question for Ghost on MF issue in IVF

rhonda01 · Post by **rhonda01** » Fri Sep 29, 2006 3:49 pm

Hi Ghost - you were so helpful before I thought I'd try my luck and see what you thought about this.

Had my follow up with my RE today and they told me that they think we're looking at a sperm issue with why my last 2 IVF cycles failed and not egg quality like they originally thought.

little history - 1 ovary - first cycle 37 follies - 24 mature- 19 fertilized
second cycle - 27 follies - 23 mature - 22 fertilized - using ICSI
none ever made it to freeze
DH has extremely low motility but count ranges between 7m to 25m

So basically RE said that while I am producing a lot because I have so many mature eggs she does not think that it's egg quality. So next cycle she's going to drop my dose a bit and try and get the follies in the 10-15 #'s and if the same pattern occurs then they'll know for sure it's a sperm issue and we should consider a sperm donor

Sperm donation is NOT an option for us and I was wondering what you thought about it. I would like to just keep trying until it works but do you think it's just a waste of time and money to just keep trying IVF until it works?

really confused and frustrated......

JES24 · Post by **JES24** » Fri Sep 29, 2006 8:16 pm

Hi, Obviously I'm not Ghost but I have a similar problem to yours in that I got 11 eggs but half of them quickly distintegrated after fert., and none made it to freeze. We did get pg though. DH has severe oligospermia (about 150,000/ml), with low motility. I was under the impression that motility doesn't really matter that much for ICSI, and in fact men with no sperm motililty at all are successful with ICSI.
I'm really interested to hear Ghost's answer too!

rhonda01 · Post by **rhonda01** » Fri Sep 29, 2006 11:57 pm

JES24 - thanks for the info! you made me feel a lot better to know that there is hope for us.

AuntyPebbles · Post by **AuntyPebbles** » Sat Sep 30, 2006 1:29 am

Hey ladys i hope you dont mind me crashing in but i found this very interesting... i am on my third IVF so far it seems my eggs are good but DH has low sperm and low motility...we have not been told he has a sertain condition and he seems to do ok fertilizing but same thing as jes 11 eggs 10 mature they just dont make it...looking forward to hearing ghosts thoughts too ...i never considered it could be sperm taht was the problem..i was tking all the blame

hugs Aunty...hey maybe third time lucky for us

Ghost · Post by **Ghost** » Sat Sep 30, 2006 5:06 am

rhonda01 wrote: So next cycle she's going to drop my dose a bit and try and get the follies in the 10-15 #'s and if the same pattern occurs then they'll know for sure it's a sperm issue and we should consider a sperm donor

Sperm donation is NOT an option for us and I was wondering what you thought about it. I would like to just keep trying until it works but do you think it's just a waste of time and money to just keep trying IVF until it works?

Your clinic has a different philosophy than ours. I agree that mild stimulation is good for the fresh cycle, but I suspect that is largely because it disturbs the endometrium less (less estradiol and progesterone). But the goal is childbirth, not specifically after just a fresh cycle. So we try to maximize oocyte yield, keeping both fresh transfers and FETs in mind. But our FETs have a "BFP" rate well over 50%, so they count for a lot in our system.

What is a "waste of time and money" is a personal judgement call. Is a 20% chance of a child worth $15,000? I cannot answer that for you. What if it's a 15% chance? Now let's complicate it: We really don't know the chance for any given patient. Keep in mind that best guess about the cause is just a guess.

Of course, once the kid is born, the cost of IVF starts to seem more trivial. Our oldest is driving now and will be starting college soon... Our youngest cost $110K right out of the gate, due to a heart valve defect, fortunately insurance paid most of it. That was just the first surgery. My point is, your perspective on these costs will change in a hurry if/when you succeed.

Ghost · Post by **Ghost** » Sat Sep 30, 2006 5:07 am

JES24 wrote:I was under the impression that motility doesn't really matter that much for ICSI, and in fact men with no sperm motililty at all are successful with ICSI.

Unfortunately, motility still matters, even after ICSI. ICSI helps, but does not fully eliminate the effects of motility. Here are some abstracts recent publications on it:

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_DocSum

http://www.ncbi.nlm.nih.gov/entrez/quer ... med_docsum

rhonda01 · Post by **rhonda01** » Sat Sep 30, 2006 1:30 pm

Thanks for the info Ghost - I checked out the websites and I guess I feel a lot better becasue the success rate seems to be the best with motile sperm found in an ejaculated sample which is what we are dealing with. just that there's only a few to choose from but at least there's some to choose from and I'll just have to keep hope that next time we'll get at least 1 good sperm!

I got your point about the money factor - I think any amt of money we spend will be worth it when or if we have a child of our own.

Any thoughts on anything that could be done to test DH's sperm before we do IVF again? Like DNA testing?

Ghost · Post by **Ghost** » Sat Sep 30, 2006 3:50 pm

rhonda01 wrote:Any thoughts on anything that could be done to test DH's sperm before we do IVF again? Like DNA testing?

I don't know much about it. In fact, I've studied male infertility very little, although I can confirm motility correlates with pregancy even in ICSI cycles.

Your doctor will have a much better idea of the value of DNA testing in your case. I wish I could help more, I must admit ignorance on sperm DNA testing. I don't know that our clinic has ever used it.

question for Ghost on MF issue in IVF

question for Ghost on MF issue in IVF

Re: question for Ghost on MF issue in IVF

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