IUI with poor morphology and ok sperm count

Had IUI today. Motile sperm recovered post-wash was 5.49 million but normal morphology was only 4% (this is on the strict Kruger scale so 'normal' is 14% or over). the doc said that given my age I still had 20% of conceiving this cycle but I don't understand how this could possibly be accurate. the original count pre-wash was 35 million with 31% rapid/moderate motility and 24% slow. Pre-wash the normal morphology was a dismal 3%. I've read that poor morphology doesn't matter so much if there's a high sperm count but 35 million isn't 'high'.


I'm worried the doctor is not being realistic... maybe because he's trying to make me feel more optimistic and positive about the whole venture.... or maybe he's hoping that I'll keep on trying with IUI and therefore spend more money. From what i've read, the chances of IUI succeeding are never terribly high, even when there are no problems with sperm.


Does anyone out there have any opinions and expertise they can share on this issue?

Hi kikidee,


My husband has poor morphology and a reasonably good sperm count as well. Morphology is the most important factor of all. Doesn't matter of the count is great- if the sperms cannot move in the upward direction and move sideways or down, count makes no difference. In fact, poor morphology sperms will hinder good sperms move, because they will come in the way.


If Dr. has given you 20% chances with IUI, you must be in your early 20's because normally the chances are about 10-12%. With poor morphology, even lower.


So talk to your Dr. again, to find out why he thinks IUI is better for you and not IVF with ICSI. If you think his reason is logical- then you should go ahead as he suggests. If not- may be you might need to push him or choose a different opinion.

Thanks for the reply. I'm actually in my early thirties but it's just occurred to me that perhaps the Doctor meant I have a 20% chance over the course of three cycles. Does that make any more sense?


On a previous sperm analysis, the count and motility were low but I think morphology was ok. This time the White Blood Cell count was high as well as the morphology problem but sperm count and motility ok. I think the Doc's attitude was that we'll really get a sense of whether or not things are improving over the next couple of cycles. If it's the same then he'd suggest IVF with ICSI. I think that's partly why I was so confused..... he was looking at the numbers and saying if no improvement we should go to IVF but then also saying i had a 20% chance with IUI. Oh well, the Doc's advice as to what to do next sounded sensible to me so I guess I just have to relax and wait to see what happens.


I did wonder if it was worth having several sperm samples taken over a course of days/weeks and have them frozen with the best ones selected and put together for an IUI. Has anyone done this? if we know there's a sperm 'issue' then it seems a bit restrictive to rely on one sample taken the morning of an IUI. if it turns out to be a particularly bad sample, all the monitoring, injections etc will have been a waste of time. this kind of thing doesn't generally seem to be offered tho....


788 - have you gone straight for IVF?

Hi kikidee,


I had already gone through 2 IUI cycles before husband's reports came. Dr. suggested to try a 3rd IUI because normally patients like me take forever to decide whether to go the IVF route or not and then at the same time get agitated that the Doc isn't doing something. The 4th one he said- No. Either do IVF with ICSI or not anything at all. There was no use for IUI.


What you are suggesting- collecting and combining samples, I think is not possible. Your sperm sample taken on the day of IUI, should be fresh. I hope your Dr. told your husband from abstaining from any kind of ejaculation 3 days before to make sure the sample is appropriate and the best. My husband got the analysis done once and for every sample I have used- the results have been the same. So not sure why your husband's ananlysis is different every time. Do you know how the Dr. thinks its going to improve. No point doing IUI unnecessarily. By the way, poor motility can also occur because of poor morphology. They are floating in different directions- so become a lot slower.


Not to worry you too much- I am sure every one is different. My husband got the variocele surgery because 2 of our ivf's failed too. Lets hope we are lucky this time.