Finally, a Diagnosis! CAUTION: TMI POST

We had our consultation with Dr. D this past Wednesday to decide what to do next. Up until this point we were being told that we had Unexplained Infertility. They thought maybe it was low progesterone/short luteal phase. Maybe it was due to the poor sperm morphology... maybe poor egg quality, maybe maybe maybe. Boy! Were we ever sick of being told "maybe" and "i'm not sure."

At this last appointment Dr. D looked at us and said, "you no longer are classified under the "unexplained infertility" it is Male Factor Infertility." While this certainly isn't good news, its kind of a relief to know the "why" behind all of this. There's no anger or blame, we refuse to point fingers. Its not his diagnosis, it's our diagnosis.

For whatever reason, his initial counts were "normal" with poor morphology. Ever since, counts, morphology, and motility have all been low. There's not a concern about varicose veins/vericocele because volume is normal. (Sorry, this entire post may be TMI).

So, what does this mean for treatment?  Well, according to Dr. D, after 3 IUI's, our chances of success with this method of treatment  have diminished significantly. With normal counts, eggs, etc, there's only about 20% success rate with IUI and after three it goes down to about 12-15%... but since we don't have "normal" numbers, our chances are even less. To put it bluntly, our only real chance of conceiving a child are through IVF (InVitro Fertilization). A lot of you probably know what this is, or have at least heard of it... but I'm going to really dumb it down for this post and try to explain it as best I can.

We'll be doing a 2 month IUI with ICSI. For the first month I'll be on medication to surpress my ovaries. I'll still have a normal period, I just won't ovulate that cycle. The second month I'll be on medication to hyperstimulate my ovaries. The hope here is to get around 20 follicles at the time of ovulation. I'll go in for frequent bloodwork and ultrasounds during this month to make sure my hormone levels are ok and that my eggs are growing in number and size without causing my body any harm. I'll have a mid-cycle ultrasound, typically day 13-14, at which point, assuming follicles are mature, I'll be given another trigger injection (I'm planning on giving this one to myself... the RN's at this office aren't very good at giving injections). 

36 hours after the trigger injection, I'll go back to the office for egg retrieval. Dr. D said he'll knock me out for this proceedure since I've had.... issues in the past with this type of thing. (Thank goodness!)  They'll then go in to my ovaries and aspirate each and every follicle. Bob will also give a sample on this day for the ICSI.

Rather than put our eggs in individual petri dishes with a couple million sperm each, like they normally do for IVF, we'll be doing ICSI (intracytoplasmic sperm injection). This means they'll inject a single, healthy sperm directly into each mature egg. The embryos are then monitors by an embyrologist for (usually) 5 days. They watch for cell division and make sure that they're growing and developing correctly before the transfer.

Because we're so young, Dr. D said we can pick whether we want to transfer one or two embies at a time... I think we'll do 2. So, 5 days after retrieval, I'll go back in and they'll tranfer two embryos into my uterus. Then it's another waiting game, hoping for implantation. Dr. D said our chances for success are 50-60% with the first IVF, then it only drops 5-10% with subsequent transfers.

I've heard of multiple people having 10 healthy embies that are able to be transfered. Assuming we get similar numbers, we'll transfer 2 and freeze the rest for future transfers.

So, that's the procedure. But there's definietly other things for us to consider.

This entire process is going to cost us $10,000! The transfer itself is $6000 and the ultrasound, bloodwork and medications are another $4000. That's a lot of money. We have another consultation with the IVF nurse at the end of the month, at which point they'll go over payment plan options... but the thought of trying to come up with that amount of money is paralyzing. I could never put a price on having a child... but all I can think is... what if we don't have a child. We're gladly accepting donations! :)

Timing is another obstacle for us. Doing the 2 month IVF is going to be kind of a challenge. We have a lot of vacations and trips planned starting in September and don't have two months to commit to this until next January. The ONLY way it would work for us to do IVF this year would be if the timing fell into place perfectly to start the process mid-September and do the transfer mid-Oct. Sadly, timing is yet another thing that is completely out of our control... it all depends on when I start my next period. (Stupid body).

Side effects, side effects, side effects! In case you haven't gathered this from my previous posts, I do not tolerate medication very well at all. No matter what the medication, no matter what's it's use, I WILL have every side effect possible. Femara is supposed to be practically side effect free.... for me... every possible side effect. That being said, being on the medication to stimulate my ovaries will likely cause headaches, bloating, MORE weight gain, acne, insomnia, nausea, constipation, and mood swings, just to name a few.

Because I'm so sensitive to medications, I will be getting lower than the lowest dose of the follicle stimulating hormones. My fear is that it will be too low and we'll get terrible counts. But the Dr's fear is that if he gives me any more than that, I'll develop OHSS (a whole different issue). They'll also be monitoring me much closer than most people because of my reaction to meds.

This is a lot of information to process. Its a lot to try to digest. Its a lot to explain to other people. And its a scary thing to decide to do. IVF does not always work... We're struggling with not focusing on that. This is really our only chance of having a baby of our own.

Most of you have probably heard of the 5 stages of grief: Denial, Anger, Bargaining, Depression, and Acceptance. We've gone through these stages 11 times over the past year. Every month we're not pregnant, we experience each and every one of these. Sometimes we process them faster than others, sometimes we experience one stage longer or shorter than the rest. But this time, I'm stuck in the Anger stage... and I have been for over a month. I'm furious. I'm mad that we are going through this. I'm mad that God gave us such a strong longing to be parents, but left us barren. I'm mad that God gives babies to crack whores, but not to us. I'm mad that people keep giving me "advice." If one more person tells me its stress and that I just need to relax, I'm going to scream! You wouldn't tell someone with cancer that its just stress and they need to relax, so why would you tell that to us when we too have a legitimate medical condition? I'm mad that we're being left behind. I'm mad that I've lost friends over this. I'm mad that I distance myself from people with babies, and that people with babies distance themselves from me. I'm just down right angry. I'm angry that I still have hope... I don't want any  more false hope. I'm angry that people tell me that if I trusted God more, I'd have a baby. That if I wanted Him as much as I want a child, I'd have a baby (and yes, people have actually said these things to me).

We appreciate your continued thoughts and prayers. We often feel left behind and forgotten, and its comforting to know that there are people out there who care.

We'll keep you posted after out next appointment as to the tentative timing of our IVF.