How accurate is a single semen analysis?
23 Replies
Lin - October 11

Hi ladies. Can anyone please share their experiences with semen analyses? I just spoke to my doctor, and she informed me that, while the concentration and motility are fine, my husband's Krueger morphology is only 1%. She said that our only hope of ever having a baby is with IVF, though we'll be going in for a second SA next week. I'm so devastated. I don't know how to tell my husband. I know I've read several other ladies over the months say that they've had innacurate SAs as far as number count goes, but does anyone have any idea how accurate the Krueger morphology results are?

 

maknyle - October 11

Hi Lin. My husband had a semen analysis that said that he only has 2 million sperm. He never had another one done. The doctor told him that he will never have children. (We already have a son) He told us that the only way we will have children is to do IVF. We went to a urologist who works in only male infertility, and he said that we still had a chance of conceiving naturally 20-30%. We are now almost 12 weeks pregnant with the second child that we aren't supposed to be able to have. I highly recommend that you see a urologist that specializes in male infertility. Our regular urologist just wrote us off. He didn't even share with us the morphology or motility. I know that doesn't answer your question, but I wouldn't just jump straight to IVF without a second or third opinion. Good luck to you.

 

Mega - October 11

Lin, I'm sorry about the morphology levels. That's my DH's MF issue too. Definitely get the 2nd SA done though. Morph levels can definitely vary a bit test to test. When we had our 1st SA done in June '05 my DH's morph was 5%. So we went straight to a RE and had IUIs done. Finally my RE checked morphology again in 4/06 & we were down to 0%. Last morph check (6/06) it went up to 1%. So that's why we're doing IVF/ICSI now. But some things that can affect morph include recent sickness (like did he have a high fever in the past couple months), etc. Take that kind of thing into account as well. So while I think Krueger morph is pretty reliable as a whole, morphology can & does tend to vary a bit SA to SA. And also remember things like fevers, a dip in the hot tub etc. can affect your DH's sperm for the next 2 to 3 mos. IVF/ICSI carries a high success rate for morph issues, our 1st IVF cycle they ICSIed 19 of my eggs and 15 did fertilize. Unfortunately I didn't get PG but I'm hopefully that the odds are in my favor that it will work. So hang in there. And I'm sorry you didn't get better results from the SA. But at least now you know what the main issue is, and that's more than 1/2 the battle.

 

isa - October 11

You should never go with only 1 analysis b/c there is always chance for error and sperm is rejenerated all the time. I was told sperm tests should be 3 months apart as that is how long it takes for the next "batch" to change. You can fix it with vitamins/minerals/herbs. Google the net there is a ton on male infertility and low sperm/motility/mophology etc. Maknyle has lots of great points too go for a second opinion but dont do another sperm count next week it will more than likely give you exact or very similar results.

 

Lin - October 11

Thanks so much, maknyle. I'll definitely follow your suggestion about seeing a urologist. What's the biggest worry to me is that she said that the problem is likely something that can't be corrected and is most likely genetic. I really would like to get a second opinion on the matter, outside the second SA. You know, I was absolutely sure that the problem was with me. I've had half an ovary cut out and have scar tissue tying bits of my insides together. I never imagined that there was any chance it could be my husband's sperm. Even my doctor had emphasized that most problems lie with the woman. He's never done drugs, he doesn't really drink and he doesn't do anything (bike, wear underwear, etc.) that could harm his sperm. Thanks again for your suggestion. I'll go look up a urologist now...

 

Lin - October 11

Thanks Mega and isa. I think I missed your posts while I was writing my last one. The doctor wants us to go in next Friday for another SA, this time a pre-IVF at a different lab. I'll still make us an appointment with a urologist to get a second opinion. My husband hasn't had a fever in years, and he hasn't even had a hot bath since we moved into our apartment with only a shower a year ago. There's nothing I can think of that could have affected his sperm in this way, which I suppose supports the doctor's suspicion that it's genetic. We can't jump into IVF right away anyway, because we have to sort out how we'll pay for it first. The doctor recommended that we start him on Fertility Blend for Men right away but that we might not see an improvement for a few months. I guess all we can do is take it one step at a time. Thanks again.

 

Lin - October 11

maknyle , you know I've been thinking about this constantly since I got the news this morning, and in all reality, I think the best move for us probably IS to jump straight to IVF. While seemingly miraculous events do occur, it is not sensible to ignore statistics. While 2 million is considered a low sperm count, it is still a fairly substantial amount, differing from "normal" by an order of magnitude. That means your odds were a lot lower than the average, but not hopelessly lower. Since my husbands count of *viable* sperm is two orders of magnitude lower than your husband's, that means that our odds of conceiving are 1/100th of what your odds were. I'm 34 years old, my husband is 35, and I really don't think we have the time to take our chances and see if we're one couple of the rare lucky few to conceive given a reduction in our odds by a factor of 1000.

 

maknyle - October 11

Lin, I was just offering my opinion. You do whatever you want. The doc told us that a normal sperm count was 60 million. Two million is hardly anywhere near that. When we got the news no one told us that we have a fairly substantial amount of sperm. They told us to go have IVF done. My husband had undescended testicles and a partial orchiectomy. In my opinion you shouldn't just rush into a 16,000 treatment when there are so many other things you can try first. Just offering my opinion. Again, good luck to you.

 

Lin - October 11

I know you were offering your opinion, and I appreciate that very much. I wasn't disregarding it, just putting it in perspective. The lower limit on what is considered "normal" is 20 million/mL. So, as I said above, your husband's concentration was an order of magnitude lower than normal. My husband's concentration of viable sperm is 20,000-40,000. That's 3 orders of magnitude lower than normal. I wasn't trying to belittle your fertility issues. Again, I was just trying to put it in perspective. Your husband's count is 100X greater than my husband's, and so your odds were also 100X greater. That means that while your odds of getting pregnant naturally were around 10% of the normal odds (normal being at best 25%), ours are 0.1% of the normal odds. What would you recommend that we try first? My doctor said that we aren't even candidates for IUI, as a morphology of 6-10% is required for that. I'm going to head straight to the store today to get some Fertility Blend, as my doctor suggested, but there is apparently no treatment for a low morphology. Of course, like I said above, I'll certainly get another opinion, but what I've been reading so far this morning (and all I've done since she called is read) isn't looking promising. If you know of something else we can try, then by all means, please point me in the right direction!

 

Mega - October 11

Lin, are you in the US? If so, there's a program called Shared Risk by IntegraMed. It's a package deal, where for X amount of money it covers 3 fresh & 3 frozen IVF cycles. We're doing it now, and I'm so glad we did b/c we didn't suceed with our 1st fresh cycle but we still have several tries left. I'm doing a FET now. It's more expensive of course, but worth it for the peace of mind. For us it was almost $18K with ICSIs. Anyway, you might want to google Shared Risk, see if any participating clinics are in your area. Maknyle, congrats on your pregnancy. How exciting! As my RE says, for all they know about fertility & MF issues esp., there's so much more they don't understand.

 

maknyle - October 11

Thanks, Mega. I have followed your story because I am on a forum with CC. Sorry to hear about your IVF, but I am so glad to hear that you are involved in the shared risk program. That is great.

 

Lin - October 11

Funny that you mention that, Mega, because I just stumbled across a website on it, and it turns out that my clinic is one of a few in my area that do that. I'll definitely look into it. I'm not sure yet how we'll be able to fund it, perhaps through a loan, but we'll certainly look into all our options. I'm thinking about talking to a financial advisor. Actually, at this point I haven't even told my husband yet, because we're both still at work and I want to tell him in person, but I'm sure we still have a lot of discussion, a lot of investigation and a lot of planning ahead of us. Thanks! Oh yeah, and just in case I didn't say it above, congratulations maknyle!

 

Mega - October 11

maknyle--Thank you. That's so sweet. CC's great. Tell her I said hi & that I'm thinking of her. Yes, I'm so glad DH & I went ahead with the Shared Risk, I'd be kicking myself now. I got lucky.

 

Mega - October 11

Lin--That's wonderful that your clinic is one of the few in your area offering Shared Risk. That's luck! My clinic just joined the program a couple of months before DH & I decided our best bet was with IVF, so I thought that timing was perfect. IntegraMed offers loans too, though you might do better looking outside of IntegraMed for funding. We actually put a big chunk of it on a credit card b/c our interest was pretty low. We'll be paying that off for a long time though! But you'll definitely find a way to pay for it. Good luck tonight.

 

Justine1 - October 12

The IVF clinic I went to only did one semen analysis so I guess they must think one is pretty accurate. My DH's morphology was 3%, he also had low count (13m) and low motility (15% A and 15% B I think). Our doctor told us we would never conceive naturally and the IVF clinic said they never say never but our chances of getting pregnant naturally were close to zero. So we did IVF with ICSI, which was not easy, but I got pregnant first time and had a baby girl last October. I'm now pregnant again naturally (27 weeks) with our second, but I don't think I would have got pregnant the second time if it hadn't been for the IVF but who knows. When I got pregnant naturally I was doing acupuncture and this has been found to improve IVF success rates so might be worth thinking about. Good luck ttc.

 

Lin - October 12

Thanks, Justine. That's some great information. All my tests came back perfectly normal, so the doctor said that our chances with IVF are very good, though I've still got the HSG tomorrow. From what I've read, it will probably be best for us to do it with ICSI as well. How is acupuncture supposed to help with IVF? Is it meant to help with egg production or blood flow or ? Pardon my ignorance, but what are A and B with respect to motility? My doc said that my dh's motility was normal but didn't go into details.

 

Justine1 - October 12

I think you should definately do IVF with ICSI rather than without ICSI. Our clinic only did IVF with ICSI for male infertility as the success rates are much better. Re the motility can't quite remember what As and Bs are (and we may have a different test in England) - I think its to do with the speed and direction, something like As are very fast and going in the right direction, Bs are slower but moving, Cs are dying and Ds are dead. So only As and Bs are good - I think above 50% was considered normal. I was just doing acupuncture to relax, we were amazed when I got pregnant naturally. Acupuncture relaxed me a lot, you just lie down on a bed for 15 mins listening to music where I did it, and it doesn't hurt at all. I'm not sure exactly how its helps with fertility but I've seen studies on the internet which have shown its increased success rates for IVF and I've heard of several girls using acupuncture with IVF and getting pregnant. The herbal teas aren't recommended as its not known what effect they would have on a baby - I never used any either. Hope your HSG goes well. Its not easy to do IVF with ICSI or cheap but I think its your best option. The way I saw it is IVF with ICSI gave me my best chance of having a child with DH and if I ever got pregnant naturally then (which I never thought I would) that would be a bonus second child.

 

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