested that sperm concentration and motility were better indicators for male factor infertility. Still, because of the low morphology, we were given an ICSI protocol that gave us very high fertilisation rates of around 75%. My husband took supplements in the run up to ICSI (Vitamen) and wore baggy underwear. Every little bit helps. Good luck!
I understand 4% morphology is considered 'normal', so you're not far off. My parter had 0% and then with lifestyle changes (Impryl supplements also) it went to 1% and then 2% most recently. We've had 2 natural conceptions during this time (when IVF rounds led to there only being 1 egg, so tried naturally at home). Got told that ICSI got round low morphology, but seems debatable whether needed in any case.
What we were told is that from the 3 indicators, having bad morphology is the least bad one. The reason is because for IUI and IVF they need to "clean" the sperm. So only the best is selected for procedures and the other is discarded. As long as there is some good normal sperm, then there is no issue in a treatment. But this is in a treatment. In no way it means there is no issue or that you won't have problems TTC by yourself. For us, I have PCOS and that meant ovulation pills and trying to check timming for conception as a first procedure. But the morphology issue, made us get recommended for starting directly with IUI.
It also depends on the age group and I think this is one of the key factor for NHS to recommend IVF or not. My partner was also on low morphology, average count but sizes and shapes were not great, and other factors so with our age group (36-40) we were referred for ICSI. Bearing in mind it is one sample, we weren't on supplements before as well. Sperm's quality can be refreshed every 72 days hence it can also be improved within 3 months. I would suggest you try a repeat sperm analysis after 3 months from the previous testing date, could do it yourself rather than waiting for NHS as there are many options to do it at home.
our fertility clinic wanted to see 3%. Vitamins, exercise and not drinking for 6 weeks doubled fertilization rate for our IVF. There’s no medical treatment for it other than doing ICSI but if other numbers are good you can improve things on your own. Good luck!
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