[vw22]

Hi there,

Will be as quick as I can to get to the point!


As you can see from my history its been a long and difficult time!!!  I have gone from trying with my own eggs to donor eggs. After 3 tries with donor eggs (not including frozen transfers) I had no implantation at all. A natural pregnancy came and went followed by another miscarriage with blighted ovums last month.

The only consistent thing right from the old days of IUI up until now, has been my uterus and DH sperm.

They can't find anything wrong with me. Even so I did full rounds using immune drugs just to try something different.

We always knew he didn't have 'super sperm' but is it the sperm after all

I have just got the results of the last sample and it looks so bad to me. But I have to admit not really knowing what it all means and apart from comparing it to the WHO guidelines, am wondering if this has been the problem all along?

OVERALL HEADING; Olgoastenoteratozoospermia

Under the heading 'Fresh';
Volume 3ml
concentration 18nl/ml
A 0%
B 20%
C 10%
D 70%
A+B 20%
A+B+C 30%
Total prog. 10.8%

Then there is a different set of figures alongside under the heading 'trained" (these are spanish results so that is a literal translation).
Have they done something here to make the sample better

Volume 0,4ml
concentration 3nl/ml
A 0%
B 98%
C 1%
D 1%
A+B 98%
A+B+C 99%
Total prog. 1.18%

Fresh Morphology
Total prog. 0.32ml
Normal 3%
Abnormals 97%
(some other figures in spanish)

If this is all as bad as I think it is, why were we even allowed to continue with such rubbish sperm. Even using ICSI all the time, surely starting with bad stuff doesn't mean you can turn it into anything better.

I am now considering donor sperm as well as donor eggs, but desperately want to know if the above proves that we are doing the right thing...

In a strange way at this stage I would like to know that it is the sperm to 'blame' to give me hope that donor sperm would work.

Any comments from anyone that understands SA would be gratefully recieved.

vx

 

[Claudine]

just lost a post

I know it may seem like you have rubbish sperm, but poorer samples out there have achieved a pregnancy, so your clinic is not entirely at fault for allowing you to continue.  ICSI was invented to bypass severe male infertility; out of the 18 million you have at your disposal, despite the high percentages of "bad" sperm, there will be some "good" sperm capable of delivering the DNA package they are designed to do.

Unfortunately, there are no tests that can be carried out at an individual sperm level to see if it is genetically healthy, not without killing that single sperm.  It still comes down to the embryologists selection of what looks to be a nicely shaped swimmer!

What is not clear is whether the clinic has done the requisite testing that would enable them and you to rule out genetic causes for your DH's sub/infertility.  Has karyotyping been done?  That would reveal any chromosomal abnormalities.  What about antibodies?  Didn't you mention a hernia op?  That can affect fertility.  I'm not sure if it was you or another lady on the thread that talked about varicoceles, as that too can have an impact on sperm quality.

Without these tests, then yes, I would query whether your clinic has done the right thing because at least you could make an (somewhat more) informed decision as to the chances of success.

I'm sorry that doesn't help you much other than to say, yes, it's OATS, so yes, your DH is subfertile, but not in a clearcut ICSI would never work for you way.

 

[Claudine]

I'm not sure I understand the "trained" bit either, though I know in IUI the sample is "washed", making it "better"? Hopefully someone else will come along and shed some light on the actual figures. Did you get a chance to read Andrology Solutions PDF on SAs?

http://www.andrologysolutions.co.uk/?page_id=7

http://www.tdlpathology.com/index.php?option=com_content&task=view&id=286&Itemid=291

 

[vw22]

Thanks Claudine,


I did read those links but before I got these results today, so I will definately go back to them. Thanks for the reminder.


Yes he did have a hernia op about 7 years ago and has had an op for a hydroseal about 3 years ago but the clinics (all 3) have always said that wasn't relevant with icsi... And a karotype test that came back as 'normal'.


I am presuming the 'trained' results are based on something they did in the lab to make the sperm better to work with.


I know it sounds like it but I wasn't trying to blame the clinic and I do trust that they wouldn't have used it if they really didn't think there was a chance but when I first read those results I was quite surprised and just wanted to understand it a bit more. After 3 tries with donor eggs they suggested donor sperm but said only to try something different. I would have thought if the sperm was really that bad they would have just said it there and then?! Then my next natural pregnancy confused everyone so they let us try again with his sperm...


Sadly I am really hoping it is the sperm so we have some hope for another go for the first time with donor sperm...
vx

 

[Claudine]

What about antisperm antibodies?  Seem to remember something along lines of hernia ops damaging transport tubes, effectively blockages similar to vasectomy.  I think vasectomy reversals, failed or otherwise sometimes have high levels of antisperm antibodies.  Somebody will know better than me about this.

 

[vw22]

Thanks Claudine...looked it up and you right there can be damage. Thanks again for your comments. If I was someone else reading this with an objective perspective I think I would clearly see that the sperm is a problem!!! Whether its the only problem I don't know but its still giving me hope for donor sperm... vx

 

[Claudine]

I'm sure it would come as a relief to you to find a "problem", at least then you would know for sure.  The MAR test would reveal antisperm antibodies, and although this is not insurmountable, it does make things more difficult I understand.  As mentioned before, going to see a uroandrologist might at least put your mind at rest that you have done everything possible investigation wise.

Were the cycles with OE after the hernia op?  What clinic were you at for these cycles?  Sounds like you had quite a response to stims, what age were you when you cycled?  But then of course not much point speculating on OE cycles when DE have not worked either.

And you've had a hysteroscopy too right?

You are certainly a tough case; academically, incredibly challenging.    Personally, I can only imagine how heartbreaking it must be for you and  your DH to have gone through so much and yet still be wondering where next.

 

[vw22]

A tough case academically!!! I like that, makes me feel 'special' at least! Yes we have certainly confused every specialist so far...
All treatments IUI/IVF/DE have been after the hernia op. And all cycles have been through nz, lister and now spain, so I think I have covered all the various levels of skills. Started treatments at 40 but now 44 so... Hysteroscopies and every other poke about all fine. C test negative etc etc.


When DS was first raised I did joke and say lets try an IUI then just for the hell of it...but was met with shocked faces from the clinic and husband!


Well my mind is made up. DS it is. If we were younger and had more time...cash....energy I think I would take all the points on board you have raised and put DH through all the tests and travel the world to meet the experts and get the best sperm that we can from him. But I think he is as exhausted as me and we need to move on. I guess we will never know for sure what is wrong. But now we need to try something with more certainty.


The way forward for me is donor sperm. If it doesn't work we will know its me and be able to move on to surrogacy or adoption and know we have tried everything.


Thank you for your time Claudine. Watch me on the IVI thread or I will let you know the outcome of the next couple of months. Thanks again.
vx 

 

[Claudine]

I am wishing you all the luck in the world with your next step, I'll keep an eye out for you . And I don't think DIUI sounds crazy at all.

I was wondering who else I had come across with ASAs, apart from Jake, and a long difficult history, and I remembered Mands. She was on this thread http://www.fertilityfriends.co.uk/forum/index.php?topic=49995.msg793968#msg793968
they moved onto adoption.