A possible explanation?

Hi ladies!  Things are moving along over here.  Only three more BCPs left!  I drew a big circle around the last one that I'm supposed to take so I can use it as a countdown.  I smile when I look at it each morning.

I just got off the phone with the IVF nurse after scheduling our appointment with the embryologist (for Monday afternoon) and giving my credit card number for THE payment.  (I'd pay by check but why not get the cash back on my Discover card? :) )

We also discussed the results of my DH's complete SA from Monday.

Their recommendation?

ICSI.

That's right.  My DH.  The one with "super sperm."  The one who Dr. Smiles told us had provided enough highly motile "happy" sperm during our first four IUIs for 20 women.  They're recommending ICSI.

The reason?  His total numbers, motility and density were good.  But, his morphology was below normal.  As was his HOST (hypoosmotic swelling test).

I know morphology can fluctuate, so it's possible something has changed over the past three years or so.  But, it's the HOST that I'd never heard before.  No one had tested that before for him but it appears to be a measurement that doesn't fluctuation with time for an individual. And, reading about it, it seems that a poor HOST score is an indication of DNA problems with the individual sperm that fail the test.  According to my research (because I've always wanted to read the Journal of Andrology), a low HOST score can lead to failure in natural TTC, IUI and even "normal" IVF.  Not because of low fertilization rates.  But, because of implantation failure.  In one study, the fertilization rate, # embryos transferred and embryo morphology were all the same between those with high and low HOST scores by normal IVF.  BUT, the pregnancy rate for those with high HOST scores was 50% while that for those with low HOST scores was 0 %.  That's a zero, folks.  The authors propose that there is some sort of toxicity involved -- possibly of the other sperm around the embryo.  One article even said that it was proposed that having unprotected sex before or after an IUI if you have this sort of issue could hamper the pregnancy rate.  (I don't know about your clinics, but both of mine were always telling us to have sex a couple of times after the IUI "just in case" we missed the ovulation window.)  They say that ICSI can alleviate those issues if only sperm that do not fail the test are chosen. 

Is it an explanation?  Could this be why this hasn't been working for us?

Could I be grasping at straws?  Yes.  But, all you "unexplained" ladies out there understand the excitement of a possible reason.  Even more so, a reason with a treatment.  Yes, there are inherent issues and risks (and costs) involved with ICSI.  Yes, it might still make it less likely to work.

But, this is giving me renewed hope that it's possible that this could work.  That doing IVF is actually a useful treatment and not just me throwing money at a problem.