Antisperm antibodies?

[thislittlebird]

I've been in the infertility game a long while and just when you think you've found all your problems, along come some more. Anyone here had antisperm antibodies to deal with? I'm glad we know but there's a lot of wasted years behind us if he's had this from the start.

Bumping to say it sounds like it’s 100% MAR in case anyone sees this today.

We're also dealing with ASA - I think he had 93% MAR test. There's pretty much no solution other than ICSI. We saw some studies suggesting steroids would help but our clinic don't offer this as there isn't sufficient evidence that it works. Mostly because there haven't been any major studies into ASAs.

We did a round of ICSI in December and got 2 embryos. 1st transfer didn't work and in the middle of the second transfer now.

Have you spoken to your doctor or fertility clinic about the results?

@blueskies94 have you had the transfer already? Fingers crossed for you.

No, my doctor is on holiday and we also did another dna fragmentation test so we’ll speak to him when that’s back.

The steroid thing is frustrating because I’d rather try it and see what happens, knowing it might do nothing, than not try it. It’s frustrating that you’re basically told ICSI is the only option. We’ve had so many doctors tell us to just keep having lots of sex and I’m furious really that he’s probably had this all along and no one bothered to check. We’ve lost so many very crucial years.

Our first round made 3 ‘good quality’ embryos that survived the thaw. None of them worked but one implanted briefly. Our second round resulted in 0 blasts but the two embryos weren’t developing well and they transferred both and both failed to implant. No idea what the next round will bring but want to do PGT-A testing because of our ages now, I can’t see we’ll have any/many embryos to choose from with all our issues to contend with.

@thislittlebird

I have a lining check tomorrow so hopefully transfer will be next week!

DNA fragmentation will hopefully give you useful info! I think some men can take antibiotics if the cause is an infection, so could be a straightforward fix.

Yeah it's so frustrating that they just don't know what to do with ASAs. We didn't find out my partner had ASAs until we'd done clomid for 6 months, so I was also furious at the Drs. Feels like you've just wasted so much time.

Hope they can give you more information and come up with a plan 🤞

Hi
Have any of you had any developments with this since>? Interested as faced with same challenges!

I am in my late 30s and my OH is 52. He also has children from previous relationship. Have been TTC with 18 months. One BFP at Christmas and had a missed miscarriage at 9weeks. it did take 18 months to get a positive preg test.. I have one son from a previous marriage. Have had all my tests done and everything appears OK. However, after a lot of persuasion DH agreed to have semen analysis. Sperm IGg antibodies are at 100%..

He is very unsure he even wants more children, sometimes he is all for it, other times not. He is sometimes open to further investigation/trying ICSI with his sperm. However, I had planned a sperm donor ICSI before my BFP .
Feel I am at a crossroads. Ideally, would love the child to be his, but worried about the time and health implications the high sperm antibodies may have as well as the chance of have another MC. .
Has anybody been in this situation>> Any Advice>? X

@AgainTTC nothing much to update here. We saw one of the top andrologists this week who is running a whole gamut of tests on dh and will see if he can to the bottom of what’s going on and improve the antibody situation. We can update again in a few weeks possibly to see what he says once he has all the results. Neither of us has kids and we don’t know really why this hasn’t worked yet, the ASA is likely playing a role.

Thank you for your reply. Hopefully you get answers from the andrologist.. I feel at this stage I am going to go the donor sperm route.. time is not on my side.

@AgainTTC yeah I can understand that. it’s definitely not on mine either but we’ll persevere for now.

We're in this boat! DP's first test showed 50% ASA. He has hypothyroidism and his doctor upped his dose of thyroid medication on the off chance it might help. On his next test ASA had decreased to 40%, but apparently this is still significant so we had ICSI.

I do wonder if there's more going on with his sperm than we know. On our first cycle we had 8 embryos on day 3, and this dropped to 2 on day 5. I've read that drop off like this after day 3 can indicate a sperm issue. I'm going to look into a fragmentation test for our next cycle. If anyone has any advice or experience with this I'd love to hear about it.

I meant to add I did actually get pregnant from our second embryo transfer, but the embryo is developing very slowly (6.8mm at 8+2) so I'm likely to miscarry soon. I'm assuming it's a chromosomal issue but we'll never know.

Wonderful to know I can actually get pregnant, but now I'm researching how to optimise sperm and egg quality as much as possible before our next round.

@countrypunk sorry this is a late reply. i think there’s a lot going on with this that they don’t know, they basically said to me they don’t know much about it which is so frustrating.

Definitely do the dna frag, it gives you more info. We know DH’s frag is good but the antibodies are very high.

how did you get on with the pregnancy? I miscarried early at 5 weeks in October. I think it’s hard for them to know which sperm to pick for us because DH’s don’t move, even though they’re internally ok for the most part.

@thislittlebird Hello 🙂

As expected - I had a missed miscarriage at 9.5 weeks and surgery to remove it a month ago. I feel completely physically normal but I no sign of period yet. Hopefully we'll be doing another round in May/June.

What stage are you at now?

@countrypunk I’m sorry to hear that, it’s such a shitty journey for lots of us. Hopefully your period comes soon and glad you’re feeling well otherwise.

I’ve just had another EC this week. We saw an andrologist, did loads of tests on dh and they just said you’re very unlucky because there’s no identifiable cause and back to icsi we go! It’s exhausting and I feel like I’m just going through the motions after three ECs. We’ll get an update for day 3 on Saturday and hope there’s something to transfer on Monday. We’re going to PGT-A test if there’s any excess embryos.

@thislittlebird It's absolutely exhausting isn't it. Lots of luck for your day 3 update. I hope you get a glut of good embryos!

@countrypunk a glut might be pushing it but two would be nice lmao

Hello,

Thought I'd share the below post I shared in a VR group I'm in. Maybe something you've not come across to try.

"So following our diagnosis of 100% antibodies and need for IVF, I decided to research ASAs and natural alternatives.

I thought I'd share our 3 month trial plan incase anyone with the same fancies doing it too.

I'm not a medical professional, I'm just a pro researcher and willing to try alternatives suggested for immunological infertility.

Husband supplements, daily split across the day:

• Turmeric
• Maca
• Coq 10 High strentgh
• Tribulus Territis
• Vitamin B 12
• Zinc Sulphate
• My inositol

Plus serrapeptase 30 mins before evening meal.

My supplements:

Daily throughout cycle:

• Ashwaganda
• Omega 3
• High strength live friendly bacteria
• Coq 10
• Folic acid

Plus Tribulus Territis Day 5 to Day 14 and Ovaboost Day 1 to 14.

Do I know if it will work? I'll let you know in 3 months time at the next SA."

Hi everyone, sorry for jumping on an old post but we are starting our IVF/ICSI journey due to ASA also and was wondering if any more updates or suggestions for more information on it. We were very lucky that this was picked up on our first SA as I understand it’s not something the NHS usually test for.

hope all your journey’s are going as well as they can be ❤️

@180monkeys yeah that is lucky, nhs ignored the issue for us, we only found out after a very bad second private round and more tests. I can say what has worked for us so far. We didn’t get a diagnosis until this year, we’ve been trying since 2019. The ivf round after we had a diagnosis involved the clinic using IMSI, and the clinic also had my husband give the sample much nearer to the egg collection time than at previous collection cycles. So they left it later to collect the sample, washed? the sperm, and then selected the sperm using IMSI. We also tested the sperm ahead of the cycle to make sure it was good enough.

This was our third round. We had 5 embryos from that round, 1 5AA fresh that failed, 1 5CC is frozen, 3 were PGT-A tested and one of those (4AA) came back as euploid. We transferred the euploid on September 8th and I’m now 10.5 weeks pregnant. It’s been a very long road and not in the clear yet but it’s the furthest we’ve got in 4 years.

We also made a couple of protocol changes this time (low dose prednisolone, clexane, extra progesterone and PGT-A) so not sure if it was the sperm prep, the euploid embryo, or the changes for me, but something worked on attempt number 7.

@180monkeys I'm also pregnant now, 20 weeks! I hope me and @thislittlebird give you hope. It's taken us 3 years, 2 rounds of IVF and one miscarriage.

I think our ASA diagnosis was always borderline at 50/60%. They never wanted to say for sure that it was definitely the issue, because it's not a static thing. My AMH is low too. My partner was tested a few times and his ASA rate changed every time. He also gave a sample just after he'd had flu and all of his metrics were terrible - sperm seems to be very sensitive!

We had ICSI and got a very good fertilisation rate on both rounds using that.

Good luck!

@thislittlebird @countrypunk ah I'm so delighted to hear you are both pregnant! Congratulations!

thank you both for your replies it really helps hearing other people’s experiences and hopefully learning from them.

I feel like I’ve researched so so much and there’s still so much I don’t know! Is ICSI different to IMSI? I had always just assumed they do the semen sample at the same time as the egg collection is that not correct?

I got my AMH results back today and they were 28.3pmol/L which I think is fine but I’m not really too sure! All my other tests have came back ok, my thyroid was a bit high at 4.6 but I’ve been taking levothyroxine and it’s down to 2.1 now so hopefully that will be ok!

my husband has had 2 SA done and they came back IgG 100 both times and IgA 72 and 89 so they seem pretty consistent. I rest of the stats were much better the second time and the main difference was he had been taking wellman conception vitamins so we’ve kept using those

@180monkeys Thank you! Still can't quite believe it to be honest.

Your AMH sounds great to me. Mine was 3.6 at the last test - really quite low.

My partner had a sperm test before we started IVF. That's when the ASA was flagged. He takes levo for his thyroid like you so the doctor suggested increasing that and testing again, which he did. His second result was better. He also took a conception vitamin and CoQ10. He exercises a lot and eats pretty well. We were also told that he shouldn't have hot baths (because sperm are extremely sensitive to temperature) and that he should try and stick to a masturbation schedule! I think it was every 2 days, but can't quite remember. Google it!

I'm afraid I don't know anything about IMSI.

Wishing you loads of luck.

@countrypunk i know after trying for so long I imagine it doesn’t feel real!

Oh I will look into the CoQ10, I think the wellman vitamins already contain it. there’s just so many different factors to think about isn’t there! Did yous use a private clinic or NHS? We are on the NHS waiting list but think timings just seem so long.

@180monkeys We had our first round funded by the NHS but at a private clinic. So we were lucky and doing our first round within weeks of referral. Such a postcode lottery.

@countrypunk its crazy how much it can vary. We were told there’s basically no waiting lists here atm but it would still take nearly 18 months until treatment. We’re in Northern Ireland so not sure if we have less choice but have decided to go with TFP

Thanks @180monkeys ! I also can't believe it and it's quite an anxious time. Fingers are crossed the next few weeks go well!

So unlike @countrypunk we knew ASA would be the problem for us with natural conception, he has 100% ASA. I'm glad we worked out why the swimmers were refusing to swim. But we can't really say why we had to try 7 embryos to get this far, possibly our age (I'm 40 now), but we do manage to create decent embryos but implantation repeatedly failed. He had a fever before round 2 and it killed all the sperm dead, so what was used was crap and the 3rd and 4th embryos transferred were very poor and the clinic said the sperm was very poor. Lesson learned, next time we tested his sample weeks before the 3rd egg collection to make sure it was ok and wouldn't end up like the second attempt.

ICSI is the process of injecting the sperm they select into the egg. IMSI is the method they use to select the sperm at some clinics, not all of them have an IMSI microscope. Our clinic, Lister, does have an IMSI microscope and this was our best cycle when using the microscope. First NHS round was 4 embryos, second private round was disastrous and we got 2 embryos (not blasts) because of his fever, and third round resulted in 5 embryos, and one of those is working. So maybe using a much more powerful microscope helped them pick the ones that weren't so damaged, stuck together, dead etc.

When they take the sample depends on the clinic. For example, on our second round we checked into the private hospital room at about 10am. By 10.45am they called him down to give the sample and then I didn't go down to theatre until about 2pm, something like that. We had the clinic analyse his sperm after this round and an embryologist called us and said they can see 100% ASA and for the next attempt the sample should be as near to EC as possible. We then arrived at the clinic for round three and there we are in the room and this time the lab manager called me in the room and said this is the plan, we won't call him yet and it will be nearer the time of your EC. She was very helpful, and maybe it doesn't make a great difference but when the sperm are all clumping together in the pot, it makes sense to me to get to prepping them ASAP. I would be tempted to ask your clinic what their procedures are for prepping ASA sperm.

28 is good! How old are you now? Mine was 36 when I started but I was 'only' getting 10-15 eggs each time, even though I technically have a lot more in there. The vitamins for men definitely do help. We saw an andrologist who recommended Impryl for DH and it did seem to help. He also took Omega 3 and Coq10. We also had a regular masturbation schedule for him, it was every day or every other day, and a shorter abstinence period before the day of the IVF sample.

I did an NHS round for the first cycle, then a private for the next two because I only had one NHS round where I live. It was very slow, and I have some regrets about not doing private while I waited for the NHS (which was allowed in my CCG). We went round the houses back and forth between the NHS and private because the NHS basically told us there was nothing wrong (lol) and refused to refer us. I started the GP testing process in summer 2020, was referred to gynae in May 2021 and had a dreadful experience with the woman I saw. I ended up having to see a private specialist in June 2021 to get a letter to take to my GP saying they'd got it wrong and we evidently did need intervention. I took the letter to my GP in July 2021 and he referred me when the gynaecologist we saw in May 2021 refused to. Funding came through quite fast, and I saw the clinic for the initial meeting in August 2021. I then had to wait from August 2021 to January/February 2022 from our first meeting to start our first round with Guys. It was a bit of a joke tbh, an expensive, 4-year very bad joke.

I have heard there are longer waits in NI, I wonder if it's because there's fewer clinics? Not sure.