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  • "oliviaj22" started this thread

Posts: 1,051

Reg: Feb 24th 2009

Location: England

Children: NURTURE

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Tuesday, February 24th 2009, 1:53pm

question regarding ASA

Hi SS,

WE have been TTc for 2years and my DH has just been diagnosed with 86% ASA, IgG and mainly binding to the head; we have been offered ICSI. (everything else is normal, counts, motility etc)

Do you know about the probability of a natural coneption with this sort of diagnosis, i.e. are we probably subfertile as apposed to infertile, I guess we have been offered ICSI due to the possible prevention of feritlisation with the head binding, do you know anything about the success rates of IUI with ASA?

Paul, I wondered if you might also have any info as I think I read that ASA were your "specialist subject"

Thanks loads in advance...


ICSI #1 Mar/Apr 2009 - :BFN: ~~~ Two frosties waiting xfingers
ICSI #2 Aug/Sept 2009 - :BFP:!! :D
30/09/09 1 precious [zx076] seen






This post has been edited 1 times, last edit by "oliviaj22" (Feb 24th 2009, 1:56pm)


Posts: 2,505

Reg: May 2nd 2007

Children: A boy and a girl, both living in London

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Tuesday, February 24th 2009, 10:08pm

RE: question regarding ASA

Hi, to you both.

Finding anti-sperm antibodies in the male is not uncommon, probably around 10% of men have some degree of auto-immune problem. As you have said these reduce the sperm's fertility rather than take it away completely. This they do, predominantly, by reducing the sperms' ability to progress through the female genital tract, and especially through cervical mucus. Antibody coated sperm become immobilised in cervical mucus and get no further than this, and this is the major barrier to conception. During the sperms' passage through mucus they go through a process known as capacitation which changes their swimming pattern, and leads in turn to the acrosome, the membrane covering the head, being shed to reveal the enzymes that facillitate the sperm's binding to the oocyte. This process can be less efficient when the sperm are damaged by antibody binding.

The degree to which fertility is impaired depends in part upon the number of uncoated, motile sperm still available to survive in, and progress through your cervical mucus. So the total number of antibody free sperm in his samples is important. A further factor is to what degree, if any, your mucus is hostile to sperm. My research showed that though, in general, the incidence of females with ASA was much less than that of males with ASA, where the man had ASA there was a much higher incidence of ASA in his female partner. It seems that the process that renders sperm antibody coated whilst developing in the man can also make the sperm hyper-antigenic to the female partner, such that she in turn makes her own ASA against these same sperm.

So it can be useful to test his sperm against your cervical mucus, to see how well they survive, (i.e. the sperm/mucus hostility test). This has always been a basic, preliminary test for me when assessing a couple's fertility, as it tells me what the chances are of them conceiving a pregnancy naturally. It might be something that you can persuade your unit to do, whilst looking at other options.

IUI can be useful as it get the motile, unagglutinated sperm past the cervical where most of them might be stopped, and ICSI will always be suggested when there is any sort of male factor, but you will know the limitations of this.

It is also important that your fertility is maximised, as the more fertile you are, the more likely you are to conceive (and importantly, stay conceived), in those cycles where enough sperm get through to give you this chance. So as always it is your joint fertility and the sperm numbers game that could get you there.


Keep in touch.

Paul
Fertility Scientist and Andrologist
Fertility Counsellor, Holistic Therapist and Hypnotherapist
Providing Fertility Information, Assessment and Enhancement.
Natural family planning teacher.

  • "oliviaj22" started this thread

Posts: 1,051

Reg: Feb 24th 2009

Location: England

Children: NURTURE

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3

Thursday, February 26th 2009, 4:41pm

RE: question regarding ASA

Hi Paul,

Thanks for getting back to us and for the information, we will certainly ask our clinic about the sperm/mucus hostility test though this has never been offered to us.

Is there anything in the meantime that you would recommend that we could take in terms of vitamins etc to help with this? (I am on prenatals)

Being a scientist myself I have done a lot of reading on this and have become quite interested in the subject... :smile:

Thanks again for your time and for responding, it's really useful in helping us understand what the issues are.


ICSI #1 Mar/Apr 2009 - :BFN: ~~~ Two frosties waiting xfingers
ICSI #2 Aug/Sept 2009 - :BFP:!! :D
30/09/09 1 precious [zx076] seen










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