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Infertility/Fertility/100% abnormal sperm morphology

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Hi,



I am 35 ys old from Libya, TTC for 6ys now and all of my SA refere to 100% abormal shpe, my last one was:

Conc.:  5.26 M/ml          18.40M/sample          Volume: 3.5 ml

Motility :

Progressive(PR):          12.5%          Rapid progressive ( type A)        0.00%

Non-Progressive:        18.75%          Medium progressive ( type B)  12.5 %

Motile:          31.25%          Non-progressive (type C)          18.75%

         Immotile (type D)          68.75%

Morphology:

Head Defects 100%



Alive 31.25          Dead: 68.75%

Morphologic values          total          percentage

Micro          1          100

Amorhous          1          100

Normal acrosome          1          100

Normal midpiece          1          100

Normal tail          1          100



my wife is 30ys, and we did a failed ICSI last year, now the physician told as its impossible to get baby with ICSI with this 100% abnormal shape, and advise as to go abroad specially Belgium b/c they have more advanced technique than here.



My question, is it possible to get baby with ICSI, or it is better to try IMSI, and what's the succes percentage for both way with my SA result?



Lastely, do you have any information about successive center in dealing withmy case in european countries?





Thank you

Answer
Hello,

You have three major abnormalities on your semen analysis:
1.  Your count is only 5.26 Million (normal is >20 Million)
2.  Your motility is only 31.25% (normal is > 50%)
3.  You morphology is 0% (normal is >3%)

Based on these findings, your only options are (1) use donor sperm or (2) IVF with ICSI.  Before doing the IVF with ICSI, you need to be sure that normal sperm can be found.  I would recommend that you see a Urological infertility subspecialist such as Dr. Paul Turek in California, USA.  These are NOT general urologist, just as I am NOT a general Ob/GYN doctor.  We have additional training in infertility which makes us sub-specialists.  It may be possible for normal sperm to be extracted directly from the testicle using TESA.  If, and only if, normal sperm can be found, then IVF/ICSI with your own sperm is possible.  IF not then donor sperm is the only option.

I'm sorry but I do not know any of the IVF centers in Europe.

Good Luck,

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

Monterey, California, U.S.A.

for additional information check out my blog at http://womenshealthandfertility.blogspot.com check me out on twitter with me at @montereybayivf and facebook @montereybayivf.  Skype and internet comprehensive consultations now available via my website for those who want a more extensive evaluation that this site can accommodate.  I also now provide an Email Concierge Advisory Service with a 1 year subscription for patients that want easy access to me to answer questions along their journey (women's health, infertility, pregnancy).  Contact me at ejrmd@montereybayivf.com if you are interested in continuous access to me.

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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 19 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, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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

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