Does a 100% abnormal sperm morphology preclude pregnancy?
October 15, 2018 8:56 AM   Subscribe

My son and his wife have just had the results of a semen analysis, and my son has a 100% abnormal sperm morphology. Everything else about the analysis was normal. They are very upset and if possible, I'd like to be able to tell them there is some reasonable hope of conceiving children.

They will be consulting a specialist within the next six weeks, but I know that waiting will be very difficult for them, especially for my daughter-in-law. What options might there be for them?

Of course adoption is an option, but I think they'd like to pursue other options first.
posted by angiep to Health & Fitness (11 answers total) 1 user marked this as a favorite
I can't speak to your question directly, but I can speak to the experience of infertility. Everyone and their dog was trying to tell my husband and I about how this one person stood on their head in a rainstorm on a cliff eating gummy vitamins and they had our exact same problem and they now have 8 beautiful children, or whatever. Or forecasting doom. Or trying to reassure us things would be fine, or tell us to get used to things sucking. Or sending us links to international adoption agencies with comments about all colours of the rainbow.

It's so great that you are wanting to be supportive and I am sure that your heart is in the right place and that they are lucky to have you on their side.

Unless directly asked, I would recommend letting them do their own research at their own pace, and if I were speaking to them, I would recommend they start by toughing out the 6 weeks and speaking with the reproductive endocrinologist or whomever they are seeing who is most familiar with their case.
posted by warriorqueen at 9:06 AM on October 15, 2018 [39 favorites]

Mayo Clinic: However, having a large percentage of misshapen sperm isn't uncommon. In addition, morphology alone doesn't indicate if you are fertile or not.

I know someone with abnormal sperm who had two children after fertility treatment, but I don't know details, so it might be something different.
posted by FencingGal at 9:08 AM on October 15, 2018

This study seems fairly hopeful even without fertility treatment:

Not the best, but looks like about a quarter of men studied with 0% normal sperm went on to conceive without any medical assistance.
posted by Rock 'em Sock 'em at 9:15 AM on October 15, 2018 [1 favorite]

There are options for them to conceive a child related to both of them, including ICSI (Intracytoplasmic sperm injection). There also is sperm donation, which is very different from adoption (or even egg donation) in terms of complexity; it has its own emotional issues.

What their options are will depend on their specific circumstances and (obviously) their specialist would be best able to advise them.

One thing that is for sure (from someone going through a similar process): there will be lots of waiting. No matter what happens, even if everything works perfectly, there is waiting and waiting and waiting. I've found Belle Boggs' book, The Art of Waiting, really helpful - it's not advice, it's just her story and thoughts on children and fertility and waiting.
posted by jb at 9:17 AM on October 15, 2018

Sorry, just in case it isn't clear: ICSI is useful when the sperm has an abnormal morphology and/or motility issues, but is otherwise healthy. It's just like IVF, except that one of the best looking sperms is inserted directly into the egg.
posted by jb at 9:19 AM on October 15, 2018

I'm with warriorqueen on this. I assume you are coming from a place of wanting to be supportive and lessen their pain, but sometimes the best thing you can do for a family member going through medical issues, is sit with them and help them hold their grief. (Even if conception is in their future, as some of those studies and anecdata imply, that doesn't lessen the grief they may be feeling right now.) That's a role that their doctors and nurses aren't going to be able to do, and I imagine it's something they both really need right now.
posted by basalganglia at 9:32 AM on October 15, 2018 [11 favorites]

From what I gather, 94-96% abnormal morphology is... normal. So he doesn’t need much!
Also I’m sure they didn’t look at all 10M swimmers, there’s got to be a few regulars in there.
Finally the criterial for normal morphology is really tight. Head too oval? FAIL. Not oval enough? FAIL. Etc.
posted by St. Peepsburg at 9:36 AM on October 15, 2018 [2 favorites]

I've been through IVF, and although it's hard to say 100%, it seems likely that our infertility as a couple was attributable to me (i.e., male factor).

Your son got this test for a reason. If that reason is because the couple have been trying to conceive and have been unable to do so, then there are really only two options: keep trying and hope it works out (and sometimes it does), or get medical intervention. With medical intervention there are very good odds that the couple can conceive if his sperm are viable. If they are young and have time they can do both (if they need to).
posted by OmieWise at 9:46 AM on October 15, 2018

They are very upset and if possible, I'd like to be able to tell them there is some reasonable hope of conceiving children.

My wife and I had some minor fertility issues (we had one child through medical intervention and, after being told that we would be unable to conceive naturally, had another child the old-fashioned way) and when we were trying we really, really didn't want anyone to tell us that things would work out that there was a chance, etc. This hurt in two different ways. First, yes, we know there is a chance. Thanks for making us think about the low freaking odds again. Second, thanks for making us feel that if we don't have a kid that it is, once again, our fault. Other people managed, but we didn't.

I know you aren't trying to do that and that you are coming at this from a place of love, but maybe your best bet is to offer general emotional support and leaving it at that.
posted by It's Never Lurgi at 10:26 AM on October 15, 2018 [5 favorites]

Thank you all for your input and advice. I will absolutely restrict myself to general emotional support and love, and not go down the road of specific advice, which, in fact, I am completely unqualified to offer.
posted by angiep at 11:22 AM on October 15, 2018 [12 favorites]

Your update fills my heart with happiness. That is just what I would want in their shoes. Also, it's really great to emphasize that you (and they!) are a family already. Maybe they'll have bio kids, maybe they'll adopt, who knows? But it sure feels good to hear someone tell you that you are enough.
posted by annaramma at 3:14 PM on October 16, 2018

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