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Hi Peter
first can I say what a wonderful thing your doing coming on here to answer our questions!! It's brill!!!

Now for my question- we have had 6 ICSI transfers all with good quality embies each time and transferring 3 embies on 5 cycles and one cycle transferring 2.
They are always grade 1 or 2 but they just don't seem to implant. We did have a bio-chemical/blighted ovum on one cycle but that is the closest we've got to a +++.
I was wondering if it is the male or female that makes the embies continue after fertilsation.
One of our old consultants has said that he thinks it's the male factor problem that is just not allowing the embies to progress and implant but I can't undersatand this as they are good quality at transfer.
We have had some that are 4 and some 6/7 cells and had day 2 transfers.
We are now in the process of moving back to our old NHS clinic for DIUI.
Thanks
Allison
PS I have done egg share twice and even though they can't tell us if it has been sucessful they have said there is no problem doing it again if I wnated so I assume that I don't have an egg quality issue (donated 16 eggs first time and 13 second time).
 

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Dear Alison,

Your consultant is correct in that part of the male chromosomes carry most of the information which makes the placenta and the membranes for a pregnancy. This is not to say that your failure is due to the male component, simply that the male component does paly a role in implantation of the embryos. At transfer it is impossible to tell whether or not there is a potential problem in this area as the placenta and membranes have yet to form.

Overall your history sounds good and if you have been an egg share donor there is almost certainly nothing wrong with your eggs.

Hope this helps!

Peter

Allisonr said:
Hi Peter
first can I say what a wonderful thing your doing coming on here to answer our questions!! It's brill!!!

Now for my question- we have had 6 ICSI transfers all with good quality embies each time and transferring 3 embies on 5 cycles and one cycle transferring 2.
They are always grade 1 or 2 but they just don't seem to implant. We did have a bio-chemical/blighted ovum on one cycle but that is the closest we've got to a +++.
I was wondering if it is the male or female that makes the embies continue after fertilsation.
One of our old consultants has said that he thinks it's the male factor problem that is just not allowing the embies to progress and implant but I can't undersatand this as they are good quality at transfer.
We have had some that are 4 and some 6/7 cells and had day 2 transfers.
We are now in the process of moving back to our old NHS clinic for DIUI.
Thanks
Allison
PS I have done egg share twice and even though they can't tell us if it has been sucessful they have said there is no problem doing it again if I wnated so I assume that I don't have an egg quality issue (donated 16 eggs first time and 13 second time).
 

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Hi Peter

Maybe you can answer a question for me please. On day of egg collection my partner's sperm was found to be "not swimming" - forgive my ignorance, but does that imply a temporary inability to swim or a permanent inability to swim. As I say, I'm a relative novice to this.
 

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Hi Caroline,

Welcome to the site :)

Peter is away in Dubai for the next week, but as soon as he is back I am sure he will answer your question :)

If you have anymore questions please post them! lets keep him busy when he gets back.

Kind Regards,
Tony.
 

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Dear Caroline,

This is difficult for me to comment on without seeing your notes. In an average sperm sample about 60% of the sperm are motile (swimming) and the rest are not moving. From what you say it sounds as though your partners sample did not contain any motile (swimming) sperm. I cannot comment on the significance of this without much more detailed information.

Sorry to be so vague!

Peter

caroline said:
Hi Peter

Maybe you can answer a question for me please. On day of egg collection my partner's sperm was found to be "not swimming" - forgive my ignorance, but does that imply a temporary inability to swim or a permanent inability to swim. As I say, I'm a relative novice to this.
 

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Peter,

Its great to have you on the site, many thanks for the time you are putting in to helping us with our questions.

I've been wanting to post for a while, but am somewhat of a coward - petrified I'm going to hear something I don't want to.

I can't put it off any longer - I have a follow up appointment with my Consultant on Friday, following my 4th failed cycle at the beginning of August.

My dh has Cystic Fibrosis and had sperm retreived surgically during June 2001, direct from the testes. We had 7 vials collected.

During my first two cycles, I had 8/9 eggs collected and had 4 good embryo's from each of these cycles. On my third cycle I only had 5 eggs to ICSI and ended up with 1 very good embryo and 1 slow developer!

On my 4th cycle (sorry this is long winded) I had 13 eggs collected, of which 9 were good for ICSI and no embryo's - I was devastated! I did however go on to have an FET with one of the embyro's that was frozen from my 2nd cycle.

When I spoke to the embryologist on the phone and asked her if there were any reasons why we'd had no embryo's from this latest cycle, yet I'd had them on my earlier cycles - she said, that it's probably down to sperm quality, it's hard to determine what will be good sperm until they thaw and then it's hard to select normal sperm from there.

She said that my best cycle had been my 2nd one, when they'd used 2 vials, whereas in the others, they'd only used 1 vial. She did suggest that no matter what, during my next cycle, we use both of our last vials, to give us the best chance.

I was quite happy with this explanation. But when I phoned my nurse up two weeks later to say that my FET had failed - she made some comment that other cycles had probably proved better due to the fact they'd have used the best sperm first.

This has left me thinking that they'd graded the sperm before freezing it and if thats the case, if the vial they used during my last cycle had no good sperm in, then the last two I have, most definately wont contain anything good.

I'm pretty sure that they couldn't have done this but would be grateful if you could confirm to me one way or the other, whether they could have.

I would also be very grateful for any pointers you may be able to give me with regards to any questions you may think it would be useful for me to raise with my Consultant on Friday - I have a horrible feeling i'm going to clam up and not think of what to ask or say.

I'm sorry that I've gone on and hope you can make some sense of this - I'm just getting really nervous, I'm not ready to throw in the towel yet and my dh is also prepared to undergo another SSR if he has to.

many thanks,

Sue.
 

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Dear Sue,

Your embryologist has given a very good explanation of the problem. Unfortunately the nurses do not really understand the complexities of the lab side and often make comments (such as the one you recieved) which worry patients. There is no way of predicting how a sperm sample will thaw.

You sound to be in very good hands, try to relax and good luck with the next cycle.

Regards,

Peter

Sue MJ said:
Peter,

Its great to have you on the site, many thanks for the time you are putting in to helping us with our questions.

I've been wanting to post for a while, but am somewhat of a coward - petrified I'm going to hear something I don't want to.

I can't put it off any longer - I have a follow up appointment with my Consultant on Friday, following my 4th failed cycle at the beginning of August.

My dh has Cystic Fibrosis and had sperm retreived surgically during June 2001, direct from the testes. We had 7 vials collected.

During my first two cycles, I had 8/9 eggs collected and had 4 good embryo's from each of these cycles. On my third cycle I only had 5 eggs to ICSI and ended up with 1 very good embryo and 1 slow developer!

On my 4th cycle (sorry this is long winded) I had 13 eggs collected, of which 9 were good for ICSI and no embryo's - I was devastated! I did however go on to have an FET with one of the embyro's that was frozen from my 2nd cycle.

When I spoke to the embryologist on the phone and asked her if there were any reasons why we'd had no embryo's from this latest cycle, yet I'd had them on my earlier cycles - she said, that it's probably down to sperm quality, it's hard to determine what will be good sperm until they thaw and then it's hard to select normal sperm from there.

She said that my best cycle had been my 2nd one, when they'd used 2 vials, whereas in the others, they'd only used 1 vial. She did suggest that no matter what, during my next cycle, we use both of our last vials, to give us the best chance.

I was quite happy with this explanation. But when I phoned my nurse up two weeks later to say that my FET had failed - she made some comment that other cycles had probably proved better due to the fact they'd have used the best sperm first.

This has left me thinking that they'd graded the sperm before freezing it and if thats the case, if the vial they used during my last cycle had no good sperm in, then the last two I have, most definately wont contain anything good.

I'm pretty sure that they couldn't have done this but would be grateful if you could confirm to me one way or the other, whether they could have.

I would also be very grateful for any pointers you may be able to give me with regards to any questions you may think it would be useful for me to raise with my Consultant on Friday - I have a horrible feeling i'm going to clam up and not think of what to ask or say.

I'm sorry that I've gone on and hope you can make some sense of this - I'm just getting really nervous, I'm not ready to throw in the towel yet and my dh is also prepared to undergo another SSR if he has to.

many thanks,

Sue.
 

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Peter,

Thank you so much for getting back to me! We seem to be keeping you busy here!

So am I right in thinking that you do not think it's a total waste to thaw my final two vials of sperm, that it is possible that they will contain some good sperm and I could in fact end up with a cycle like my first two.

I do know there are no guarantees, but I just need to know that there is a chance and that the vials of sperm are not stored in accordance with quality.

Many thanks again Peter,

Sue.
 

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dear Sue,

Yes, there is every chance that the remaining vials will contain good sperm.

Good luck!

Peter

Sue MJ said:
Peter,

Thank you so much for getting back to me! We seem to be keeping you busy here!

So am I right in thinking that you do not think it's a total waste to thaw my final two vials of sperm, that it is possible that they will contain some good sperm and I could in fact end up with a cycle like my first two.

I do know there are no guarantees, but I just need to know that there is a chance and that the vials of sperm are not stored in accordance with quality.

Many thanks again Peter,

Sue.
 

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Peter,

Thankyou, thankyou, thankyou, thankyou.......... I now have hope!

Sue.
 

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Hi

I wonder if you could help me please? we had a routine sperm test done at the local district hospital and although the MAR(?) was fine the report mentioned that there may be a problem with antibodies. We then had a wash and swim test done at an assisted conception unit and the results (mobility etc) were excellent, with no sign of antibodies. I'm concerned that antibodies can come and go and that the second test may have missed them? I've just had a spontaneous miscarriage at 5 and a half weeks recently and I wondered if there are any tests that can be done on the sperm to test chromosone abnormalities please?

Many thanks
Tina
 

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Dear Tina,

The MAR test detects antibodies in the sperm sample. It is very reliable but each sample can vary in the amount of antibodies present and so each sample may have a different MAR result. It is possible that there may have been some agglutination (sticking together) of the sperm which is also sometimes is an indication of antibodies being present. On balance I would trust the IVF unit much more than the general hospital in this context as the IVF unit has much more experience is sperm analysis.

You and your partner can easily have chromosomal analysis by a simple blood test. Ask you clinic if you would like this.

Hope this helps

Peter

tinat said:
Hi

I wonder if you could help me please? we had a routine sperm test done at the local district hospital and although the MAR(?) was fine the report mentioned that there may be a problem with antibodies. We then had a wash and swim test done at an assisted conception unit and the results (mobility etc) were excellent, with no sign of antibodies. I'm concerned that antibodies can come and go and that the second test may have missed them? I've just had a spontaneous miscarriage at 5 and a half weeks recently and I wondered if there are any tests that can be done on the sperm to test chromosone abnormalities please?

Many thanks
Tina
 

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Hi Peter

My partner had a vasectomy 7yrs ago and we have recently had ivf/ics/pesa,they retrieved a lot of sperm but most of it was immotile,they managed to catch 2 sperms, 1 was good and the other one was soso,i have endometreosis and only one ovary, i managed 5 eggs, 1 was no good 2 had endo and the other 2 were good and healthy,however they did not fertilise,the consultant and embryologist have said they are 99.9% that it is down to the sperm.
They have advised us to have another try and they would give my partner medication to hopefully prevent the antibodies from killing off the sperm,it cost us £3.350 ,and we cannot really afford to go again if it fails.
Are there any tests to see if my partners sperm is any good.

Thanks
Jackief
 

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Peter,

I hope you will be able to advise me on an andrology question.

After trying to conceive for some time, we were told that our only chance of having a child would be to undergo ICSI. This was because my DH's ^sperm^ count was so low - various sperm analysis tests showed that his sperm count remained below 5 million and as low as 500,000.

We underwent IVF/ICSI and fortunately I became pregnant on the first attempt and I am now 22 weeks pregnant. Of course, we are very happy with the outcome and were happy with the treatment we received at our clinic.

However, with retrospect I have niggling queries about the investigations carried out on DH. As with anything, you always wonder why this has happened. I was suprised that my DH was given no other tests e.g. hormone levels - he was only advised to have a sperm analysis and had a basic physical examination. Would hormone level checks or any other tests normally be recommended? Can hormone imbalances cause such a low count and be successfully treated?

Obviously, I wouldn't change the treatment we have had as we have been very, very fortunate. But the time may come when we think about going down this route again and I just wondered whether there were any options we should/could consider or whether ICSI is the only realistic option. I think we would both also like to find out why we have had these problems (although I appreciate that all too often there are no answers).

Thanks for your time, Peter, and I'm sorry if I have rambled on a bit!

Allie
 

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Dear Jackie,

There are no specific tests available I'm afraid but it should be noted that pesa samples can vary enormously. Lets hope that the next one is a good one!

Regards,

Peter

jackief said:
Hi Peter

My partner had a vasectomy 7yrs ago and we have recently had ivf/ics/pesa,they retrieved a lot of sperm but most of it was immotile,they managed to catch 2 sperms, 1 was good and the other one was soso,i have endometreosis and only one ovary, i managed 5 eggs, 1 was no good 2 had endo and the other 2 were good and healthy,however they did not fertilise,the consultant and embryologist have said they are 99.9% that it is down to the sperm.
They have advised us to have another try and they would give my partner medication to hopefully prevent the antibodies from killing off the sperm,it cost us £3.350 ,and we cannot really afford to go again if it fails.
Are there any tests to see if my partners sperm is any good.

Thanks
Jackief
 

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Dear Allie,

Congratulations! Please read my message on umbilical cord stem cell storage, you may find it interesting.

Decisions in IVF or ICSI are usually made on the basis of sperm count, motility and morphology (normal forms). There is no great value on any hormonal analysis. On this basis it sounds as though ICSI was the correct choice for you although in my opinion (and not relating to your particular case) I think that there is often a leap to ICSI where IVF would be just as good. If you do try again I would ask the clinic some detailed questions on exactkly why you need ICSI.

Hope this helps,

Peter

Allie K said:
Peter,

I hope you will be able to advise me on an andrology question.

After trying to conceive for some time, we were told that our only chance of having a child would be to undergo ICSI. This was because my DH's ^sperm^ count was so low - various sperm analysis tests showed that his sperm count remained below 5 million and as low as 500,000.

We underwent IVF/ICSI and fortunately I became pregnant on the first attempt and I am now 22 weeks pregnant. Of course, we are very happy with the outcome and were happy with the treatment we received at our clinic.

However, with retrospect I have niggling queries about the investigations carried out on DH. As with anything, you always wonder why this has happened. I was suprised that my DH was given no other tests e.g. hormone levels - he was only advised to have a sperm analysis and had a basic physical examination. Would hormone level checks or any other tests normally be recommended? Can hormone imbalances cause such a low count and be successfully treated?

Obviously, I wouldn't change the treatment we have had as we have been very, very fortunate. But the time may come when we think about going down this route again and I just wondered whether there were any options we should/could consider or whether ICSI is the only realistic option. I think we would both also like to find out why we have had these problems (although I appreciate that all too often there are no answers).

Thanks for your time, Peter, and I'm sorry if I have rambled on a bit!

Allie
 

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Peter,

Thanks very much for getting back to me.

I really appreciate it and I will keep your comments regarding IVF vs ICSI in mind if we do ever decide to go through the process again.

Thanks again.

Allie
 

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Hi Jackie

Obviously you should also ask the advice of your clinic but my dh had a vasectomy reversal which worked surgically (i.e. the tubes got re-attached successfully), but he has a very high level of antibodies so no live sperm in his ejaculate. Presumambly if you know you dh already has high antibody levels then even if he had a reversal these would still be present?

We've done one cycle of icsi with pesa and they managed to retrieve enough sperm to fertilise 15 eggs so lets hope your next attempt is better.

I've heard the only drugs available to try to reduce antibody levels are steroids which can have quite serious side effects, did your clinic tell you that?

I'd be interested to know if there is any safer alternative, as we might be able to conceive naturally if we could reduce the antibody levels!!

Good luck Jackie, let me know how you get on,

Vicky


 
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