Infertility/Fertility/Normal ivf or icsi?


Hi I'm IK from Spore,
Please help to advise whether normal ivf is possible or it should be ivf with icsi?
My husband hba test result:
Progressive motility : 23L
In situ motility : 10
Agglutination : nil
viability : 58
Sperm concentration : 75.5
Round cells : 0.8
White blood cells : 0.1
Normal : 2 L
Head piece defect : 51
Mid piece defect : 19
Tail piece defect : 28 H
Normal motile sperm count : 0.347 L
classification : astheno teratozoospermia
% sperm bound : 56 L
survival test :
ph : 7.8
Debris : yes
Sperm motility %/ml : original 38, swim up 92, 24hr 75, 48hr 62, 72hr 40
Density (x10^6/ml): original 79, swim up 16
Normal forms : original 2, swim up 2


Hello Ng from Singapore,

I presume you are trying to second guess your doctor, that is don't trust his recommendation.  I am also presuming that you were recommended to have ICSI done with IVF, which is the correct recommendation.  ICSI with IVF is ALWAYS the recommended treatment when there is a semen analysis/sperm abnormality.  Not doing it risks that you won't have fertilization or will have poor fertilization.  If the eggs don't fertilize, then you won't have embryos.  Without embryos, the cycle is essentially over. . . no pregnancy.  Why would you want to take that risk?  In my clinic over 90% of patients elect to have ICSI, even when there is not male problem, just so that they don't risk fertilization failure.  I think that is wise.  I've seen too many cycles end without having a transfer simply because there was no fertilization.

Good Luck,

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

Monterey, California, U.S.A.

for additional information check out my blog at 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 if you are interested in continuous access to me.


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Edward Joseph Ramirez, MD, FACOG


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.


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.

American College of OB/GYN, American Board of Obstetrics and Gynecology, American Society of Reproductive Medicine, California Medical Association, American Association of Gynecologic Laparoscopists, Fellow of The American College of Obstetricians & Gynecologists

American Journal of Obstetrics and Gynecology, Wall Street Journal, Monterey Herald, SERMO, Women's Health and Fertility Blog

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

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