Monday, April 18, 2011

Progress and some bad news

MM and I were able to check another item off our DE cycle "to do" list this weekend.  We had our joint counseling session with NC, as required by St. Mungo's.  MM felt this was an unnecessary formality because we had already discussed all the psychological issues involved with doing this type of treatment long ago, and I think NC kind-of agreed with him.  (She did, however, explain why clinics require this and why it's a good thing.)  No new ground was covered, but NC did validate my decision NOT to disclose our treatment to my father and stepmother for the reasons I discussed in this post over two years ago.  So that was good.

We also got an email from our nurse on Saturday afternoon with the results of MM's semen analysis.  (Note to those who know me in real life and are reading: MM would NOT be happy if he knew I am writing about this, so keep it to yourself.  Thanks.)  MM's last semen analysis was over two years ago, and at that time, so far as we knew, there were no problems.  In fact, I believe the local RE said he had "super" sperm.  All MM's post-wash counts for our IUIs were good, and we have been under the impression that he has no problems or issues.

Well, we learned yesterday that his morphology is low.  It was 4% this time, when it should be >14%.  (Last time it was 10%, which in retrospect I realize was low but which our local RE told us two years ago was "fine.")  On the positive side, his count and motility are normal.

I don't know that this result has any significant implications for the success of our upcoming cycle.  (It does, however, provide an alternate explanation besides "old eggs" for our failure to achieve an ongoing pregnancy in three years of TTC, though.)  From what I understand, St. Mungo's would likely have done ICSI on most of our eggs anyway; now they will just do ICSI on 100% of the eggs.  Because I know very little about this area, not having realized previously that it was a problem, I have asked St. Mungo's for more information on how, if at all, this might affect the outcome of our cycle.

MM was very upset about this result.  For a long time I think he has dealt with our infertility in part by reassuring himself that he was not the one with A Problem.  Now it turns out he DOES have a problem that was likely a contributing factor, if not the cause, of our infertility all along.  It has been a bitter pill for him to swallow, and he felt that in giving him the news, I was probably happy to find out it "wasn't just [me]."

Um, no.  I am NOT happy to find out that he has a problem that we never knew about.  Learning this has given me cause to doubt whether our DE cycle will be successful.  Before, I thought that we were correcting for the only barrier we've had to conception by replacing my old eggs with younger, better quality eggs.  To find out now, so close to our DE cycle, that there is another fertility challenge in the mix in no way makes me feel good.

[Also, had we known this two years ago, I think we might have made a different decision about whether to go ahead with an IVF cycle with my eggs.  Might have.  But as I am now over 40, that ship has sailed, and I am fully committed to doing DE instead.]

Currently I am off all medications (yea!) and waiting for my post mock cycle AF to arrive.  When it does, I will be starting BCPs and coordinating my cycle with our donor's.  So we are getting closer all the time.

The only remaining hurdle for us is my sonohysterogram on May 6.  I have never before had any type of uterine abnormality, so fingers crossed that this is still the case and we can proceed with our cycle as planned.

14 comments:

  1. Oh boy, I bet those SA results did not go over well. My husband has probably had 20 SA at this point and I can tell you, they vary from test to test. Plus, with a KSM, it all depends on the andrologist who is reading it.

    Your clinic will ICSI all of your Donor eggs. I asked the RE recently about sperm quality vs egg quality. He said you can overcome an ok sperm over a an ok egg. The embryologist will cherry pick the best sperm.

    It is upsetting when their morphology comes back low. But, I wouldn't worry too much about it affecting this cycle. Most men decline in their morphology as they age :(

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  2. That morph doesn't sound that bad to me. Where are they getting the 14% number for what they consider normal? My DH's morph was 5% and they considered that normal - they said anything 5 or above is normal. Are they going to repeat the SA?

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  3. Jay, I hope you are right that this won't affect the cycle much.

    Francie, >14% is part of strict Kruger morphology. It's interesting that your clinic considers anything >5% normal; seems that our local RE thinks the same, since he told us 10% was "fine" two years ago.

    They don't plan to repeat the semen analysis; no need to, since they will just use ICSI on 100% of the eggs retrieved.

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  4. Honestly, I wouldn't worry about morphology and IVF. Reason being, since they are going to ICSI on 100% of the eggs, morphology shouldn't be a big issue. I just did a quick search on this (I am a curious person,) and found out that ICSI mostly solves this problem because morphology is a penetrating issue, and ICSI penetrates the eggs....so try not to worry too much with your upcoming DE cycle!

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  5. Krista, thanks. I also consulted "Dr Google" yesterday, and it seems that low morphology CAN result in a slightly lower fertilization rate, even with ICSI. But my hope is that we will have enough eggs that it won't be a big deal. Our donor has produced between 17 and 29 eggs in all her previous cycles.

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  6. wow, your donor produces a ton of eggs! (wouldn't we all love to be her)

    I agree with the others, you will doing ICSI so the morph won't really matter much. GL getting started!

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  7. My DH's morphology is 3% and was probably a big factor in why we couldn't conceive. We did IVF with ICSI when I was 39 (own eggs) and had a healthy baby. The ICSI will totally take care of the morphology problem; morphology just makes natural conception difficult because the sperm is not the right shape and thus can't penetrate the egg. Nothing to worry about!

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  8. It's an interesting twist when you're suddenly given a second (or in my case THIRD) opinion that there are male AND female factors afterall.

    Sorry to hear that is the case for you two as well... But at ICSI is the best medicine, and all should be just fine.

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  9. Hey S...I can't say I have any experience but I often think of the males when they are told their sperm is not "gold" but rather silver or bronze. Males I think have a strong connection with their sperm and in their minds I think strong sperm signifies a strong man ya know? Which is total crap by the way...but just such news I think is a huge blow to their ego. Hoping MM is able to get over it as I don't think there will be any problems with your DE cycle. ICSI is a wonderful thing.

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  10. ICSI and a good embryologist is all you need!

    yes, the male ego - oh so fragile. funny that it is okay for it to be "your" problem but not nearly as fun for it to be "our" problem.

    dh's SAs were ok. but we knew that ICSI would overcome any issues with sperm - too bad my eggs were just too old (at 39).

    your DE cycle will be fantastic and you are moving towards it so quickly!!

    xoxo

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  11. I wrote a post a lot like this back in the late fall/early winter when we found out we had the same problem. It was (and is) so hard for my husband to accept that the problem wasn't just with me. It's a lot easier for him (and, I guess, for your husband) to support someone than to actually be part of the issue.

    But that being said, you're doing ICSI anyway, and to my understanding once you're doing that, morphology like your husband's doesn't matter. It shouldn't really affect your cycle, so although this was hard for him to hear, it really shouldn't derail things at this point.

    Good luck!

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  12. Sorry about the morphology, but liked everyone else has said, icis will make up for the morph issues. I hope MM is able to digest this quickly.

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  13. Good luck with this cycle! I am glad you're almost there! My hubby also had issues in that department but we did IVF with ICSI and now I have a 4 year old and 19 month old twins via 6 cycles total. I just found you, added your link and I'm your newest follower. Happy ICLW! (early)

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  14. Our local REs both said that my hubby's sperm were great all around. When we went to CCRM, his morphology was only 3% and Dr. Schoolcraft didn't bat an eye at it since we were doing ICSI anyway. Not that this gave me any warm fuzzies, but he mentioned that many labs do not perform the SA correctly when it comes to the Krueger scale and whenever he sees results above 6-8% he believes there is a lab error. I really do think this shouldn't hinder you at all. I do know all about that fragile male ego though!

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