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About Edward Joseph Ramirez, MD, FACOG
Expertise
I am a specialist in infertility and advanced gynecological care. I can answer questions about infertility, gynecology related ills, menopause...virtually anything that affects women's health. PLEASE tell me where you are writing from as I am always interested.

Experience
I have been practicing as an Ob/Gyn and Infertility Specialist for over 23 years. Gynecology, advanced laparoscopic surgery, basic infertility, IUI's, IVF, reproductive surgery, and ovulation induction are all areas of my expertise. I am Board Certified. I have been doing In Vitro Fertilization in my clinic for 15 years.

Organizations
American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, Society of Assisted Reproductive Technology, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists,Resolve-National Chapter, Open Path - Northern California, Board of Directors Monterey Medical Society

Publications
American Journal of Obstetrics and Gynecology

Education/Credentials
Medical Degree from Stanford University, Residency at Tripler Army Medical Center, Reproductive Training at Pacific Fertility Center, San Francisco

You are here: Experts > Health/Fitness > Women's Health > Infertility/Fertility > infertility

Infertility/Fertility - infertility

Expert: Edward Joseph Ramirez, MD, FACOG - 11/4/2009

Question

my husband and I have been trying to concieve for 2.5 years been to infertility doctor and have discovered my husband has tapered sperm with 1% morphology but has a sperm count of 79 million with motility was very high can't remember the exact number. I dont' ovulate reguraly have discovered that as well. what are the chances of pregnancy with IUI with these problems and taking clomid? I dont' want to get my hopes up for failure. even though they pick all the good ones out and inject them into my uterus will the chances increase? or is this tapered sperm problem to big for IUI? any information will help greatly. I have tried to search tapered sperm on the internet and get a bunch of meaningless stuff and nothing answers my questions about tapered sperm and iui. we are preparing to do IUI this month I take clomid tomorrow. Please help
Trisha

Answer
Hello Trisha from the U.S.,

There is a chance that IUI could work, but it is not a good chance with the morphology problem that your husband has. With IUI, the sperm are washed to remove the semen but not to isolate the good sperm. That can only be done with IVF and ICSI.

I would recommend that you consider IVF with ICSI as the treatment of choice. That would give you your best chances of pregnancy and is the only way that "good" sperm can be chosen to inject into each egg. Again, IUI does not do this.

Despite a sperm count of 79 million, only 1% are normal i.e. 790,000. This is insufficient numbers for the IUI to work. That is why ICSI is the treatment of choice. With ICSI, you only need as many normal sperm as the number of eggs.

Does your infertility doctor do IVF? If so, why is he recommending IUI instead of IVF with ICSI. If he does not do IVF, I suspect he is recommending IUI because that is the only level of care he can provide. In your internet search, you might want to try "abnormal sperm" or "abnormal sperm morphology" as your key words in the search.

I hope this helps,

Sincerely,

Edward J. Ramirez, M.D., FACOG
Executive Medical Director
The Fertility and Gynecology Center
Monterey Bay IVF Program
www.montereybayivf.com

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on facebook and twitter with me at @montereybayivf

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