Thank you for your query. Your ages are not a factor. 35 for females and 40 for males seems to be the amber light. I note you have only been trying for 8 months, do not forget the time is important and at your sort of ages most would not yet be going for active further investigations and treatment. As 80% of couples like you conceive within the first year of trying and of those remaining another 50% conceive in the 2nd year. I am saying this despite your worries about semen analysis results which I personally feel are not that bad. There are different types of low morphology so I would have to know what his problem is before making further comment and also there can be simple explanations for this such as a varicocele. However as the topic has been raised to put your minds at rest I think it is wise at this stage for you to consult with an expert in the area whilst of course still trying to conceive under your own steam for you do not want I am sure to rush into considering ICSI at this stage which would be the most likely way forward.
We've reached 1pm so please no new questions. Prof Harrison has agreed to answer as many questions as possible that have already been posted, however. Many thanks for all your queries and a big thank you to Prof Harrison for his extremely authoritative replies. It would be lovely to welcome the Prof back another day if he can make time in his schedule! Web Ed Nicola
[Modified by: webeditor on August 24, 2009 01:17 PM]
Thank you very much for your query. Really the best place to answer your queries (is the hospital that you and your husband are going to for ICSI) for unless you understand exactly what is going on you will not be able to give true informed consent. In general terms however based on my own clinic here we realise that nobody knows what a normal sperm looks like but we assume a certain shape and size is correct and that if it moves it can be used. Indeed even if it does not move but looks okay some clinics as a desperate last measure would use such a sperm. Ask your clinic what their minimum criteria for ICSI are on the day.
In terms of your cycle being irregular this is not a particular problem in IVF or ICSI as except in a few centres where natural cycles are used control is taken over your ovarian stimulation by the drugs. Again the clinic you are going to will be able to explain all this. Hope this is what you are requiring and you never know maybe you will get pregnant whilst waiting.
While I am not a great advocate of alternative therapies I have to say that in our own unit we tried out a wrist bead which when put on the wrist pressure point (Neguain, the No. 6 Meridian point on the Pericardial channel) relieved pelvic pain after egg collection better than a sham control. Additionally a study elsewhere at embryo transfer but not confirmed elsewhere showed a positive effect with the odds of pregnancy increasing by 65%. This was interpreted as meaning that 10 women need to be treated with acupuncture to give one additional pregnancy.
I think acupuncture to me is best summed up as employable in situations best described as placebo responsive a term which definitely includes infertility.
Realistically anything that can help improve your lifestyle can have a positive effect on your health but not necessarily increase your chances of having a pregnancy.
Sorry to learn of your problems and the two miscarriages you have had. The definition of habitual miscarriage classically is three consecutive miscarriages but some authorities do consider after two that tests should be carried out. I am sure if something was suspected the IVF clinic you attended would have dealt with this. As it is only 3 months ago why not go back to your clinic and discuss your worries with them. However I should warn you that in the vast majority of cases no abnormality is found. Early losses can suggest a chromosome abnormality (4-6 weeks) and later 12+ weeks a uterine or cervical problem but generally nothing is found.
Best of luck and do go back and talk to your clinic.
Thank you for your further information. I really to feel at this stage you and your husband need to consult his specialist again for I would have hoped there should have been some response at this stage. Certainly following radiotherapy and chemotherapy sperm can return at a later date spontaneously but as he has had his pituitary removed as well this is unlikely to happen and hence his need for hormone therapy which statistics say in his situation works in up to 30% and usually within the first six months or so. If the radiotherapy was total body radiation as opposed to directed at pituitary his testes could also be affected. Again I would recommend him going back to his specialist or mentioning it at his next check-up.
I very much enjoyed this my first every webchat and I look forward to more in the future, if the opportunity arises. Meanwhile however I hope I have been able to answer all your queries but in case I haven't please note from the 10th September my book "The Smart Guide to Infertility - Myths and Reality" published by Hammersmith Press ISBN 978-1-905140-23-7 will be available. This book covers comprehensively the whole of infertility (not just IVF) and will I hope provide a reference guide to help those in need.
Thank you again for all your queries and I hope I have been of some help to you.
Replies
Thank you for your query. Your ages are not a factor. 35 for females and 40 for males seems to be the amber light. I note you have only been trying for 8 months, do not forget the time is important and at your sort of ages most would not yet be going for active further investigations and treatment. As 80% of couples like you conceive within the first year of trying and of those remaining another 50% conceive in the 2nd year. I am saying this despite your worries about semen analysis results which I personally feel are not that bad. There are different types of low morphology so I would have to know what his problem is before making further comment and also there can be simple explanations for this such as a varicocele. However as the topic has been raised to put your minds at rest I think it is wise at this stage for you to consult with an expert in the area whilst of course still trying to conceive under your own steam for you do not want I am sure to rush into considering ICSI at this stage which would be the most likely way forward.
Very very best of luck.
Prof. Harrison
Many thanks for all your queries and a big thank you to Prof Harrison for his extremely authoritative replies. It would be lovely to welcome the Prof back another day if he can make time in his schedule!
Web Ed Nicola
[Modified by: webeditor on August 24, 2009 01:17 PM]
Thank you very much for your query. Really the best place to answer your queries (is the hospital that you and your husband are going to for ICSI) for unless you understand exactly what is going on you will not be able to give true informed consent. In general terms however based on my own clinic here we realise that nobody knows what a normal sperm looks like but we assume a certain shape and size is correct and that if it moves it can be used. Indeed even if it does not move but looks okay some clinics as a desperate last measure would use such a sperm. Ask your clinic what their minimum criteria for ICSI are on the day.
In terms of your cycle being irregular this is not a particular problem in IVF or ICSI as except in a few centres where natural cycles are used control is taken over your ovarian stimulation by the drugs. Again the clinic you are going to will be able to explain all this. Hope this is what you are requiring and you never know maybe you will get pregnant whilst waiting.
Best of luck.
Prof. Harrison
While I am not a great advocate of alternative therapies I have to say that in our own unit we tried out a wrist bead which when put on the wrist pressure point (Neguain, the No. 6 Meridian point on the Pericardial channel) relieved pelvic pain after egg collection better than a sham control. Additionally a study elsewhere at embryo transfer but not confirmed elsewhere showed a positive effect with the odds of pregnancy increasing by 65%. This was interpreted as meaning that 10 women need to be treated with acupuncture to give one additional pregnancy.
I think acupuncture to me is best summed up as employable in situations best described as placebo responsive a term which definitely includes infertility.
Realistically anything that can help improve your lifestyle can have a positive effect on your health but not necessarily increase your chances of having a pregnancy.
Kind regards
Prof. Harrison.
Sorry to learn of your problems and the two miscarriages you have had. The definition of habitual miscarriage classically is three consecutive miscarriages but some authorities do consider after two that tests should be carried out. I am sure if something was suspected the IVF clinic you attended would have dealt with this. As it is only 3 months ago why not go back to your clinic and discuss your worries with them. However I should warn you that in the vast majority of cases no abnormality is found. Early losses can suggest a chromosome abnormality (4-6 weeks) and later 12+ weeks a uterine or cervical problem but generally nothing is found.
Best of luck and do go back and talk to your clinic.
Prof. Harrison
Thank you for your further information. I really to feel at this stage you and your husband need to consult his specialist again for I would have hoped there should have been some response at this stage. Certainly following radiotherapy and chemotherapy sperm can return at a later date spontaneously but as he has had his pituitary removed as well this is unlikely to happen and hence his need for hormone therapy which statistics say in his situation works in up to 30% and usually within the first six months or so. If the radiotherapy was total body radiation as opposed to directed at pituitary his testes could also be affected. Again I would recommend him going back to his specialist or mentioning it at his next check-up.
Best of luck.
Prof. Harrison.
I very much enjoyed this my first every webchat and I look forward to more in the future, if the opportunity arises. Meanwhile however I hope I have been able to answer all your queries but in case I haven't please note from the 10th September my book "The Smart Guide to Infertility - Myths and Reality" published by Hammersmith Press ISBN 978-1-905140-23-7 will be available. This book covers comprehensively the whole of infertility (not just IVF) and will I hope provide a reference guide to help those in need.
Thank you again for all your queries and I hope I have been of some help to you.
Many thanks.
Professor Robert. F. Harrison.