A member asked:

I'm ttc wid 1tube open and hubby's semen analysis:total sperm 35mil,normal morphology 70%,pus cel 2-3,rbc 1-2.unable to conceive wat may be the cause?

A doctor has provided 1 answer
Dr. Dimitri Novitzky answered

Specializes in Thoracic Surgery

Trying to conceive): There are two components; the maternal and the paternal. Are you sure that you have ovulation ? and the ova is healthy,? That the hormones through the menstrual cycle are normal? for the implantation of the egg. On the other paternal side, the spermatozoa, must also be healthy, in morphology and motility. First once the sperm finding confirm that are normal, the second step is for you. It can be challenging with low morph because it makes it difficult based on the shape for the sperm to penetrate the egg. Kruger strict morphology testing is very helpful in predicting the fertilization capability of the sperm. For this test, freshly ejaculated sperm are smeared on a slide and stained using a morphology staining product for human sperm. Sperm are judged as normal based on the following criteria: Head must be oval in shape with smooth contours, 5-6 µm in length and 2.5 to 3.5 µm wide with the acrosome taking up 40-70% of the head. Neck and mid-piece must have no abnormalities and a cytoplasmic droplet (a remnant from sperm production) if present must not be larger than half the size of the head. Tail must not be coiled or bent and should not have a droplet at the end. After 200 individual sperm are counted at a magnification of 1,000 times, the percent normal forms is calculated. The prognosis is based on the following scale: >=15% normal: Normal range - Good prognosis 5-14% normal: Sub optimal range - Prognosis is fair to good, however, the lower the percent normal, the lower the chance of successful fertilization 0-4% normal: Poor prognosis - Will usually need IVF with intracytoplasmic sperm injection (ICSI) The Kruger strict morphology test can be highly subjective, therefore choosing a lab with extensive daily experience that can also correlate the results with fertilization in vitro is extremely important. Based on our experience we currently recommend a couple consider IVF with ICSI if the Kruger strict morphology is 5% or lower. Intrauterine insemination is often recommended for couples with Kruger results in the sub optimal but good prognosis range if there are no other factors that would prevent pregnancy.

Answered 5/22/2016

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