Low Morphology

[abc123woman]

Hello Dr. Roseff,
The plan for my husband and I with our RE was to try injectibles and an IUI. My husband recently had another sperm analysis done and we found his morphology count has decreased again. It has now ranged from 4 to 7 (strict K scale) with four being the most recent score. His count is also low, ranging from 5 million to 14 million; motility is good at 59%. Our RE has scheduled consultation for us in mid April before we move ahead with any meds, etc, for me. I am going to be 41 in June and all tests have shown I have good levels, lining, etc especially considering my age. My hsg showed my tubes to be open in January '10. I ovulate regularly. Though I am overweight, I continue to loose weight for a healthier baby, delivery, and me and am exercising regularly. We conceived our son who just turned two within one and 1/2 cycles, naturally on our own somehow without even trying, so there is still hope we may conceive. We have been trying for baby #2 for over eighteen months now.

I'm anticipating that our RE is going to recommend IVF with ICSI, but I may be jumping the gun, admittedly. My husband has some moral concerns about the ICSI part of IVF. So, I am worried this avenue may be our best shot, but we may not be able to attempt it.

Do you think we have much of a chance of conceiving with injectibles and an IUI? Can men improve their morphology? If so, how? My husband saw a urologist who was highly recommended for infertility, but he did not believe there was anyway to improve the morphology; I figure it doesn't hurt to ask and we value your thoughts on this.

Also, in a situation such as ours, do you think "natural" IVF would be a possible good way to go?

Thank you for your input, Dr. Roseff. You have answered so many questions for me and other women and your thoughts are greatly respected and appreciated.

In warm sincerely,
Amy

[Scott Roseff MD]

Hi Amy,

While it's illegal for me to tell you what you should do, I can give you broad generalizations based on some of the information you gave me.

Most of my 41'ish year old patients do best with IVF rather than injectables/IUI (assuming good ovarian reserve). It's usually our highest odds of success in the shortest period of time. This is especially true when there's a fairly significant sperm factor.

I published a paper in the Journal of Reproductive Medicine demonstrating a significant improvement in sperm morphology in men taking Pycnogenol. Even if IVF/ICSI is done, it may be helpful to have the Pycnogenol on board so the sperm can be at its best when used.

Natural cycle IVF has overall very low success rates, and doing this in a 41 year old would not be my preference.

Hope this helps,
Dr. Roseff in FL

[abc123woman]

Thank you, Dr. Roseff, for the generalized information; I understand why you are unable to comment directly on my particular situation.

The journal link listed for your article came back "page not found". I will try to locate it elsewhere online for my husband and I to read it--and place an order for pycnogenol tonight.

Thank you again! Your time and knowledge is greatly appreciated.

In warm sincerity,
Amy

[Scott Roseff MD]

Sorry the link didn't work, Amy. I messaged INCIID to let them know their hyperlink system is flawed.

The page can be viewed at: www.reproendo.com/pdf/pycnogenol.pdf

Dr. Roseff

[abc123woman]

Thanks, Dr. Roseff! Found and read the article last night and my DH is placing the order today.

Have a good day and thanks again--
Amy