CD1

It's cycle day one again. Not really a suprise given those morphology results I got in the mail yesterday. This is just another reminder that IVF is probably our best option.

SA results

So... We just a letter in the mail regarding K's most recent SA. His count was increased (20 million/mL, 50 million total) but percent motile was down (18%, 9 million total motile sperm). This time they checked morphology, because for some reason they hadn't checked morphology for either of the other 2 SAs that he has done (They pointed out that we did pay for them to check morphology when we did the IUI in November, and they charged us for it, but "for some reason didn't perform it" hmmm). The letters from our hospital with lab results are always formatted poorly so I am trying to look for an actual normal morphology percentage and I can't find one. The morphology section (Tygerburg criteria) is broken down into:

strictly normal HS (0),
acrosome defect (1),
moderately amorphous (19),
severely amorphous (71),
abnormal head size (0),
pyriform defect (7.5),
borderline head shape (1.5),
and other defect (0).

All those number do add up to 100, so perhaps they are percentages... which means we have 0% normal sperm?? I am glad we only did 1 IUI if that is the case. Although I wish they would have checked this earlier so we didn't waste a whole year trying to get me to ovulate, when K's sperm are such that they probably can't naturally fertilize any egg I would produce. I assume this means we will do ICSI with our IVf. I only wonder/hope if the results are so bad that we won't be able to use his sperm? Time to begin googling...

Do you girls think I should contact HR or my Dr and complain about the whole morphology issue? Since I saw we were charged for it in November and the packet said they check morphology for all IUIs, I assumed they checked morphology then and as the clinic generally says "No news is good news." I assumed morphology had been checked and was ok. If we knew we had 0% morphology in November we could have start IVF several months ago... ugh! As K said "So everything we have done so far had no chance of working?" It seems we have wasted a year with a lot of ups and downs, hope and despair, for naught. And although some of it was unavoidable we could have avoided the hope and despair of November, December, and January if they had completed what they were supposed to do. As it is I have only found out about this in the letter. The doctor called and told K his count/motility % and never mentioned the morphology. On top of it all, I just checked the bill, and I think they charged us for morphology again, even though it was supposed to not be charged since we already paid for it in November.

Test Results

So to begin the whole IVF process I was required to get screened for a bunch of STIs - gonorrhea, chlamydia, hepatitis B, hepatitis C, HIV, and syphilis. And unlike my pregnancy tests, I have been very pleased with all negatives :) Now K just has to go in and complete the same tests, and we will be all set for our IVF appointment 2/4. I am really excited to get started with IVF and wish I didn't have to wait any longer!

Appointment Scheduled and Rants on (In)fertility

So the IVF clinic called and I scheduled the first available appoitment - Febuary 4th! I am excited, but it seems like it is taking forever to get here. At least when we go I will (hopefully) get a schedule for when we can finally start the process. I know my RE said we would probably do birth control in March and stims/retrieval/transfer in April, which if we got pregnant would likely mean an early January 2014 due date! I reviewed the packet on the IVF guarantee and it seems we should qualify, so hopefully I won't have to do a bunch more tests at my appointment.

Right now I am on CD20 and am either 11dpo or 7dpo. My bbt spiked really high on CD12 then dropped back below coverline for 3 days, then shot back up (CD16) and has been climbing since. K went out of town so we only bded CD9 and CD12. We made a last chance effort this month using mucinex, preseed, and soft cups. I still have hope that we will get pregnant before the IVF appointment, but I know it is extremely unlikely.

Now onto my rant. I have been working in a pediatric clinic the last 2 weeks and I have seen soo many children. I am happy to see the children and in fact seeing the children doesn't make my uterus hurt. But when I see some of the parents of these children I get very jealous/enraged/confused. There have been many great parents, but there have also been so many parents where I wonder "How come you get to be a parent and I don't." I know my feelings aren't kind/generous/understanding, but I need to get this rant out. I have seen several children who were shaken as babies and now are permanently disabled, yet still live with their parents. I have seen parents who can't financially support their children, yet still have multiple children, generally spaced out every 11 months. I have seen parents who are drug addicts and alcoholic. Parents who don't seem to care about their children. And each time it makes my heart hurt. I want a child so badly, and K and I could financially support our child, love our child, and appreciate our child, yet we can't concieve one, even after a year of trying. I can't help but question why?

Big Change of Plans

So the last week has been crazy for us in terms of our ttc plan. We went to our RE's office last Thursday where I posed a plan that we use a combo cycle this month - femara + injectables + IUI. Since this would be the absolute best month for me to get pregnant in terms of medical school scheduling I was ready to go all out to get that BFP this month. My RE finally agreed on my plan (with me pushing her a little) so we added on to our visit a wonderful CD3 (which was actually CD5) ultrasound and saline sonohysterogram, which was oh so fun and will end up costing us a good deal of moolah. We found out my tubes are both open - woohoo - although I was never really concerned that they weren't. Unfortunately at this point it was 5 pm and the clinic was closing so my RE said we needed to come back in the morning for injectable training.

When we got there the next day there is this weird message that we need to see the RE before the nurse. It turns out my RE had never reviewed the results of my husband’s SA from our first IUI and the results were quite low - less than 1 million total motile sperm post wash, which upsets me because I know the bill for our visit the day before will be big and it now will be unnecessary because she thinks that it would be the best use of our time/money/resources for us to move onto IVF.

My husband and I have been discussing it and I think we might just move onto IVF. I just got the packet in the mail today to review and will send in the form for a consultation appointment with the IVF clinic tomorrow (which apparently is different from the RE clinic.)

I have mixed feelings about moving on to IVF. Part of me is excited for it because the chances of success are so much higher than our chances with IUI, although I am still trying to figure out for sure our actual percentages of success with each method – I am quite a nerd and need to know all the info. I am hesitant because it will cost a lot of money, and don't want to spend a lot of money on IVF if we could get pregnant with IUI + x. 

I am probably the worst patient ever (my husband agrees) since I am a medical student and have the books/articles/journals to read so I know what can be done, and what I think should be done, but am not actually a doctor, so I don’t actually know what should be done. I am constantly reading up on infertility, and now that I read blogs and see what options/care other women receive I ask my clinic all the time “can we do this?” “do you do that?” And I ask things like “Are there donated meds for me to use?” (no) “Where can I get the meds the cheapest? Is there a best online source?” (which I think they should definitely know, but neither my RE or her nurse knew – which is crazy since this is a big university and they have thousands of patients seen in this clinic. Shouldn’t they know where to get meds the cheapest?!)  

My clinic says with IUI + femara a couple with a good sperm count has a 15-20% chance of success. If K and I do it our chances are lower since his sperm count is low (She didn't say an actual number, just significantly lower than 15%). The clinic says if we do IVF (+ICSI) our chances of success are 60%, and if we meet criteria they have an option that guarantees either a BFP or baby (should definitely clarify which) or our money is refunded.

It looks like my infertility blog might now become an IVF blog!

Child of the Universe

My inspiration for the blog:

Go placidly amid the noise and haste, and remember what peace there may be in silence. As far as possible, without surrender, be on good terms with all persons. Speak your truth quietly and clearly; and listen to others, even to the dull and ignorant; they too have their story. Avoid loud and aggressive persons; they are vexations to the spirit. If you compare yourself with others, you may become vain or bitter, for always there will be greater and lesser persons than yourself. Enjoy your achievements as well as your plans. Keep interested in your own career, however humble, it's a real possession in the changing fortunes of time. Exercise caution in your business affairs, for the world is full of trickery. But let this not blind you to what virtue there is; many persons strive for high ideals, and everywhere life is full of heroism. Be yourself. Especially do not feign affection. Neither be cynical about love; for in the face of all aridity and disenchantement, it is as perrenial as the grass. Take kindly the counsel of the years, gracefully surrendering the things of youth. Nurture strength of spirit to shield you in sudden misfortune. But do not distress yourself with dark imaginings. Many fears are born of fatigue and loneliness. Beyond a wholesome discipline, be gentle with yourself. You are a child of the universe no less than the trees and the stars; you have a right to be here. And whether or not it is clear to you, no doubt the universe is unfolding as it should. Therefore be at peace with God, whatever you conceive him to be. And whatever your labors and aspirations, in the noisy confusion of life, keep peace in your soul. With all its sham, drudgery and broken dreams, it is still a beautiful world. Be cheerful. Strive to be happy.

- Max Ehrmann, Desiderata: A Poem for a Way of Life