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 ;-)