Dr Ramsay - 0% Morphology / ICSI

[Pomegrat100]

Hi all, we have been seeing Dr Ramsay following 2 years of trying and after lots of test it shows my husbands sperm Morphology is 0% - so 100% abnormal morphology :-( the other results seem fairly normal although we are still waiting for DNA frag tests results to come back and an ultrasound - we are then seeing Dr Ramsay again in 4 weeks time.

My question is, has anyone got any positive experiences with Dr Ramsay helping with morphology issues? I am hopeful we will be able to have ICSI- if it comes to it, does Dr Ramsay suggest IVF clinics to you or does he do the IVF process himself? Does anyone know the names of the clinics or hospitals he recommends?

thanks so much in advance!!x

Hello, I am truly sorry to hear that you are experiencing this. While I can't offer personal experiences, based on what I know, he is one of the best experts in infertility. If you're interested in exploring clinics he recommends, you can check out sites such as eggdonationfriends or fertilityclinicsabroad, which feature top IVF clinics globally. I hope this helps.

Hey @Pomegrat100 good luck with your appointment.

I caveat this with I am not a doctor but my husband has issues with sperm so we also saw a wonderdul urologist who was amazing and helpful. I know how exhausting and terrifying this situation is so wanted to share what we were told. Obviously they may not apply in your case but if helpful have included below.

Couple of things mentioned that seem to be received wisdom are:

• progressive motility is a more important stat than morphology.
• 0% morphology with a reasonably high spern count doesn't necessarily mean no 'good' sperm (can just be less than 0.5% which is still quite a few sperm if count is normal, my husband has a very low sperm count and 2% morphology so you may have more sperm than us and we have been advised as good candidates for ICSI!)
• we were advised not to pay for fragmentation testing as it would show problems and what would we do differently based on this (generally sperm with lower parameters will show it, my husband's situstion may be super different but that's what we were told!).
• the two IVF clinics in London they recommend for MFI are King’s and CRGH as they focus more on this area. We were lucky to qualify for NHS funding to King's and so far the process has been super smooth.

Wishing you all the best and lots of baby dust x

Are there any updates on this thread? Myself and my partner are in the exact same position, thinking about seeing Mr Ramsay and would love to hear how you got on! Xx

Hey @OneHeapedTeaspoonOfSugar we saw Dr Pippa Sangster for a sperm issue in May last year, very low sperm count with all round sub optimal parameters.

We did all the tests and found nothing so we took a lot of supplements and focused everything on sperm/egg quality before going for ICSI at Kings's Fertility in October (funded NHS IVF - there was no wait list because of the severe sperm issue and we pushed to go there as they specialise in male factor infertility) and we were super lucky it worked (sperm quality was a little improved although still very low) and our much longed for baby is due any day now 😀

I hope this update is helpful x

Hi @TheFanciestPants may I ask a bit more about your request to go to kings. Background on our situation , my partner has been diagnosed with severely low sperm count and we are waiting to see a urologist specialising in MFI. We most definitely will be needing ICSI but are concerned with the numbers we have that getting quality embryos will be an issue. We are in the south east (Kent) but London will prob not be one of the first they offer us via IVF. Are you allowed to request one that is out of area if you have a specialist issue? Also how long from GP referral to gynocology to then IVF did you have to wait ? I didn't realise if there was specific issues then there isn't a wait as such ? any information would be great at this point as we are completely clueless and starting at the beginning of what seems a terrifying journey 😩

Sure @Anniekent1 . Sorry you find yourself here. It's a horrible situation to be in. We actually had a miscarriage before we got the sperm tests so we really weren't expecting the sperm results to be so bad (sort of funny as there's basically 0 chance of us conceiving naturally). We paid to see the urologist privately I think around £2k for everything so that cut out about a year of wait times. She suggested King's or CRGH were good for MFI so that was really helpful. She also said MFI has really good IVF success and was super helpful and positive on our chances so I wanted to share that too!

I then asked my GP for a King's referral (this has to be done via the female partner). The admin staffed mucked it up and sent me an appointment for St Thomas's. So I had a call with the head of the practice who agreed it made sense to go to King's (as they are an MFI specialist centre). As it's a known reason of infertility you should be able to get an IVF referral straight away and at the time King's didn't have an IVF waitlist.

The referral was sent beginning of June and because we had all of our ducks in a row on the sperm side we were able to start asap after our appointment in August. I understand the King's sperm selection equipment is better than most other centres (think they use AI!) and we had an amazing embyrology experience. Especially given our sperm parameters are terrible - on the day of egg collection we got 100k sperm which is pretty low, but the motility was almost up to normal levels.

If you want our stats, we got 7 eggs, 4 mature, 3 fertilised. 3 symmetrical 8 cell embryos at day 3 (sperm quality drop off of embryos is after day 3) and ended up with 2 AA top quality embryos, one at day 5 and one at day 6 and one poorer quality embryo that they didn't recommend freezing (King's are stricter on what to freeze relative to other clinics). So we successfully transferred the day 5 and the day 6 is in the freezer. We also froze 10 vials of my husband's sperm in case we need it for the future as MFI can get worse with age so always worth thinking about that too!

Hope this helps, let me know if you have any questions.

Hi @TheFanciestPants thank you for replying so quickly. And congratulations on your success story it's always so positive to hear when someone has had a struggle but had a happy ending

Ahh think we have already. Even referred to a clinic by our GP And it's not kings as didn't realise we could specify. Although I would imagine being Kent based we wouldn't be allowed to have it there ? I do worry that NHS just do a one size fits all round but we have a very specific and challenging case. I can't believe kings did not have a waiting list that is ver lucky ! Can you see before hand if clinics have waiting lists.

That's really good news you also have an embryo in the freezer for future use. I hope also that goes well for you. We will definitely try to advocate and push for some support in making sure we make the most of our round whatever happens

Thank you for your kind wishes @Anniekent1 ! You can normally check on the clinic's website or email a clinic to ask about waiting times (it does seem to vary a lot). If you have had a referral but not an appointment yet you can certainly talk to your GP about what is possible. I would suggest asking to talk to your practice manager as they will be best placed to advise on their referral protocol. Generally MFI has good IVF success rates relative to other issues so it may be that your clinic's protocol works well anyway! But definitely feel empowered to ask as many questions from whomever you need to, to make an informed decision and don't worry about being a pain (I definitely was! 🤣).

One thing I learnt during the process is to advocate for yourself all the time and don't assume things aren't possible just because one doctor or admin staff member is negative.

I wish you all the luck in the world with your IVF journey and if you have any more questions etc happy to answer.

Hi @TheFanciestPants oh you have been so lovely and reassuring. And I envy the positivity. Wish I could be a bit more like that, I always assume the worst and boy with this diagnosis you can definitely research the worst!
We might go back to the GP and just at least see what she can do. She was very sympathetic in our first appointment so if she can do something it might be better to nip it in the bud sooner rather than later. Problem is getting a gp takes weeks now 😅

Thank you I do appreciate your kind words. Might have to reach out to you again before too long ! Your advice have been invaluable
Have a lovely weekend!