Some Thoughts on Adoption

An old, very dear, friend of mine sent me the sweetest card last week.  It took me a while to process it because it was unexpected, but I have finally worked up the strength to address it now.


This friend was adopted.


She started out her lovely letter telling me she'd been reading the blog.  She told me how much her heart aches for what B and I have been going through.  She told me what a good Mommy she know's I would make.  She told me she admired my "I will be a better mother" post.  I love this quote from her letter:

"If we never experienced a rainy day, how could we ever appreciate the warm sunshine?"

With that being said, she also acknowledged that remembering such wisdom doesn't make the hard days any easier.


I also love that she said that while she agrees infertility doesn't define me, "it will shape you, cause you to grow and think in ways you have never known before, but it isn't you!"


She went on to tell me all the things I am in her eyes.  She reminded me of all kinds of childhood memories together (we've known each other since first grade!).  She told me she is here to support me, no matter what I need from a friend right now.


She left me with a few silly quotes to help me cope:

1. "The will of God will never lead you where the grace of God will not protect you"
2. "One day at a time... one day at at a time."

Then there was a P.S. at the end that kind of rocked my world for a minute.


She said that she wasn't even going to write this last bit, but in the end felt she needed to be honest.  She said that she completely resepects B's & mine feelings on adoption, but the sections in my blog on that topic where a little hard for her to read.


I had to go back an read what I had written, because I know there weren't any posts yet with a title like today's title... and then I remembered the post-turned-into-a-page, "What not to say."


At the end of this post I make two different statements about adoption, and now that I go back and reread them, they do come off as very dismissive and negative.  Rather insensitive actually.


I feel it is important to explain where I was coming from the day I wrote those words and a little bit more about where B and I are coming from on adoption in general.


B flat out doesn't want to adopt.  He is not interested in open or closed, foreign or domestic, baby or older child adoption.  He just keeps saying he is not comfortable with raising someone else's child.  He is afraid that if there are serious difficulties, handicaps, issues or whatever, that he won't be able to handle it, and would end up resenting me.  He says that if it was our genetic child, he'd feel differently, like it was more his responsibility to work through the tough times and so he'd be able to manage through it with our own child.  But if it was someone else genes and we didn't know what we were getting ourselves into, he'd regret it.  I hope I have articulated that accurately and with the spirit in which he feels.


Because it is all about the genes for him, not just the lifestyle of the mother or the environment of foster homes & orphanages, B is not interested in embryo adoption either.  For the same reason, he is not interested in sperm donation.


I don't know how he really feels about fostering, but I think he would be very concerned of my "falling in love" and pressuring him to adopt any children we welcome into our home/family temporarily, so I think he would be very against fostering as well, though I have not discussed this with him to the point of exhaustion as I have the adoption topics.


This has been very difficult for me to absorb and accept.  I know many people who have adopted or have been adopted, and I think it is a beautiful loving thing.  


I love babies.  I love children.  I am the oldest of four children, the oldest of seven grandchildren.  I grew up with my mother running a home daycare in our house.  I started babysitting other people's children when I was eleven.  I taught Sunday School.  I taught children's swimming lessons for years.  My friends with children always comment on how good I am with their kids and sometimes even call me the "Baby Whisperer."


For me, this whole infertility struggle isn't about our inability to conceive our own genetic child.  It would be beautiful and amazing, and world-changing (to us) for B and I to create a being that is part of each of us.  But I don't need to have my own genetic child.  I'd love to have the experience of being pregnant and giving birth, that rite of passage into womanhood.  But I don't need to be pregnant to feel like a woman, or an adult.


What I do need is to fill this empty hole that is growing inside of me.  This need to nurture, to give, to love something that depends on me for everything.  I need to be a mother.


I honestly believe I'd be very content and my needs would be beyond satisfied with adopting a baby.  An embryo adoption would allow me the opportunity to experience pregnancy and labor, but like I said before, I don't need all that.  I just want a baby.


Sometimes I even think fostering would help, though I'm sure it would be a very slippery slope toward wanting to adopt.  It would be hard to give them up once they've been part of our little family.  Maybe I'm putting words in B's mouth when I say he'd be afraid of me doing that... maybe I say he'll feel that way because part of me worries that I'll do it...


So when I wrote those comments about adoption, about how it's not for every one, about all the negative aspects and risks of it... I was trying to convince myself of these things.


I needed to convince myself that I too felt this way about adoption.  Or that it was ok for someone to feel this way about adoption.  I had to separate myself from my own true feelings about it because the fact of the matter is, I cannot adopt.  In the life I have chosen, I am half of a partnership.  My life is not just about me anymore, it is my and B's life together now.  He feels very strongly against something that I think could take away my suffering.  I have to accept that.


If I don't come to terms with and accept the fact that we will not adopt I only have two other options.  Continue to live in pain with tension between us, or abandon our relationship and pursue adoption without him.  The first is not healthy and won't solve anything and the latter is unimaginable and not an option at all.


I want a baby, but I want B more.  I can't imagine spending the rest of my days without him.  I can't imagine choosing to be a single mother over being a childless couple.  I can't imagine meeting anyone else that I could have children with and being able to love them the way I do B.  I never could have imagined myself not being a mother, but I also could never have imagined myself loving a man like B this much either.  Now that I have him, I don't ever want to let him go.  I'd rather have a good love story be the legacy of my life than an unknown future without the love of my life.


So that's why I have been struggling to come to terms with the fact that adoption is out for us.  Because it has to be.  Because I have to.


That's also why I put so much emotion, time, and energy into fertility treatments and options.  Because they are my only hope of having it all.  Of being the person I thought I was meant to be.  Of feeling complete as an adult woman in the only way I know how to...so far.


To all my friends and family who have either adopted or were adopted. I'm sorry if my comments in earlier posts/pages were hurtful to you.  I see now how insensitive they were.  I just want you to know that I wasn't thinking of anyone or anything besides myself and what I am experiencing with B when I wrote those.  I talk so much about wanting others to be sensitive to infertiles like me, and then I go and do something so thoughtless.  I'm sincerely sorry for any pain or discomfort I may have caused.

Varicocele Surgery: What are the success rates?

Varicoceles are identified in 35% to 40% of men with primary infertility and 81% of men with secondary infertility.  The majority of available evidence favors the surgical treatment of clinical varicoceles in men with infertility, which is thought to halt their duration-dependent effects.

Varicocele repair surgery can result in a significant improvement in semen parameters in 60% to 70% of men, with natural pregnancy rates up to 50%.  Men with larger varicoceles tend to have poorer semen quality than those with smaller varicoceles, and tend to have greater improvement with repair surgery.

Overall, a significant percentage of couples who undergo varicocele repair surgery will go on to achieve pregnancy without ART, and those who do need ART will have optimized their sperm quality.

It takes 90 days (3 months) for the male body to generate new sperm, so no improvements will be seen for 3 months following the surgery, with best results occurring in the first year, and some even into the second year following the surgery.

How this relates to us:

Since B and I have scheduled the surgery for the first week of April, that put our TTC routine on hold until around the week of the 4th of July.  Some things I've read online claim that better results are seen after 6 months, so that will put us at October before we'd really have our hopes up.  If it doesn't happen by the end of the year (trying naturally), then I think we'd be ready to allocate some money into our flex spending account for 2013 to try a few more rounds of IUI next year.

If trying naturally and with IUI's through 2013 doesn't work for us, then the next step would hopefully be saving up for IVF in 2014 or beyond.  I'll be 32, turning 33 by then, so our odds of successful IVF will still be high, but we'd only have a couple of years to get it done before my fertility starts falling.  

But seriously, IVF? The idea of saving up $13,000 for one round of fresh IVF cycle seems plausible by then... but what if that doesn't work what would we do?  With the plan described above, IVF is obviously our last resort.  

We could try to save up for the "shared risk" programs out there, where you pay $20,000 to $26,000 for 3 rounds of fresh and 3 rounds of frozen, and if it doesn't work, you get some or most of your money back.  But where would we come up with that kind of cash?  It would take longer, and then again my fertility will just decline further the longer we wait.

I wish I had a crystal ball.  I'd love to know that I'm just "catastrophe" thinking right now and we'll be pregnant naturally this summer.  Or that one round of IVF will get us twins and we'll be done.  Or that nothing will work but a 3rd frozen IVF cycle and so I should not bother getting my hopes up with anything else along the way.

Also, I wish we'd win the lottery.  That would solve a lot of our problems.

Varicocele Repair Surgery

• There are three methods in which varicoceles can be surgically treated: open surgery, laparoscopic surgery, and the third, which isn't even really surgical (it's performed by a radiologist), is percutaneous embolization.
  Open surgery. This treatment usually is done on an outpatient basis, using general anesthetic or local anesthetic. Commonly, the surgeon will approach the vein through the groin (transinguinal), but it's also possible to make an incision in your abdomen or below the groin.
  Advances in varicocele repair have led to a reduction of post-surgical complications. One advance is the use of the surgical microscope, which enables the surgeon to see the treatment area better during surgery. Another is the use of Doppler ultrasound, which helps guide the procedure.
• Laparoscopic surgery. The surgeon makes a small incision in the abdomen and passes a tiny instrument through the incision to see and to repair the varicocele. This procedure requires general anesthesia.
• Percutaneous embolization. A radiologist inserts a tube into a vein in the groin or neck through which instruments can be passed. Viewing enlarged veins on a monitor, the doctor releases coils or a solution that causes scarring to create a blockage in the testicular veins, which interrupts the blood flow and repairs the varicocele. This procedure is done with local anesthesia on an outpatient basis. This procedure isn't as widely used as surgery.
• So what's best?
• According to Dr. J's article, "Do varicoceles really affect male fertility?" although most methods yield similar short-term results, open micro-surgery tends to have lower long-term complications, such as recurrences and hydroceles.  This is due to the ability to tie off all veins while sparing the arterial blood supply and lymphatic vessels.  
• Although laparoscopic varicocele ligation was once touted as a minimally invasive method of repair, several experts have demonstrated similar recovery rates with open micro-surgical methods along with equal efficacy, fewer complications, and the advantage of not having to enter the abdomen.
• The most common complications from any of these varicocelectomy procedures are hydrocele, varicocele recurrence, and testicular artery injury.  Use of the operating microscope allows for reliable identification of spermatic cord lymphatics, internal spermatic veins and venous collaterals, and the testicular artery or arteries, so that the incidence of these complications can be reduced significantly.  Thus, the microsurgical technique of "open micro-surgery" provides a safe and effective approach to varicocele repair that preserves testicular function, enhances semen quality, and improves partners' pregnacy rates.
• What to expect from Open Micro-Surgery 
  Most men prefer general anesthesia, though the procedure can be performed under local with intravenous sedation.  Time to recovery varies, but most men get back to work within 3-4 days and and resume full activity within 7-10 days.
• From mayoclinic.com:
• You may be able to return to normal, nonstrenous activities after two days. As long as you're not uncomfortable, you may return to more strenuous activity, such as exercising, after two weeks.
  
  Pain from this surgery generally is mild. Your doctor may prescribe pain medication for the first two days after surgery. After that, your doctor may advise you to take over-the-counter (OTC) painkillers, such as acetaminophen (Tylenol, others) or ibuprofen (Advil, Motrin, others) to relieve discomfort.
  
  Your doctor may advise you not to have sex for one to two weeks. You'll have to wait three or four months after surgery to get a semen analysis to determine whether the varicocele repair was successful in restoring your fertility.

• **Dr. J has recommended Open Micro-Surgery for B.**

What the heck are varicoceles?

A varicocele (VAR-ih-koe-seel) is a dilation of the veins that drain the testis, known as the pampiniform plexus. A varicocele is similar to a varicose vein that can occur in your leg.

As it turns out, varicoceles are present in approximately 15% of the general male population. They account for up to 40% of male factor infertility, yet nearly two-thirds of men with varicoceles are fertile... so could varicoceles be causing mine & B's infertility?

The answer I've been able to come with so far is "maybe."

Causes

Varicoceles are typically not noticed until after puberty because testicular blood flow remains low prior to that and so these veins do not become apparent until adolescence when blood flow increases.  However many are not detected until a man is evaluated for fertility problems later in life. 

It's not certain what causes varicoceles, but many experts believe a varicocele forms when the valves inside the veins in the spermatic cord prevent your blood from flowing properly. The resulting backup causes the veins to widen (dilate). 

Varicoceles usually occur on the left side, most likely because of the position of the left testicular vein. However, a varicocele in one testicle can affect sperm production in both testicles. 

Our doctor, Dr. Jay Sandlow (I like to refer to him as "Dr. J"), published an article called, "Do varicoceles really affect male fertility?" in Sexuality, Reproduction & Menopause, arguing that it is not the valve that is the issue, so much as the anatomy of the entire drainage system that plays a major role in the the development of varicoceles.

"Because the left side drains into a system with higher resistance (the renal vein), small venules may persist or open during embryogenesis." - Jay Sandlow

Don't ask me what that means... after looking up definitions for venules and embryogenesis, I think it means the way a man's anatomy is formed while still a fetus determines whether he'll have varicoceles, though they aren't detected until after puberty when things really start flowing down there.  Maybe I should ask Dr. J if I understand that correctly though :)

How can they affect fertility?

In cases of where men who have varicoceles happen to be experiencing infertility, varicoceles are thought to cause spermatogenic defects by raising the intratesticular temperature in both the affected and the adjacent testes. However, not all varicoceles affect sperm production, which explains why not all men with varicoceles (in fact, most of them), are fertile.

Diagnosis


When varicoceles are suspected of causing infertility, abnormalities in all of the seminal parameters are usually present.  However, they can also cause isolated defects in sperm count, motility, morphology, or function.  Therefore, according to the article written by Dr. J mentioned above, the results of semen analysis are not a good predictor of the presence or absence of varicoceles.  And so, they are typically diagnosed by physical examination.  Most experts agree that the only varicoceles to worry about are the ones that can be detected by physical examination, though ultrasound can be used to identify them as well.


In our case...


B's were visible right away upon physical examination, and he has them on both sides.  We discovered this back in April 2011, but because the results of his seminal parameters testing were all coming back within the range of normal fairly consistently, Dr. J instructed us to first continue trying naturally for 4-6 months, with timed intercourse (only every other day during the fertile period of my cycle).  


That brought us to September, when we did our first IUI, which failed.  That's also when we learned how low B's "good sperm" counts were post-washing.  It was at that time that Dr. J recommended doing one more IUI, and if the numbers came back that low again post-wash, then he would recommend varicocele repair surgery as our next course of action.


We attempted an IUI earlier this month (February 2012) and his count came back lower than last time, so in effort to save money, we didn't even go through with it.  I was on clomid that cycle for the IUI, so there could have been a chance of increased fertility for us naturally... but I got my period Wednesday night so [sigh] that's disappointing.


So we scheduled the surgery for early April.  I'll post more soon about what that entails and what the success rates are.

And I thought last week was rough!

So last week I posted about what a hard time I had preparing for 3 baby showers for the weekend.  Not that I was sad about it, but that it was just mentally taxing for me to spend that much time planning gifts, shopping in the baby section of stores, and picking out thoughtful cards for my friends and coworkers on one of the most memorable events of their lives.


The two coworkers' baby showers last Friday went really well.  I made homemade chex mix the night before as my snack to pass, I wrapped their gifts and signed their cards.  Before the shower I helped to decorate and set up the room.  During the party itself I had a great time socializing with the professors and staff that I work with, and any anxiety I had about the gifts I'd picked out went right out the window when the Moms-to-be squealed with delight and thanked me for my cute gifts!


B and I went out with some old friends that were in town over the weekend on Friday night.  I was kind of tired but we haven't seen them in years and I wanted to catch up with them, so we went and had a great time.  I was able to eat a vegan meal and enjoyed one specialty cocktail.  It really was fun and we all had a great time reminiscing about when we all lived in La Crosse and worked together, back in the early days of my & B's relationship.  It was fun to see that people just fundamentally don't change.  They may grow up, but they are still the same people that they always were, deep down.


Saturday we were supposed to get up, take the dogs to a dog park, and then drive down to IL for a "couples shower" for some of our closest friends.  Only I couldn't do it.  Not because I was "having a rough week," but because I woke up with the worst migraine I've had in over 3 years!  I stayed in bed until 2pm, when we were supposed to leave for the party, but it was still so bad that I had to text my friends and tell them I couldn't make it.  I stayed in bed and slept on and off that entire day.


I am really afraid that all our friends probably think we didn't show because I "couldn't take it."  To be honest, a small part of me did wonder if maybe the migraine was brought on by all the stress of the past week, preparing for all these baby events.  But if that was the case, you'd think that once we decided not to go to the party, you'd think my migraine would have subsided. Not the case.  It continued into the next day and I had to miss out on my father-in-law's birthday party too!  My entire body was starting to ache at this point and I started to worry that I was getting really sick.


Monday I woke up and my throat was sore, I still had the severe headache, and all my joints ached.  B worried I was coming down with influenza.  I had to call in sick to work which always causes a lot of stress when you come back, and I had to reschedule 2 meetings because of it, disrupting everyone else's schedule, not just my own!  Tuesday the sore throat was gone, but my head still hurt, so I took one more day off of work.  At least I know none of this could have been because of a baby shower!


Wednesday I was still weak but went back to work.  Found out my cousin and his wife had their baby.  I'm happy for them, but not really something I was super excited to read about first thing in the morning after emerging from my sick-cave.  It was like I left the real world in the midst of 3 baby showers, went into my hibernation cave for 4 days while recovering from whatever weird illness I'd picked up, and when I emerged afterward, I got smacked in the face with a birth announcement.  I know I'm hypersensitive to all things Baby right now, but I think anyone would agree that this stuff is pretty blatantly surrounding me right now, right? Right?


While I'm at work, I learn that my coworker was out Monday and Tuesday too, with the exact same thing, and it had also started for her with a severe headache on Saturday as well!  Maybe it was something we ate at the baby shower on Friday?  B said the secretary at his work had something similar last week too, so perhaps something weird is going around.


AF arrived last night.  I wasn't expecting her until today, but still pretty much on time.  Like clockwork.  Always like clockwork.  I have a normal 26 day cycle, ovulate on days 14-16, get all the appropriate signs in my body for each  phase of my cycle, and yet I can not get pregnant.  So frustrating.


Woke up this morning and found out my best friend down in AZ is in the hospital and they are going to deliver her baby today.  She wasn't due until April 1st.  She is only 34.5 weeks along.  My very first reaction was, "oh, no, not another premie."  Her firstborn came way to early as well.  I'm so worried about my friend and her baby.  Everything worked out fine last time.  My friend was fine, and the baby miraculously was absolutely fine as well, didn't need any kind of support or anything!  I hope it works out the same way this time, but I'll be worried about them until I hear more news.


Guess I should have picked up a little something for this friend after all when I was out shopping last week!

Surgery Scheduled

B's varicocele surgery has been scheduled for April 5th.  He'll need 5 days after the surgery to recover so we won't be going home for Easter this year.  This was the best time for us to schedule the surgery though because he only will have 3 days of sick time built up by then and his work gives him Good Friday off.  So between the weekend, the holiday, and his sick time, he'll have just enough time off.


I still plan to post more about what varicocele's are, how they can effect infertility, and what the surgery is all about soon.  In the meantime, we are just mentally preparing for this big next step.

I'm blessed to have such sensitive friends

To the friend who happens to be a former infertile and I wasn't sure if she'd been reading my blog or not, but sent me a private FB message today warning that she'd posted a few pics of her twin infant sons upon request of other friends & family today: thank you.  Thank you for reading my blog.  Thank you for being so sensitive.  And thank you for being so thoughtful.  You are a blessing in my life and I'm so lucky to be able to call you a friend.  And I love your little blessings and can't wait to see them again soon!

Rough Week (Baby Showers Galore)

This is a picture of children's books that I collected at the library conference I attended in Dallas last month.  I discovered last year that you can find newly released books, sometimes signed by the others, at really good prices in the exhibitor's hall.  I picked up a few last year and gave them away as baby shower gifts so quickly that I ran out by Christmas.  I decided to really stock up this time around since so many babies are on the way this year.


I've got baby showers for 3 babies this weekend.  Two tomorrow (Friday) and one for a close friend on Saturday.  I was actually starting to get kind of excited for these showers when I went out shopping on Monday to pick up cards, wrap/bags, and a little something to go with the book or two I'll give each baby-on-the-way.  That is, until I got completely overwhelmed.


First I picked up some outfits, and the cards, and the gift bags.  I was doing good.  Then I remembered that another friend had had her second baby last Fall & I never sent a little gift because I was out of books, so I thought I'd send her one of the many you see in the picture above, but then I'd need a card, so I went back to pick one up.


While I was at it, I thought I should think ahead and pick up a card for another close friend who lives far away but is due with her second child in April, & I'd want to send a gift when the baby arrives.  So I had to pick out a really thoughtful card to go with the book I'd send.  But then I thought she was such a good friend, I should go pick out a little outfit or something too, so I went back over to the baby section...again.


Then I remembered that my husband's cousin in Germany just had their second child, and we should at least send them a card.  One of my books wouldn't really do since it would be all in English though, so I should pick out another outfit or blankie or something.  I picked out a sleeper and then went back to the cards...again.


Well then I remembered that another friend just announced her pregnancy and would probably be having some kind of shower soon, so I should just get it all taken care of while I was at it, because who knew how emotional I'd be in the future, and it would be nice to just have it all done now.  As I walked back to the baby area it dawned on me that I don't know the sex of this baby.  In fact, it's all so new that the mother might not even know the sex yet.  Anything I picked up now would not be very personal for such a close friend.  I decided I really needed to stop and just go home.  The anxiety was setting in.


My bill came to $58 and that's when the husband called warning me not to spend too much.  Really?  REALLY?  I needed 3, count them 3 shower gifts, cards, and wrapping, plus cards for 3 more babies, not to mention another two on the way this summer that I wasn't even worrying about yet!  Plus, it was all I could do to muster the strength to spend over an hour weeding through baby clothes, blankies, toys, bibs, etc., and now he was lecturing me about spending too much money on this project?!?  I was annoyed to say the least.


Plus, when I got home, I remembered that my cousin is due this summer too, and there will surely be a family baby shower for her soon too.


So that was all earlier in the week and kind of left me feeling anxious about everything coming up this weekend.  I'm feeling like I spent too much, like I should go to the dollar store to get cards and wrapping and return the stuff I got at Target.  I have to make snacks to pass and I don't have the energy to shop for and cook anything tonight plus work out with my workout buddy, but I don't want to buy some cheap processed junk food either.


Oh, and guess what? My co-worker just told me her daughter who has endo just got pregnant... one week after going off the pill.  Don't get me wrong, I don't wish this pain on anyone and I'm super happy for them that they didn't have to struggle with infertility like they assumed they would, but seriously?  Someone who went into TTC knowing they'd have trouble get's knocked up right away?  And we, who've been off the pill for 3.5 years and TTC for 1.5 years have no babies and no answers?  Come on!


I know this is kind of a whiny "ranting" post, but it's my blog and this is one of the things I created it for: getting my feelings out in a safe place.  I can't always walk around optimistic and hopeful and seeing the silver lining in things.  Sometimes I just want to vent.  That way, I can clear my head, put on a smiley face again, and go have fun at these showers this weekend.  Which, by the way, really are going to be fun.  I love party food and the one on Saturday will have many of my closest friends coming from all over a tri-state area, so I am super excited to hang out & spend time with everyone, not to mention dote on the parents-to-be who are going to be AMAZING parents and I can't wait to meet their little guy :)

Why Even Bother Washing Sperm?

The title of this post, "Why even bother washing sperm?" is what we asked our medical professionals after getting the results of B's post-wash counts this morning.  Before the wash, he had 11 million of the little guys, they say 20 million is normal, but this wasn't a bad number to start with.  Post wash though, we only had 3 million good ones left.  So we wondered, why even bother washing them when you lose so much, why not just put it all up in there and let the good ones fend for themselves.


Turns out their are two reasons according to our urologist's assistant:


1.) We really don't want the dead, slow, or "just jiggling" sperm up in there anyway.  They may have DNA fragmentation or chromosomal abnormalities.  If we'd had intercourse, they wouldn't have made it up into my cervix, that close to the about-to-be released egg(s).  We only want the best of the best to make it in there.


2.) If they put unwashed semen directly in my cervix, it would cause MAJOR pain and cramping. A woman's body creates all kinds of defenses for us. Outside the cervix, special chemicals dissolve the semen around the sperm so that only the sperm gets inside the cervix.  Semen isn't meant to be inside the cervix.  We do want the sperm put directly in there though, because that's what improves our chances of them meeting my egg(s).


So here's how it went down this morning: we had 11 million sperm total.  Of those, 3 million were dead, slow, or "just jiggling," but 8 million appeared to be moving around pretty fast.  Not a bad number.  After the wash, only 3 million made it through the obstacles of washing.  Only 3 million were actually good enough to make through an IUI procedure.  They want a minimum of 5 million good sperm post wash.


Last time we had 4.3 million and felt we were close enough to their minimum to go ahead with the procedure... and it didn't work.  This time we were even less than last time.


If we decided not to do the IUI with such a low count, we'd lose this month.  We had already done the u/s this morning, so we'd have to pay $400 for that, but we'd get $900 back of the $1300 back that we'd paid for the entire package if we cancel the IUI.


We cancelled it.


In the back of our minds, we always knew that the reason we were doing this IUI was to see if B's counts come out as low as they did last time.  If that was just a fluke, then trying more conservative methods such as IUI's would be a better choice for us then jumping to IVF (which we had been all set to do last month... see the navigation bar above for details on what happened).


But if his counts came out low again, then B's Urologist, Dr. Jay (as I like to call him), recommended varicocele repair surgery for us.


I'll post another day about what varicocele's are and what the surgery will all entail.  Right now I'm still just kind of absorbing the fact that we aren't doing the IUI today.  I know we were mostly doing it to see if his counts would be low again, but I had to go into it thinking we were going to have a chance at getting pregnant because otherwise, without optimism, there would be no chance whatsoever of conceiving.  Not to mention how awful the stress of going through all of this for no reason/without hope would be.


The other thing I'm trying to process is that we may now have just transitioned from the category of unexplained infertility to male factor infertility.  


I always wondered if it would feel worse to have a diagnosis, or if I was correct in feeling that unexplained is worse.  So far, I think I was right. At least if you have a diagnosis, there might be some action you can take to try and fix the problem, which for us, may be this surgery.  Even if you had a problem that couldn't be fixed, at least you'd know that and not torture yourself every month trying all kinds of things in vain, or suffering through the two week wait (2ww) month after month. No, you could move on.  You could move on to more extreme ART treatments such as IVF, or move on toward acceptance of adoption or a childless life.  But not knowing always keeps you stuck in limbo!


So it's only been a few hours since I received all this new information, but so far it feels a little disappointing, very surprising, and a little bit motivating.  As my RE pointed out as I walked out of his office this morning, we have a plan of action again now.  And having some sense of control in all this is one of the biggest thing that infertiles struggle with.  So I'm excited to have a little bit of that again.  For now anyway ;-)

Everything will now come your way

I just took a break from blogging to eat lunch: leftover Chinese food from last night, some delicious homestyle tofu to be exact.  I treated myself to a fortune cookie with my meal, and the fortune I received is pictured above.


"Everything will now come your way."  This is could be taken several ways.  Maybe it means that today's appointment was productive and we will be getting pregnant and having a baby soon.  Or, maybe, it means everything bad will come tumbling down upon us.  They always say, "When it rains, it pours."


So this morning B and I got up early and went to the RE's office.  We had seen a picture online of a sign that one fertility clinic had posted in their room where men "collect their samples."  The sign that apologized if some clients were uncomfortable or offended by the pornographic videos in the cupboard next to the TV & DVD player, but that some men produced better "samples" if sexually aroused, and that they [the clinic] were willing to help them do what ever that took [including providing porn].  So, this time, instead of sending B to awkwardly go into the clinic to do his business by himself in a little room off of a busy hallway where he could hear everyone talking right outside the door...I went along to make him feel more comfortable in effort to maximize our chances of success.  Sorry if that's TMI.


We thought we'd be in and out of there within 15-20 minutes, half an hour max.  While we were there, I mentioned my concerns about the results of the OPK testing yesterday.  The nurse ushered us into a consultation room to talk about what our options were.


It was so funny, as we tried to explain what was going on and what our concerns were, nurses, receptionists, assistants, students, and the doctor himself kept revolving in and out of that consultation room to talk to us.  It was like a clown car in that tiny room!


The issue is this: if we got a false positive, then it might be too early to do the IUI today. Today is only cycle day 12.  I usually get the positive with the OPK between days 14-16.  So this is early.  But on our first IUI, I got the positive result on day 12 too.  However, last time, we had paid for the package that included ultrasounds (u/s).  That package is $1300.


When I met with my RE last month to talk about our action plan for this IUI, he had said that everything went so well last time with the u/s monitoring, that we wouldn't need to do it this time.  Doing an IUI cycle without u/s is only $800.  So that's what we planned to do.  Since we'd be saving $500, we would be able afford to do another IUI later this year if we needed to, and would only need to come up with an extra $300.  You see, we'd put $1300 into our flex spending account for the year (originally thinking we'd need that much just for one IUI), so we have to spend that much on medical expenses anyway. Why not spend a little bit more and take two good cracks at making a baby this year instead of just one?


So now that we are wondering if the OPK positive was accurate, the best way to solve that mystery was to do an ultrasound.  I mentioned earlier that I got the postive LH surge on the OPK on cycle day 12 with the IUI last time, just like I did this time.  However, last time, I went in for an u/s the next day and my RE decided that my follicles were to small, so we waited another two days before doing a second u/s.  That's when he decided they were big enough and we did the IUI.  If we would have done it when I first got the positive OPK results, it would have been way to early.  This is why we were so torn about whether it would be better to trust the OPK this time around, or to do an ultrasound and get more detailed information about how close my body is to ovulating.


If we do an u/s now, we'd have to pay for the more expensive package ($1300), and then we couldn't afford to do a second IUI later this year if we need to.  But if we don't do the u/s, and we blindly go ahead with the IUI today, trusting the OPK results from yesterday, then we might be doing it too early and the sperm wouldn't survive in my body long enough to meet my egg(s) when I ovulate.  We'd be wasting $800.


Finally, the RE came in and flat out recommended that we do the u/s because he too was concerned about the results of my OPK.  So that settled it.


By this time it was nearly 9:30am.  We'd been there over an hour, and B had to get to work for a meeting he couldn't miss.  I told him to go, and I'd stay to get the u/s and then catch a cab home.


As they guided me into the exam room, one of the nurses said that they were going to try to move up my IUI from 2:15pm to earlier this morning, as soon as B's sample was done being processed (about another hour)!  That was a huge relief because last night I was so nervous about B's swimmers surviving for almost 6 hours before they performed the procedure on me!


The u/s went well.  On my left side I had a large follicle which was almost ready to release.  On the right, there was a second smaller one that needed a few more days.  Last time I'd had two on the same side, so this was different, and for whatever reason I was feeling kind of good about that.


My RE decided that he was still uneasy about my OPK results, even after the u/s, and wanted to test my progesterone and FSH levels in a blood test.  So they drew some blood and told me as soon as we had the labwork back and got the results of B's post-wash counts, we could do the IUI & I could go home.


I went and got some breakfast in the cafeteria while I was waiting for all these results.  I selected a hard-boiled egg (not vegan, but I wanted protein), a whole grain scone, and a small fruit cup.  I got a soy chai too, but only took a few sips because I decided I didn't want to drink caffeine before the IUI.


When I finished my little breakfast, I walked back over to the reproductive medicine clinic to check on the results of my pending tests.  They led me into a consultation room before they'd say anything... "this can't be good," I thought to myself.


The bloodwork wasn't back yet, but it didn't even matter.  B's post wash count was even lower than last time.

I was shocked.


We had done everything we could think of the last four months to improve our chances.  When they analyzed this "sample" before the wash his numbers were good.  Only 11 million total, but they had still said that was a decent volume for this procedure. So what happened?


Again, this post is getting too long and the next segment of the saga is pretty detailed too so I'll save it for yet another separate post.  Stay tuned for more!


To be continued... again

Nothing Like Peeing on a Stick in the Bathroom at Work

What a roller coaster the last two weeks have been... again.


First off, let me clarify that the stick pictured above and the kind that I was peeing on in the bathroom at work yesterday are ovulation predictor kits, not pregnancy tests.


B and I had scheduled another IUI for this month.  On day one of my period, I had to call my RE back here in WI and let them know I was menstruating.  His nurse sent my Clomid prescription to my pharmacy and told me to take a pregnancy test before taking the medication on days 3-7 of my cycle.  


I had met with my RE right after returning from Dallas last month to ask about using my two Gonal-F pens left over from our cancelled IVF cycle, but that would cost us around $3500 per cycle and B and I only set aside $1300 for a regular Clomid cycle with ultrasound monitoring.  So, not only would using injectables be much more expensive for us, it has huge risks of high-order multiples.  I mean, we're talking like Octomom here.  Those pregnancies are very high risk for the mother and babies, and if you choose to reduce (terminate) the number of fetuses, you risk miscarrying all of them.  So that's not the best option for us at this time.


On day 3 of my cycle I took a pregnancy test (knowing the answer since my period was getting heavier, not lighter), and that night I started taking 50mg a day of Clomid for 5 days.


I'm wondering, what dosage of Clomid my readers have taken?  I know 50mg is the lightest dosage you can get.  But during our last IUI it got me two good sized follicles, so that's exactly where the doctor wants me.  Also, at that dosage, it didn't effect the lining of my uterine wall, which Clomid can do, so this is a good amount for my body.


I felt very bloated all week while taking the Clomid, and actually did gain a few pounds, I wonder if any of my readers noticed weight gain while taking Clomid?


On cycle day 10 I began testing with my OPK.  My RE said to test once a day, preferably mid to late morning after having not peed for four hours.  The kit's instructions will tell you to pee with your first morning's urine, but the doctor feels that the concentration hasn't had enough time to build up by then, so later in the day is better.  I told him that I usually test at least twice a day anyway.  He told me I don't need to do that, but I told him I always do it so I don't miss the LH surge.  He said that's my choice, but if I get a positive surge in the morning, we'd schedule the IUI the next day, and if I get it in the evening, we'd do it the day after the next day.  Whatever you say doc.


Cycle day 10 was Monday, so I was testing with my first morning's urine (just in case) as soon as I woke up all week.  Then I would hold my bladder all morning along and at around lunch time, sneak into the most private bathroom I could find at work and test again (that's where the title of this post comes in).  Then, I'd  test again when I got home from work or before bed, depending on how often I'd relieved my bladder in the 3-4 hours prior.


Yesterday was Wednesday, and I got a negative result in the morning.  I had back to back meetings all day from 9am-4pm, to the extent that I hardly had  time to pee in-between meetings, let alone sit around waiting for OPK test results.  So, I did pee on a stick, but then shoved the tester in my drawer in my office with the stick still in it.  An hour later, when I had a chance to sneak into my office before another meeting started, I looked at it.  It was blank, which is usual with the digital tests, after a while the results disappear because the tester kind of "turns off."  I pressed the eject button to release the tester and, as has happened for me in past experiences, the last test result displayed on the screen.  It was a smiley face!  I had a positive result!


I kind of didn't trust that because I hadn't seen it in real time, so I didn't pee all afternoon and at 4pm snuck back into the bathroom at work to test again. Unfortunately, the tester was malfunctioning and the smiley face wouldn't go away.  I couldn't test with it and didn't have a spare, but had to pee REALLY bad, so I just went to the bathroom and figured I would hold my pee all evening and test again with my other tester when I got home, at around 7pm.


In the meantime I scheduled our IUI appointments for today.  B had to go in as early as possible because he had important meetings later in the morning at work that he couldn't miss, so the scheduled him to give his "sample" at 8:30am.  But they couldn't get me in until 2:15!  I was kind of freaking out that his swimmers wouldn't be as good if they had to wait around all day, but the receptionist assured me it would be fine.


When I tested last night after work with my other tester, there was no smiley face...


That made me question the validity of the test I'd taken at noon and not looked at the results of for an hour, so I thought I'd better say something at our appointment in the morning.


The results of that conversation and the appointment in general are complicated enough to warrant a separate post, so stay tuned for the rest of the story coming soon!


To be continued...

Newt suggests IVF is immoral

Newt Gingrich, a known pro-lifer, has recently attacked the regulation of clinics performing in vitro fertilization procedures.  He doesn't outright say it, but he's basically implying that the practice of IVF is immoral, because of the left over embryos that are never transferred.

Parents have to make a tough decision if they have completed their family: either destroy the unused embryos, donate them to science, or donate them to another couple for adoption.  It is assumed that Newt finds the first two options unacceptable.

My first reaction to the TIME article below is to disagree that this might not be such a bad idea, but I do like the statement made by Julia Shapiro that while perhaps these are ongoing issues that need to considered, legislation is not the answer.

Just another reason (out of many) not to vote for this guy.

http://healthland.time.com/2012/01/31/gingrich-wants-scrutiny-of-ivf-clinics-why-thats-not-the-worst-idea/