0% morphology advice

[Eirlys75]

Hi, We've recently had my DH's SA back, which showed 36mil count, and 0% morphology. In July, he had a 10mil count with 2% morphology, so there's been an increase in count, but it decreases with morphology.

We're confused about what to do. We've booked to see a private urologist tomorrow to talk about varicocele removal, but a few days ago the IVF clinic that we had been waiting for, called us as were now at the top of the waiting list (typical timing). They've booked us in for the 11th of March to run some tests and get us started.

I had a super early chemical pregnancy 13 months ago (like 2/3 days late for my period), and I've recently had a blighted ovum at 8 weeks at the end of November. Had medical management for that.

I know there's always a risk, but I don't want to go through IVF with an increased risk of miscarriage due to poor morphology. Equally, I know a varicocele removal takes 3+ months recovery. I've read more about 6+ months before IVF would be considered, and I'm unsure whether my IVF clinic will wait that long. Where I'm based, we only have 1 full round of IVF.

I'm wondering if anyone has any experience of this? I'm debating whether to:
A. Postpone IVF, pay privately for varicocele removal (£5k+) and risk losing our funded IVF.
B. Go through with IVF, risk embryos failing due to poor sperm quality or miscarriage.

I know that I'll get a better idea after speaking to the urologist and the IVF clinic, but it's all I can think about, and the IVF appointment is still quite far away.

Any advice greatly appreciated!

Non fertilisation or non progression to blastocyst would usually be more likely outcomes than miscarriage. However in light of your loss history it's worth checking the expert's view tomorrow.

Unless you are about to cross an age threshold, I don't see why you would lose your funding if your partner pauses for treatment. You could still go ahead with initial tests.

Thanks, but actually after speaking to the specialist yesterday, he's advised IVF. Varicocele removal wouldn't necessarily improve morphology, apparently.

@Eirlys75 you can always get your partner on a cocktail of supplements. Mine had vitamin C, D and E 3 months before he gave his sample and it was the best it had been on the day apparently. He also stopped drinking and kept fit and healthy xx

Thanks, I really appreciate your response. My husband is on impryl, so you're supposed to limit the amount of other vitamins with this! Only recently started taking them.

Yeah, neither of us drink, we're both fit and healthy; exercise often, and my husband is a big old food snob. Refuse majority UPF (ultra processed foods), lots of leafy greens, walnuts, seeds and pulps, selenium, avoid dairy, vegetarian (that's just our preference)..

Fingers crossed the impryl will make a difference, as I'm honestly lost with what else we could do!

@Eirlys75 sounds like you are absolutely on it. That's a really solid start. I have everything crossed that this works for you 🥰 xx

Saha results also improved with lose boxer shorts and stopping cycling.

Ultimately ICSI is probably the way to go. As long as count is ok and morphology isn't zero they should be able to get good sperm.