Advice needed - just got results back - not good.

[furtivefeline]

We have only been TTC DC2 5 months but just had a feeling something wasn't right. Periods always a bit irregular but otherwise no real reason for this concern.

GP agreed to run tests which have come back today and results are really not looking good so I'm just hoping to hear from anyone else in this situation and to learn a bit more about what might lie ahead for us.

Results are:
Day 21 progesterone 5nmol/L (ovulation unlikely with

Hi Shellster I can hardly imagine how difficult it must be going through the IVF process so many times. I'm amazed how positive you still manage to be. Did you think at the start that you would be prepared to keep going this long? In my mind I guess I have a limit of 3 or 4 IVF/ICSIs - not that I have even been through one yet! Its just I can't imagine being able to pick myself up after that many disappointments.

Have the specialists been able to tell you what they think has caused the IVFs to fail? Is it related to the quality/number of eggs or is it a sperm morphology issue?

I have no idea at the moment what my egg quality will be - all I know is they don't seem to be being released, and as you say that is something that the IVF process tries to overcome. Do you know what effect sperm morphology has on the success of ICSI, compared to say low count or motility on its own? Intuitively it seems that if there is something structurally wrong with the sperm that might be worse than just low numbers, but I would be keen to know if that it the case or not.

I was also a vegetarian for a long time then started eating fish too a few years ago. Since getting the results back I have decided to really sort out my diet and general health. Before DD I used to exercise at least 3 times per week and ate fairly healthily too. But in the last couple of years things my lifestyle has really gone downhill. A combination of being too busy/not as interested in living healthily and also I must admit, couldn't really see the point of getting back into good physical condition if I was just going to get pregnant again fairly soon. That's certainly changed now.

I really hope your next cycle is successful. It feels like you are long overdue some good luck and certainly if BFPs were handed out to people who deserve them you would have got one ages ago! Nice to chat to you and thanks again for listening.

Hi I would take Lister's advice on whether to try clomid - I have heard good things about lister so of they say no then I think I would accept that. Much would depend on your test results I guess?

I hope you find Mr Ramsey helpful - my dh found him compassionate and knowledgeable - the fact he is still actively involved in research etc! e asked to see us both for 3rd apt to help is decide what to do, and as we had no chick are suggested his Sat clinic in Windsor and to being our 2yr old! His fees were the cheap bit of our journey - £200 for him. he was brilliant at suggesting blood tests we needed and has got our gp to do some for us!!!! They use TDL in London for bloods privately.

Immune testing - yes lots of people have different opinions. many clinics now treat people for immune issues without doing the tests. the reason why I read about them and wanted the was because:
I have asthma, hayfever, coeliac disease
I am under an immunologist for a primary immune disorder ( will not write here as not want to our myself!)
Family history of diabetes and allergies

therefore despite no known miscarriages I wanted to test. immune issues cause implantation and miscarriages at a basic level. I had never knowingly had a mc as I could not conceive. however since ICSI and ds I have had a 5wk miscarriage - only knew was pg as started testing on day 28-30 every month.
Immune testing is expensive sadly - we were under George Nduwke who suggested we got the list of level 1 tests and got our gp to do as many as possible! then the rest of L1 tests the gp could not get done and all of L2 we paid for - about £1600!!! This is because some tests have to be sent to Chicago - or they did 4yrs ago!

Some of the more simple level 1 tests are for things such as thrombophilias - blood clotting. I discovered I had 3 genetic results - so I take aspirin to try to conceive (75mg - the baby dose as it is known) and take it every day to prevent strokes on advise from a stroke consultant now. I also need clexane injections all the way through pregnancy.
Personally my other issues involve raised NK cells, a problem with TH1:TH2 cytkoteine levels and a few others ( need to look them up!) So I need:
5mg folic acid
Aspirin
Clexane
Levothyroxine
steroids until 12 weeks pregnant
3 intrallipid infusions ( some of the more serious or heavy duty clinics prefer to prescribe IVIG which is horrifically expensive) - these have come down in cost if can have them done at a London clinic for eg - but I have to have them at home so £290 a time instead of £170.

But that is my journey and I sort of knew immune issues would be a problem hence I went to a clinic that did treat them. L
The Lister I think do immune testing and treatments - most so now.

But if in UK I suggest getting a comprehensive list of all L1's and ask gp to do as many as possible. I thought they would say no as had used up my NHS funding of one cycle but the gp was impressed by my neatly typed list and printed our clinical research in a simple short document!! The labs struggled to do some and had to have them done several times!!

I think the basic thrombophilias ones are most useful.

Interestingly when I saw midwife at 8 weeks she filled in a DVT risk form and as I scored high on it ( if high BMI and older score high - I scored high due to known thrombophilias, previous DVT and known faily history and age!!) she said I had to take clexane all way through pregnancy for those factors - whereas when pregnant with ds a few years ago the midwife and dr's all considered me "odd" for saying I needed clexane for immune issues when now they offer it to many people with no tests " just in case". problem is I need it to get to 8 weeks!!

But many people do not have immune issues. Research I read said it is not unknown to have a child and that to cause immune issues subsequently.

again I would take your consultants advice at Lister.

Your age is an advantage [furtive] - just turning 34 is a good age - I am over the 37 bracket when results seem to drop for ICSI. Also of dh had been ill that may be a cause for drop in sperm count etc? My dh had abdominal surgery hence his issues.

Oh furtive will gp do your day 21 again as done on wrong day? if so did she test your prolactin levels? A basic test which if too high can be cause of female infertility? Over 1000 I think is too high from memory.

TO do ivf/ICSI you will need a smear in date but within 12 months not the usual 3 years and you will need a chlamydia test in date - my clinic wants this by swab so done at same time as smear. if you not done worth getting sorted to recent delays and get done on NHS. if gp will not sort then go to a sexual health clinic - some do it free or for small fee there depending if you honest or not. My gp did mine for me!

Hi Silver
We will need to wait about a month to see Mr Ramsay unfortunately so that will be after our appointment with the Lister. I'm not sure how that is going to work. Do you think we will need to have the semen analysis repeated at both places or will they be able to work from the same results? I was really hoping that the Urology appointment was going to come through sooner, particularly as DH is now saying that his testicles are a bit sore and he wonders if the epididymitis is flaring up again. He is going to try to get seen locally at a walk-in clinic at the weekend but I'm worried as this has happened a couple of times before and the antibiotics he has had don't seem to have done the trick. I just have visions of all the sperm becoming damaged/dying as time goes on...

May I ask, in addition to the £200 for Mr Ramsay appointment, how much did you pay for extra tests? Our email from his secretary says to budget £500 - just wondering if that was your experience.

Thanks for explaining about the immune testing. I don't have any of the allergic conditions or risk factors you've mentioned. Does this mean we're probably OK to not do those tests at least before a first ICSI attempt? DH has various allergies - does that come into it, or is it just the egg/female that's relevant?

I don't know whether the GP would retest day 21. Do you mean later this cycle or in a new cycle? I'm quite convinced that I haven't ovulated as cervix has remained fully closed (sorry), also boobs are sore - apparently common in anovulatory cycles due to high oestrogen relative to progesterone. If I didn't know better would think I was pg .

I asked at the last appt whether GP would test prolactin and AMH for me but she said GPs were not supposed to do this now as too expensive and results not useful unless interpreted by a specialist. Might ask her again given that we've got an appointment booked now. Will also see about chlamydia and any others we can get done - thanks for the tip. Hope all's well with you silver. How many weeks pg are you now?

The big thing that's making this whole thing even harder is that DH seems to be in complete denial that there's much of a problem. He's a very positive person anyway, sees no point in worrying about what might/might not happen. Usually a great attribute, but not at the moment - I just feel so alone like I'm doing all the worrying for both of us and he just doesn't understand how I feel.

Also didn't help that I don't think the GP gave us a realistic indication of the severity of our issues when she gave us the results last Thursday. She focused mainly on the fact I hadn't ovulated and said lots of times that that was easily fixed with clomid. She barely mentioned DPs sperm - just said one or two parameters were slightly low. I'm not sure whether she hadn't read the results properly or if she genuinely didn't recognise them as bad results.

In either case, that combined with a quick google (that apparently showed people can sometimes conceive with 0% morphology) means that DH is feeling absolutely fine about everything. He trots off to work each day, happy as anything and seems puzzled when he asks me how my day was and I say not good. Doesn't have a clue what to say when I'm crying... I can definitely understand now how fertility problems put a strain on a couple's relationship. I hope that after the appointment we'll be a bit more in tune.

Hi, no immune issues are just an egg/female issue apart from the karyotype test ( the most expensive of the blood tests!)

Most gp's will not do the AMH blood test but the prolactin should have been done before a gp referred on NHS to fertility clinic - my gp said in our area she had to do 2 sets of blood tests and 2 semen analysis before our fertility clinic would accept a referral. As she said she would not refer us for secondary infertility ( grrr!!!) she did say she would fund the blood tests.

My top tip is to get print outs of all tests from your gp receptionist ( we just ask for them to be printed out so no need to see gp), put them in a file and take to every appointment.

No Mr Ramsey will accept NHS or private semen analysis results - and will want to compare them.

the most expensive test we had was a scan to check for blockages due to the surgery ( abdo) my dh had but you should not need one of those!! a semen analysis was £100. The blood tests included hormone profiling etc and was a fee paid direct to the clinic that did blood tests not the urologist - I would say the receptionist is right.

Annoying you having to wait 4 weeks, we waited 3, but out of choice due to getting to London, we could have had one in a week. perhaps on holiday or very busy. worth asking to be contacted if there is a cancellation to be informed?

Just a thought as you are London based, he accepts NHS referrals at Chelsea and Westminster I think so why not get dh to ask for NHS referral - so if you end up needing several appointments etc your NHS slot should kick in eventually, as 18 week waiting list times??

Oh dear about dh's optimism. Clomid may be able for some people to fix ovulation if that is the only issue - but does not mean someone can conceive. might be worth having clomid from Lister for a few months if they suggest waiting til 2015 ( as hard to do ICSI over Xmas as most clinics close!!) - just to see if it works and to show dh there is more to it than that? You will probably find you cannot do ics straight away as they will want to do more blood tests - or other tests etc. I think if I knew I had to wait x months to do ICSI and clomid was affordable and an option I would try it.

sadly gp's are just that " general" - I had to have blood tests 2 weeks ago due to abnormal results at midwife ( am only 11 weeks), and we got print out of results from receptionist - whichever gp had reviewed them had put on results " no further action required". A few days later the midwife rings saying " tomorrow you have to go to the hospital for gestational diabetes testing as the blood test I ordered confirms what your urine showed and your levels are too high." So off I went to the hospital - thank goodness a more specialised nurse/midwife overruled the gp note!!

Thanks silver. Yes I'm glad the GP was happy to refer us quickly (though NHS would have only covered investigations, not treatment and so we decided to go private to avoid waiting list).

Do you think I should email Lister to ask for a list of bloods/tests that we could try to have done on NHS prior to our appointment - or will they want us to get them done there (to make more money)?

Yes I wish we could be seen sooner but the secretary said earliest appointments are end of November. Just waiting for her to reply again so we can get something booked. DH says he's not able to take time off work so would like a Saturday appointment so not much chance of an earlier cancellation. Will mention it though when we book.

Good idea about trying to get NHS referral as a back up. I'll speak to DH about doing that tomorrow.

Yes I was thinking the same about Clomid. I think it makes sense for us to wait at least 3 months anyway to check for sperm improvement before starting ICSI so that would be February earliest. Could try clomid while I'm waiting but I do wonder how much point there is making myself ovulate when the sperm hasn't had a chance to improve? Still it can't make things worse (can it?) so maybe worth a go if not very expensive.

I think the "no further action" is exactly what was on DHs SA - checked by another GP, which was why our doctor didn't check them properly. Glad that all worked out fine with the gestational diabetes but annoying that you had the extra stress.

Oh Sat appointments tend to have longer waits. Dh's work were great and he worked 4 long days then on the train both ways to make time up. But they knew about our previous ivf etc so were helpful!

I have never done clomid as I just about scraped the tests for ovulation being classed as "ok". can you get dh on all the supplements if he is not taking any. I made my dh eat Brazil nuts every day, freshly cooked meals, no alcohol at all for over 9 months, cotton boxers and banned him from having his phones in his pocket - he had no choice!!!!!

Do Lister have details on their website with prices of initial tests? ZW do: www.zitawest.com/fertility/fertility-checks-and-tests/gynaecological-investigations/

Oh found the most useful page now on this link: www.zitawest.com/about-zita-west-fertility-clinic/useful-information/about-useful-information-assisted-fertility-fees/

It tells you the mandatory blood tests you have to have ( for regulations!!) before do IVF. as your gp was going to refer you for testing on NHS for secondary fertility after 5mths ttc I imagine they will accept you gone private so hopefully will do the tests? they do not cost the NHS what they will cost you? I hope so. my gp did them all. Note the male partne has to have blood tests as well!!

My gp did : rubella, HIV, Hep B ones, smear and chlamydia, Vit d, prolactin, thyroid ( fertility consultants like it below 2.5 but in NHS they say ok if 4.5) and the day 2/21 tests.

sorry should have posted that info before!! My clinic did not use AMH tests but antrial follicle count on scan when first did ivf.

It also has all the level 1&2 immune tests down do you

furtive, I am so glad that SilverStars lives in your area so can give you advice on clinics and gps. I am in Australia so not much help to you in that department.

As for the morphology issue and you wondering what this aspect of sperm has on ICSI success, I too have never read any specific studies addressing this issue. I know two other couples with male morhpology issues. One had a total of 50 eggs collected over 3 cycles, of which only 5 fertilised. The measly 5 that did fertilise were top quality and 3 made it to blast and she got pregnant. So that would make you think poor morphology causes fertilization issues, but then I went for a walk with a girl last weekend whose husband has also been diagnosed with abnormal morphology as their reason for failing to conceive after years of trying. She got 8 eggs, 6 fertilised and all 6 embryos made it to blastocyst!!!! So their high fertilisation rate is the opposite of my first friends experience, yet the same diagnosis of poor morphology.

As for me, we seem to have a good amount of the eggs I make fertilise. The trouble is I don't make many eggs to begin with and the ones that do fertilise have died before day 5 so I haven't made it to transfer. Have been doing high protein diet which is supposed to increase number of eggs that make it to blast so we shall see if that helps next time.

Did I ever start with a limit of the number of IVFs? Well, with my first IVF I was just expecting this to finally be the solution and get me pregnant so I hadn't prepared myself for any extras. When it failed, I was so shocked that I did the second straight away which got cancelled for poor response. So I looked up a protocol to improve my response and tried again. I then had a better response but the embryos were poor quality at day 2. So I looked up how to improve quality and tried again... and so I kept going after each one failed trying to be practical and work out how to solve it for the next one.

I think now I am PERHAPS starting to accept that this MIGHT be my last try and I have small moments where I think my DS will be just fine without a sibling. But of course I am pinning all my hopes that the adjustments my Dr and I have made to my next cycle will improve my egg numbers and the cycle will work, so I might not feel this way if I get a shock and it fails again. Not forcing myself to feel any particular way or make any definite plans. Just focus on doing what I can now to make this cycle the best one and see how I feel with each new day.

Wow, sorry for the long rant this has turned out to be! Please feel free to rant away in return. Lovely to hear from someone in similar circumstances.

Oh Silverstars, I notice you say that you take Aspirin to conceive. Can I ask - have you taken it for months in a row. I started taking baby Aspirin daily to increase my day two follicle count for my IVF cycle. It worked wonders and I started my Dec 13 IVF with a day 2 count of 15 instead of the usual 6-7. When that cycle failed I continued to take it for a few months before my next IVF but my cycles started going haywire. I then read that Aspirin can inhibit ovulation so I stopped it and voila, my cycle returned to normal. But then I had only 5 follicles at day 2 for my next IVF so I can't win. Just curious if it has had any similar side effects for you?

So we have a date confirmed for the Mr R appointment now - not til early December and that wasn't even for a Saturday - DH has decided he will be able to do a weekday.

Lister have said it's OK to get the GP to do some of the bloods in advance in addition to the HepB/HIV ones which are mandatory so I will go and see the GP next week armed with a list and plead my case. Thanks for letting me know about that silver. Hopefully will save a few £ at this point so we have more to spend on treatment later.

I will stock up on supplements (Proxeed isn't it?), brazil nuts and have already ordered him some loose boxers.

Hi Shellster good to hear from you again. Interesting how your two friends had such different experiences with the same diagnosis. I guess that shows it's not worth trying to look into the stats too much as morphology issues are probably quite varied. I think I'm just desperately seeking concrete evidence so I can either reassure myself it'll be OK or prepare myself that it won't.

Good that a high proportion of your eggs manage to fertilise. I wonder why there has been the problem with them reaching blastocyst stage though. I suppose could be either sperm or egg-how do you tell? I hope your high protein diet is successful.

It sounds like a good plan to take each day at a time and not force yourself to plan for all the what ifs. I wish I could do that! In my head I have already done 3 or 4 unsuccessful IVFs and am wondering whether to give up - all before I've even had my first appointment!

I would love to be able to take the pressure off and just accept that DD might not get a sibling but at the moment even typing it makes me cry. Logically I know she should be fine either way but I couldn't bear it if she was to start asking why she doesn't have a baby brother/sister. Fortunately her language is not at that stage yet though it might not be long and like most 2 year olds she is very interested in babies!

Can I ask both of you at what stage did you tell friends in real life about your infertility issues/IVF? I have spoken to my sister and one good friend which was helpful as DH just isn't wanting to discuss it. I feel like I would prefer to be quite open about it (which isn't my usual approach) but at the same time am not ready to deal with inappropriate questions/comments from well meaning people!

Although you have a wait now for appointments you can start making adjustments ( proxeed yes - best taken in orange juice my dh said!!), cotton boxers, Brazil nuts etc!! I think the fact that starting to make changes is helpful - mentally and hopefully physically for sperm and eggs!! I found once we " started" it helped me feel was doing something positive. The good consultants tend to have waiting lists!! We once had to wait 12 weeks to see a private consultant. Worth every day once we saw him mind you.

We started ttc aged 29, O gave birth aged 36. I did not tell many people to be honest, as it was a long and uncertain road. So only told people really when started ICSI. It has taken: over 2yrs, urology appointments and immune treatments for me for the second pregnancy ( for which I am still nervous about as long way to go!

Shellster - I only started aspirin 2 months before my first conception and have continuously taken it since then so am afraid no idea on numbers etc. I have to take it for medical reasons not specifically for ICSI though so not thought about how it is affecting conception.

Furtive, I bought special fertility briefs online. My hubby isn't a boxer fan so these briefs still give support but have mesh instead of material to allow air to circulate around the err, groin region.

Can totally understand you wanting to have a definite answer now as to what will be your fix for your particular circumstances. It is so frustrating just twiddling thumbs and waiting for appointments so it feels good to be able to research and get answers in the meantime. But it really does seem very individual. No idea why mine don't reach blast. Like you, I am trying to do research. I like the factual studies rather than someones opinion. So I have hope that my high protein diet will help as the study looked at many women and saw their blast rate rise to 50% on this diet. I can only hope and time will tell.

I remember looking into foster care and even how to 're-lactate' so I could have that bond with the child. But like you, it just made me cry because it isn't what I wanted. Do try to keep your chin up. I know it seems doom and gloom right now because of your diagnosis but actually it is great to know what your issues are and that you have loads of eggs inside of you (which I can only dream of) and that ICSI will overcome hubby's issue. At first I was ashamed that I needed IVF instead of being able to have a 'normal' baby. But the technology is amazing these days and it just takes time to accept IVF as a precious gift that will get you your baby rather than the way we initially thought.

To answer your question, I don't really chat to people in RL about this. Family know we are having issues but I don't give specific dates as it just puts extra pressure on me that an ICSI cycle has to work because I have to report back to them with an outcome. Also like you, hubby doesn't like to discuss it too much so I have you wonderful ladies on Mumsnet as my release.

Feeling quite a bit better today, probably as AF arrived yesterday so hormones are in a better place. The idea of making changes is definitely helpful. I am trying to improve my diet, eat more protein and veg, less sugar and processed stuff. Have re-joined the gym (stopped after having dd as not enough time/motivation), will continue low alcohol and caffeine. Going to try soy isoflavones this month as apparently they might help me ovulate. I will give temping a go (though will be difficult as I am a very poor sleeper) to try to tell whether ovulation is happening. And of course the proxeed etc for DH. at the fertility briefs Shellster - I am picturing them now!

You are right about me scouring the internet to try to determine what's going to happen before we've even had the first appointment, let alone any IVF! And now my brain is saturated with so much information and so many anecdotes both positive and negative. I agree that each persons circumstances are different and am finally accepting I can't predict our future so I am going to try to rein it in a bit now!

Thanks to both of you for sharing your stories. At this stage it's hard for me to understand what you have gone through but it is great to have people to talk to who understand this initial stage of being a bit in shock with it all. I might take a step back from the internet for a day or two but will no doubt be back with more questions if you are still around. In the meantime lots of luck to you both. I hope your preparations for the next cycle are going well shellster. And that you stay happy and healthy as you head towards the 2nd trimester silver.

Thanks furtive. Will definitely still be around. My IVF starts in 3 weeks so I live on Mumsnet to keep me remotely sane in the lead up to and during IVF. Plus, being on here is an alternative to researching on Dr Google which only stresses me out.

I've heard of those soy isoflavones on another thread on Mumsnet. Never heard of it before that. Have you actually read any research about it. Very curious to find out what you know. In my attempts to improve my next IVF, I have been trying to eat natural foods and gave up dairy. Been drinking soy milk which I love and although I do try to eat some chicken and fish for protein, I much prefer vegetarian sourches... which include soy. But wondering if this is affecting my hormones and hence the outcome of my IVF cycle. Perhaps if it's a good thing for ovulation, I can continue to take it up until ovulation this cycle and then stop it (boo hoo) until I start my next cycle which will be IVF?

Hi Shellster. I haven't read any research about soy isoflavones, just lots of tales of people getting pregnant when taking them! They are supposed to be taken similarly to clomid, just for 5 days or so in the early part of the cycle. They work by binding to oestrogen receptors so the body is tricked into making more oestrogen. At this stage in the cycle, the increased oestrogen is supposed to improve the chances of ovulation.

I'm not sure whether soy from other sources works in the same way or whether it's just the isoflavones that have this effect. (I'm sure I remember reading somewhere that soy containing food should be avoided when TTC, but perhaps it depends what stage you are at in the cycle. So confusing!)

So is it 3 weeks til you take the drugs to make you produce all the eggs? (I don't know anything about IVF - sorry). Do you get many side effects from the IVF drugs?

I too have read controversial things about soy and TTC so it's probably safer if I cut it out from now on. Thanks for that explanation furtive. Makes sense. Today is CD10 so I think I shall stop my soy from today (boo hoo) so it's out of my system after ovulation. I am already restricting myself on so many things with my diet and now this is one more thing I can't have!

I have to start estrogen on day 20 of this cycle (probably another reason I should cut out the soy so it isn't bound to my receptors and the estrogen tablets can bind there) and then on day 2 of my next cycle I start the IVF drugs - so about 2 1/2 weeks away.

Hi shellster hope you're doing ok and feeling good about starting your next IVF cycle. I've been trying the higher protein/lower carb diet but without much success! It's fine when I'm feeling relatively happy and motivated but on the more miserable days it falls by the wayside and I end up eating badly again. Still, part time is probably better than nothing.

I tried soy isoflavones at the start of this cycle (not that there's much point due to the condition of DH sperm! But I thought if I can try and get myself to ovulate this cycle at least we stand some chance of conceiving). I've started temping but not sure how reliable it will be as I normally wake up a few times each night. Do you temp at all? Any tips?

I came across this article and thought of you as it's a really large study that found that poor sperm morphology doesn't adversely affect the success of ICSI. You might have seen it already, but thought I'd share as it made me feel a bit more hopeful. Not sure if the link will work but here it is -

www.clevelandclinic.org/lab/pdfs/25_blastocyst_formation.pdf

I am exactly like you furtive that I am a part time high protein dieter for exactly the same reasons... it's very hard to eat perfect on the days when it all feels like doom and gloom and hopeless. Glad to hear you say that as I am feeling guilty that I am not dedicated and can't even stick to my diet so glad that it's not just me.

I found the temping really tricky. My oral temps were all over the place so I read to take it vaginally... but then I can't hear when the thermometer beeps. Gave up in the end and now use OPKs. I also have a magnifier where you put a drop of saliva on it to see if it creates a ferning pattern meaning your estrogen is sky high and you are about to ovulate... but that was negative this cycle even on the day when the OPK was positive... ??? Who knows what's going on there. Anyway, I was just really doing it for something to do as I am having endo scrape next week so absolutely no chance of natural this cycle. Putting all my hopes on IVF next cycle (well, what little hope I have). Do you use the OPK's? I find them the easiest of all the tracking methods.

Thanks so much for the article. I am about to leave work and want to get out of here but will have a look later. I had actually banned myself from doing research on the net as I found myself walking away more stressed or needing to ask my Dr more questions about wanting to change my next IVF cycle. So I was glad to have found Mumsnet as an alternative. But if this link will give me hope about hubbys morphology and ICSI rather than stress me out, it sounds worth a read. Thanks again.