Why we may not be "unexplained" after all...

rachel_va · 06-28-2006, 02:13 PM

We did a couple of IUI's that failed and switched to IVF. One of the tests that the RE requires before starting IVF is a Kruger morphology test. Although DH's SA was normal for count, motility and morphology under the WHO standard SA the Kruger showed signifcant abnormality with morphology. Our RE is convinced that is why we have been unable to get pregnant on our own and tells us with our Kruger count as low as dh's was, IUI is not recommended and we will need to do IVF with ICSI (sperm injection).

Even if dh's WHO SA is normal, you might consider asking your RE for the Kruger test. It is a few hundred dollars but was worth it for us.

Familyof2 · 06-28-2006, 08:31 PM

Wow. I didn't know there were different tests. I'll have to talk to my RE about it if this IUI fails.

glendag · 07-13-2006, 03:54 PM

I agree with Rachel.....We also were unexplained after several failed IUIs, until my Dh took the SCSA which tested the DNA fragmentation. It turned out the my dh's results were very poor, so our RE recommended that we move straight to IVF with ICSI.....We are planning to start our first IVF in August when my natural cycle starts.

thunderbird · 07-15-2006, 01:48 PM

So Rachel, after reading some of your posts and info, I went to my RE's office and asked the NP there what was up with my DH's morph because it was 8% Kruger, and my RE had said the SA was 'fine' when we went to see him.
The NP admitted it was a little low on the morph (and numbers - it's 51.9mil), but that they try IUI on everyone with Kruger morph >5% in their clinic.
I'm a little concerned, but my RE said that if 2 IUI didn't work, he'd refer us to IVF anyway.
Still, doesn't sound like what your RE office said.

rachel_va · 07-17-2006, 04:25 PM

Thunderbird:

I've heard of people (on this board) getting pregnant with IUI and Kruger above 5%. Ours is 5% so we think our IUI's were a waste of time and wish we'd done the Kruger morph as part of our initial infertiility workup instead of just the WHO SA. There are so many costs and our insurance doesn't cover anything so sometimes you skip the "elective" tests. I won't make that mistake again.

8% is not as bad as 5% but you are right, it is below normal. Do you have insurance issues? Sometimes they require IUI before moving to IVF. We're also in a hurry ...
Best of luck to you,
Rachel

thunderbird · 07-17-2006, 04:49 PM

IVF would cost a lot more than IUI, but it'll cost us that much no matter what order we do it in.
I got lucky, and before my OBGYN referred me to an RE (on my first appt with her) - she suggested I get the SA with Kruger done ahead of the first RE appt, and even specified which lab would do a Kruger.

Dufresne · 08-09-2006, 08:14 PM

Is the solution to a poor Kruger number to do IVF? We're trying to see if there are anyother tests that could help us find out our "unexplained infertility". We are on for our first IVF next cycle and am wondering if we should ask for the Kruger test or the SCSA test.

If the "solution" to bad results for those tests is IVF anyway...then I guess there is no sense doing them now.

macbrahmas · 10-30-2006, 12:54 PM

We had the same results. DH was tested using the WHO-ranges and semen analysis came out normal. But after 3 failed IUIs, we decided to swich REs. The new RE had DH test using the Kruger Strict criteria and his morphology was below the average. However, RE said that it's worthwhile to take the test again to confirm accuracy as sperm results can change from day to day. A recent study showed that sperm motility, and counts differed AMAZINGLY for monthly sampling over a year from the same guy. The only parameter that did not vary was the percent of morphologically normal sperm - the shapes.

rachel_va · 11-13-2006, 09:15 AM

All tests (HSG, FSH etc etc etc) were normal for me, although my lining is on the thin side, never above an 8. Dh's WHO SA was normal but Kruger was abnormal (5%). We were told with that Kruger #'s like that, IUI was a waste of time for us.

We are 30 weeks into a singleton pregnancy thanks to IVF/ICSI and a great RE at the SIRM clinic.

Rachel (38) & dh (35)
lining issues/mf
4 IUI's BFN
1st IVF BFN
2nd IVF ER but no ET (lining issues)
#1 FET BFP

Good luck to all the unexplained!

kmeizy · 01-11-2007, 12:38 PM

Hi all,
I just had my second FSH done and it came back at 5.5 which is DOWN from the 7.3 it was last year. Is this even possible? I thought the older you get the higher the FSH gets? Has anyone ever had this happen before? Do you think it's a mistake? Or do I have it backwards?
Thanks!

Karen

06-28-2006, 02:13 PM	#1 (permalink)
rachel_va 1000-4999 post queen of hearts Join Date: Mar 2006 Location: VA Posts: 3,177	Why we may not be "unexplained" after all... We did a couple of IUI's that failed and switched to IVF. One of the tests that the RE requires before starting IVF is a Kruger morphology test. Although DH's SA was normal for count, motility and morphology under the WHO standard SA the Kruger showed signifcant abnormality with morphology. Our RE is convinced that is why we have been unable to get pregnant on our own and tells us with our Kruger count as low as dh's was, IUI is not recommended and we will need to do IVF with ICSI (sperm injection). Even if dh's WHO SA is normal, you might consider asking your RE for the Kruger test. It is a few hundred dollars but was worth it for us.

11-13-2006, 09:15 AM	#9 (permalink)
rachel_va 1000-4999 post queen of hearts Join Date: Mar 2006 Location: VA Posts: 3,177	update/success ment. All tests (HSG, FSH etc etc etc) were normal for me, although my lining is on the thin side, never above an 8. Dh's WHO SA was normal but Kruger was abnormal (5%). We were told with that Kruger #'s like that, IUI was a waste of time for us. We are 30 weeks into a singleton pregnancy thanks to IVF/ICSI and a great RE at the SIRM clinic. Rachel (38) & dh (35) lining issues/mf 4 IUI's BFN 1st IVF BFN 2nd IVF ER but no ET (lining issues) #1 FET BFP Good luck to all the unexplained! Last edited by rachel_ca; 04-09-2007 at 04:33 PM.

01-11-2007, 12:38 PM	#10 (permalink)
kmeizy Registered User Join Date: Oct 2006 Location: San Diego Posts: 21	FSH going down? Hi all, I just had my second FSH done and it came back at 5.5 which is DOWN from the 7.3 it was last year. Is this even possible? I thought the older you get the higher the FSH gets? Has anyone ever had this happen before? Do you think it's a mistake? Or do I have it backwards? Thanks! Karen Last edited by kmeizy; 01-11-2007 at 02:18 PM.

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06-28-2006, 08:31 PM	#2 (permalink)
Familyof2 Registered User Join Date: Nov 2005 Location: TX Posts: 2,322	Wow. I didn't know there were different tests. I'll have to talk to my RE about it if this IUI fails.

07-13-2006, 03:54 PM	#3 (permalink)
glendag Registered User Join Date: Sep 2005 Location: Alabama Posts: 226	I agree with Rachel.....We also were unexplained after several failed IUIs, until my Dh took the SCSA which tested the DNA fragmentation. It turned out the my dh's results were very poor, so our RE recommended that we move straight to IVF with ICSI.....We are planning to start our first IVF in August when my natural cycle starts.

07-15-2006, 01:48 PM	#4 (permalink)
thunderbird 1000-4999 post queen of hearts Join Date: Jun 2006 Location: Bay area, california Posts: 1,731	So Rachel, after reading some of your posts and info, I went to my RE's office and asked the NP there what was up with my DH's morph because it was 8% Kruger, and my RE had said the SA was 'fine' when we went to see him. The NP admitted it was a little low on the morph (and numbers - it's 51.9mil), but that they try IUI on everyone with Kruger morph >5% in their clinic. I'm a little concerned, but my RE said that if 2 IUI didn't work, he'd refer us to IVF anyway. Still, doesn't sound like what your RE office said.

07-17-2006, 04:25 PM	#5 (permalink)
rachel_va 1000-4999 post queen of hearts Join Date: Mar 2006 Location: VA Posts: 3,177	Thunderbird: I've heard of people (on this board) getting pregnant with IUI and Kruger above 5%. Ours is 5% so we think our IUI's were a waste of time and wish we'd done the Kruger morph as part of our initial infertiility workup instead of just the WHO SA. There are so many costs and our insurance doesn't cover anything so sometimes you skip the "elective" tests. I won't make that mistake again. 8% is not as bad as 5% but you are right, it is below normal. Do you have insurance issues? Sometimes they require IUI before moving to IVF. We're also in a hurry ... Best of luck to you, Rachel

07-17-2006, 04:49 PM	#6 (permalink)
thunderbird 1000-4999 post queen of hearts Join Date: Jun 2006 Location: Bay area, california Posts: 1,731	IVF would cost a lot more than IUI, but it'll cost us that much no matter what order we do it in. I got lucky, and before my OBGYN referred me to an RE (on my first appt with her) - she suggested I get the SA with Kruger done ahead of the first RE appt, and even specified which lab would do a Kruger.

08-09-2006, 08:14 PM	#7 (permalink)
Dufresne Registered User Join Date: Jul 2006 Posts: 54	Is the solution to a poor Kruger number to do IVF? We're trying to see if there are anyother tests that could help us find out our "unexplained infertility". We are on for our first IVF next cycle and am wondering if we should ask for the Kruger test or the SCSA test. If the "solution" to bad results for those tests is IVF anyway...then I guess there is no sense doing them now.

10-30-2006, 12:54 PM	#8 (permalink)
macbrahmas Registered User Join Date: Oct 2006 Location: CA Posts: 20	We had the same results. DH was tested using the WHO-ranges and semen analysis came out normal. But after 3 failed IUIs, we decided to swich REs. The new RE had DH test using the Kruger Strict criteria and his morphology was below the average. However, RE said that it's worthwhile to take the test again to confirm accuracy as sperm results can change from day to day. A recent study showed that sperm motility, and counts differed AMAZINGLY for monthly sampling over a year from the same guy. The only parameter that did not vary was the percent of morphologically normal sperm - the shapes.