QuestionDr. Ramirez,
I was hoping to get your thoughts on the chances of a successful IUI with low morphology. My husband's morphology is low (0%). My RE suggested that we try a cycle of Clomid with IUI. What are your thoughts on this? With such low morphology, what are the success rates? What are your thought on ICSI with low morphology?
Additionally, I am taking Crione due to a short luteal phase. This has increased my luteal phase from 10 days to 13 days. Is this something else that I should worry about?
Any insight would be greatly appreciated.
Thank you
Dina from Boston
AnswerHello Dina from the U.S.,
0% is not a "low" morphology, it means there are NO normal sperm. IUI will NOT work if there are no normal sperm. In fact, with this finding, IVF with ICSI would be the best treatment if some normal sperm can be found either through an ejaculated specimen or via testicular biopsy (TESE). If there are no normal sperm at all, then donor sperm would be the only possibility. If normal sperm can be found, then ICSI can be done and the pregnancy rates should be very good depending on your age. Make sure that the semen analysis is repeated at least once to verify that there are no normally formed sperm. If the repeat semen analyses confirm this, then you should see a reproductive urologist, a urologic sub-specialists that specializes in male infertility. There are only a few of these around the country so you might have to go to a University to find one.
A short luteal phase is called a "luteal phase defect" and the problem is that it will interfere with implantation. The endometrial lining will not be in the proper phase for embryo implantation to occur. Other than that, it is not a problem. Most fertility treatments will correct this, but either correcting the hormonal balance or with supplemental progesterone such as Crinone.
Good Luck,
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 twitter with me at @montereybayivf and facebook @montereybayivf
