You are currently browsing the tag archive for the ‘Fertility’ tag.

TUESDAY, APRIL 7, 2009

Today is the day, we have been somewhat anxiously waiting for…whatever this “foreign body” is showing up on my ultrasound is disturbing to me. As I said before, it renders as a BRIGHT WHITE object among a field of black and grey sound waves. I am going to ask for the films today when we go in. I like to have everything in my own file, and then maybe I can post for you all to see. It isn’t subtle.

I am challenged by the angles we look at the uterus during the ultrasound, so I am unclear exactly where it is. Suddenly I feel uneducated, I am usually pretty on top of it.

I have a few small pre-op instructions, and as I have reviewed them this morning, I am getting really anxious. Not so much that it will go wrong. From what I understand, there are very few risks…infection, puncture of the endometrium…all less than 1%. I think I am scared of the pain. The HSG and Saline Sonogram were more painful for me than the average bear. I am working hard at just breathing this morning, and not getting worked up. However, I have not been able to keep myself out of the bathroom for long, yikes! Nerves.

The procedure is at 1p, with a check-in of noon. I’ll pick hubby up at 11:40a.

Here are the pre-op instructions:

  • Take 1 Doxycycline at bedtime night before procedure
  • Take 1 Doxycycline morning of procedure
  • No food or water after 10a
  • Bring pre-op meds with you to noon check-in (They called in 1 valium, 2 vicodin)

OKAY! I’ll be interested to see how it goes. I expect I’ll be drugged up after the procedure as they’ll give IV fentanyl or verced during as well. Luck to me 🙂

Advertisements

FRIDAY, APRIL 3, 2009

It would seem that the bcp was the culprit. I am feeling better all the time. Thank god the crying is over. Although, I am now very anxious about what is to come with the injections. Right now I can’t think too much about it, I just need to go day by day.

We decided to head out of town for the weekend. Hubbo has been working too hard, and a change of scenery will do me good.

Tuesday, April 7 is the hysteroscopy. I am sure there will be plenty to report next week.

MONDAY, MARCH 30, 2009

Still waiting on my mom, listening to one of my favorite songs by Lyle Lovett, If I Needed You. My husband had said, If you need me, call me, have them get me if I am in a meeting, I can be home in five minutes. He means it, he does. But he is busy, and we need him to have a job now! So I listen to this song instead and have great solace.

If I needed you
Would you come to me
Would you come to me
And ease my pain
If you needed me
I would come to you
I’d swim the seas
For to ease your pain

In the night forlorn
Ah, the morning’s born
And the morning shines
With the lights of love
You will miss sunrise
If you close your eyes
That would break
My heart in two

Lady’s with me now
Since I showed her how
To lay her lilly hand in mine
Loop and Lil agree
She’s a sight to see
And a treasure for
The poor to find

Here is a video of EmmyLou Harris doing a cover. LOVE THIS SONG.

SUNDAY, MARCH 29, 2009

I have been crying for two days straight. I don’t know why. I am trying to attach all of these reasons why I could be so upset. You would think by now I would have run out of tears. I cry about not having a baby. About not being able to find a job. About being so incredibly lonely being on my own all day. I cry listening to the new Miley Cyrus song. I know for sure there is something wrong. I don’t know what. I would think that all my tears would be gone.

Two days. I woke up Saturday morning with that feeling…the moment where your life feels beautiful, and before you can realize you are fully awake, you have crashed. My husband was off already on a long bike ride. I lay in bed wailing, sobbing, gasping for air…hoping it would be gone before he returned. I had no explanation.

By the time he came home I was exhausted by tears, dehydrated, nauseated. Still, no good explanation. I started grasping for things. I thought I needed REAL help, like to go to the hospital.

We made it through Saturday with a lot of crying, gatorade and hubby by my side.

Today is worse. I called my mom. I didn’t know what to do. She put my dad on the other line. I cried to them. I don’t know what I said. I have a therapist. We called her, made an appointment for tomorrow, Monday. I am hanging on to get to her.

I don’t know if the hysteroscopy threw me over the edge. Maybe this whole year has been too hard. All I know is that I want to have a great sleep and wake up to a sunny day and a happy feeling.

MONDAY, MARCH 9, 2009

Brief conversation with Dr. Fujimoto…he said that he felt the bright spot on the saline sonogram was likely an air bubble and we should go ahead and review again at my baseline ultrasound when we get ready for our first round of IVF in a few weeks.

YAY! I thank him and am ready to hang up. He is not ready to hang up.

He wants to talk about my Day 3 blood work…my FSH remains about the same, 8.9. However, my Estradiol was 148 and shouldn’t be higher than 60-70. This will make it a challenge to balance my hormones without overstimulating my ovaries.

What does this mean? Can we keep on our schedule? What will we do?

He says: You need to be on the Microdose Flare Protocol. AND, with your husband’s latest test results, and his sperm count going down, I strongly recommend ICSI for you. Ok, ta ta!

That was pretty much it. He is busy. I always talk to him on speakerphone which makes me think he is multi-tasking on me, even though he is totally on top of it.

He did say that I needed to schedule my baseline ultrasound for Day Seven. I’m on it. I WANT TO DO THIS NOW.

MONDAY, MARCH 2, 2009

I am set today for my Saline Sonogram. From what I have read, it should be a really easy, painless procedure. In fact, so much so, that I told hubbo not to cancel his important meetings and that I could take myself. And, to be honest, the HSG was SO painful, I can’t see how this will be painful. Instead of dye, this is simply saline injected for contrast. The saline sonogram is used to evaluate the inner cavity of the uterus (endometrial cavity). It can also be used to discover whether either of the fallopian tubes is open. This test does not reveal any abnormalities on the outside of the uterus or on the ovaries, such as adhesions or endometriosis. From what was explained to me, I was told they would be looking for polyps, fibroids, or any “foreign matter.”

This is what we hope the sonogram looks like…dark with no light streaks or spots!

Normal Saline Sonogram

Normal Saline Sonogram

Okay, off to the procedure! More later…

Hey gang, it’s the next day, last night was ROUGH, to say the least. I am coming to learn that I am incredibly sensitive—and that my retroverted uterus makes it tough to get up in there.

The procedure was performed by Dr. Sohn, who couldn’t have been more kind, knowledgeable and gentle. In the practice they rotate docs, so this was my time to meet Dr. Sohn. Unlike many, he talked me through the entire procedure, which I appreciated. The procedure is performed as follows:

  • The procedure is performed in the office
  • A speculum is inserted into the vagina.
  • The cervix is swabbed with an antiseptic to help avoid infection that can be caused by insertion of a small, balloon-tipped catheter through the cervix.
  • The speculum is removed and a transvaginal ultrasound probe is inserted into the uterus, providing a picture on a monitor.
  • A warm saline solution is injected through the catheter, expanding the fallopian tubes to allow for better visualization.

The doctor and nurse will tell you to expect mild cramping, and to take 800mg ibuprofen an hour before the procedure. If there is any pain, it should go away after the probe is removed.

THAT IS THE EXPECTATION. I, of course, could not be the norm, and had to be in dire pain. It wasn’t as bad as the HSG, but we ran into a few issues that created more pain than anticipated. Due to my retroverted uterus, Dr. Sohn had to manipulate the cervix in several ways to insert the catheter. My opinion is that the balloon on the end of that sucker is what hurts. Following that, there was some resistance flushing in the saline. When it did flush through, it felt like the most incredible menstrual cramp where you would expect an enormous flow to exit. I felt the cramp swirl from the bottom of the right of my uterus and flow up around the top around to the bottom of the left. I visualized a large marble in there. Then I started thinking about roulette. Then I started thinking about the movie Casino Royale…then I wondered if I would ever design anything as amazing as the opening credits for that movie. ANYTHING to distract, I suppose. I laid back on that table crying silent tears down the sides of my face.

Very Cool. I pulled it together. I got to watch the whole thing on the video monitor. I didn’t actually know what I was looking at. Kind of like Rachel on Friends when she can’t see the baby on the ultra sound. At that moment, Dr. Sohn showed me a bright white spot on the monitor. It kind of looked like a AA battery. Maybe an air bubble? He asked, Have you ever had an IUD? Uh, no. Are you sure? I laughed. He said, yes, you would likely know better than I would. So he, in his words, rooted around in there for a while to see if he could change the size, shape, position…an air bubble shouldn’t remain that long.

After about 45 minutes he removed the probe, sat me up and said, I think you have a “foreign body” lodged in the lining of your uterus. Uh, EXCUSE ME? He suggested I have a hysteroscopy to determine what it was. This is where they insert a camera into the vagina to get a better look. Want to know something funny? THE FIRST THING I ASKED? Do I get any pain medication for that procedure? I was not doing one more thing that was going to hurt that much. He said he would discuss with Dr. F and they would call me later.

I WILL TRY TO GET THE IMAGES OF MY SONOGRAM SO YOU CAN SEE WHAT IT LOOKED LIKE.

MY TIPS FOR THE SALINE SONOGRAM

Procedure Time. 20-45 minutes depending on size, shape and position of uterus. Additionally, any findings can increase time to take additional images. It seemed to pass quickly for me.

Ask for meds. If you had a hard time with anything else, get a valium or vicodin or something more than advil.

Wear granny panties. I don’t know about you, but I am a thong wearer! I have found that for these appointments I need to wear full undies to wear a sanitary napkin.

Wear loose clothing. They shoot you up with TONS of saline/water. You will be bloated for about 24 hours. Since it is not in your bladder, it will need to be absorbed or leak out, so fun.

Sanitary napkin! They gave me one, but it was short. When I took a few steps, I GUSHED saline and blood. I had to stop in the lobby and change out. Be prepared.

Recovery Time. Take it easy. AS ALWAYS…I say take it easy that day, and don’t over-exert the next. The doctor will tell you that you can resume normal activities within 3 hours. Having had it done, IF you can, relax. Let someone take care of you. My hubbo made me really fresh swordfish, cous-cous and my all-time favorite SO bad for you dessert of vanilla ice cream with magic shell chocolate. He is the best.

IMPORTANT NOTE: I was completely ok to drive myself home. I had terrible cramps, but nothing worse than a very bad period by the time I left.

MONDAY, FEBRUARY 16, 2009

So we notified UCSF we were ready to get started with the IVF process. We had questions, but wanted to go to the Orientation, see how many were answered there, then follow up with Dr. F. A few days later we received a large manila envelope in the mail with our startup goods:

  • Orientation confirmation
  • IVF prep checklist
  • Set of prescriptions for both hubbo and I
  • Blood work order for both hubbo and I

Holy Cow! It was really a lot to take in. And honestly, coming as a checklist, not enough explanation for me. There was some explanation as to when some of the tests needed to be complete, but not others. I didn’t hesitate to call our coordinator Janet for questions. We are developing a very good relationship over the phone!

I’ll scan the checklist so you can see what there is, but a quick recap:

Bloodwork—Female

  • Rubella
  • Varicella (chicken pox)
  • Infectious disease screening (HIV-1, RPR, VDRL for Syphillis, Hep B surface antigen, Hep C antibody and HTLV I/II Ab) NOTE: This test is absolutely mandatory before you can proceed by federal to protect the lab employees handling sperm, eggs and embryos.
  • Cystic Fibrosis
  • CBC with platelets
  • Fasting Glucose
  • TSH or Prolactin Levels
  • Cycle Day 3 FSH and Estradial
  • Blood type and RH Screen
  • Fasting Lipid Panel

Bloodwork—Male

Infectious disease screening (HIV-1, RPR, VDRL for Syphillis, Hep B surface antigen, Hep C antibody and HTLV I/II Ab) NOTE: This test is absolutely mandatory before you can proceed by federal to protect the lab employees handling sperm, eggs and embryos.

Testing—Female

  • Pap Smear
  • Baseline Ultra Sound
  • Saline Sonogram

Testing—Male

  • Semen Analysis with Strict Morphology

Medications—Female and Male

  • Multi Vitamin with Omega 3 and Folic Acid for female
  • Doxycycline Pre-treatment (this is a one time 10 day anti-biotic treatment, as long as you remain monogamous, to be taken twice daily at the start of menses.

PHEW!!! All of this, plus the orientation and a financial consultation need to be completed prior to even starting hormone therapy.

TUESDAY, FEBRUARY 24, 200

I have never been SO excited to get my period. My husband, not so much. Before we started TTC, I was on continuous bcp, so we never had a break. THEN, when we were really trying naturally, we were on it all the time. POOR GUY. Do any of you really feel for him? No, I don’t either. 🙂 I do love him more than anything, though. Like I said before, even more than the Valentino handbag I want 🙂

As instructed, I called our coordinator, Janet {we LOOOOVE her} and got our instructions:

  1. Day One: Begin taking the Doxycycline
  2. Day Three: I needed to have all bloodwork done (dude, that is a lot of blood)
  3. Day Seven: We scheduled the saline sonogram

Okay, I feel like I am on my way. Happiness.

happy happy

happy happy

WEEK OF FEBRUARY 9, 2009

It is so interesting…we got home and said, Okay, let’s take the week to determine what to do, IVF or IUI. But I think we both knew right away that IVF was the way to go. Like I said, I tend to get all the info and have the ability to make a decision immediately. The hubby? He ruminates. I get it. And then I don’t get it. At the same time, it did feel a little strange to meet one time with a doctor and then make a major life altering decision. We decided to do the following:

  • Talk it over with our parents
  • Review the financial ramifications of trying IUI first, then moving on to IVF if IUI was unsuccessful.
  • Complete a list of unanswered questions to email to Dr. F.

IUI

To begin, we learned more about the IUI process. Most people we know call it “The Turkey Baster.” I guess this is the way they can make is comfortable to talk about. {Maybe this is something I’ll talk about later, how much people DON’T want to talk about this, even your closest friends.}

IUI is defined as the process by which sperm is deposited in a woman’s uterus through artificial means. From what I have read, many IUI candidates are those who have male fertility issues and can use assistance getting the “good” sperm separated and inserted past the cervical mucous.

Process

TheAdvanced Fertility Center of Chicago has a good description of the process in my opinion:

  1. The woman usually is stimulated with medication to stimulate multiple egg development and the insemination is timed to coincide with ovulation – release of the eggs from the follicles.
  2. A semen specimen is either produced at home or in the office by masturbation after 2-5 days of abstinence from ejaculation.
  3. The semen is “washed” in the laboratory (called sperm processing or sperm washing). By this process, the sperm is separated from the other components of the semen and concentrated in a much smaller volume. Various media and techniques can be used to perform the washing and separation, depending on the specifics of the individual case and preferences of the fertility doctor and laboratory. The sperm processing takes about 20-60 minutes, depending on the technique utilized.
  4. A speculum is placed in the vagina and the cervical area is gently cleaned.
  5. Then the separated and washed specimen consisting of a purified fraction of highly motile sperm is placed either in the cervix (intracervical insemination, ICI) or higher in to the uterine cavity (intrauterine insemination, IUI) using a sterile, thin and soft catheter. Intrauterine insemination has a better success rate than intracervical insemination. Therefore, it is the preferred method at the large majority of fertility specialist centers.
IUI Insertion Example

IUI Insertion Example

After reviewing this option, my husband is REALLY, REALLY wanting to do this. He feels like it is more natural, in so much as those procedures that need assistance. He is getting pretty upset that our baby may be made in a petrie dish. I keep joking we can name the baby Pete. Apparently, not so funny. I think it is. The other consideration here, this is MUCH LESS invasive and emotionally and physically demanding on the woman. My husband did not want to see me go through this.

IVF

I thought I knew a lot about this process. You take some hormones, they harvest your eggs, they fertilize them, re-implant them and you are pregnant. Yippee! I DID NOT KNOW. I JUST DID NOT KNOW. Every situation is quite personalized For us, we were starting from a poor baseline. Let me take you through the process of IVF, later I’ll talk about follicles, eggs, etc.

IVF has many steps, and is much more complicated to explain than IUI. In short, the goal of IVF is to stimulate more than multiple follicles {as opposed to one} into multiple eggs for retrieval and fertilization in a lab. These fertilized embryos will be implanted into the woman’s uterus anytime between 2-5 days after fertilization. Two weeks after implantation you will know if you are pregnant. I will go into MUCH greater detail the IVF process in a later post.

TALKING TO OUR PARENTS

This just didn’t go so well. My hubbo isn’t that close to his, so we went to talk to mine. I just started to cry. I startled myself with this. They just didn’t think it was as “bad off” as we said. My dad, the doctor, was convinced that our test results were wrong. Bless them, they just didn’t want to see us in pain.

OUR LIST OF QUESTIONS

  • You quoted us possible success rate of 35-40% with IVF. Is this per embryo implantation per cycle, or per cycle only? And, is this rate based on our specific case?
  • How many eggs will you aim to retrieve? What is a normal retrieval?
  • How many eggs do you recommend implanting per cycle?
  • What is the increased percentage of multiple births?
  • What is the risk for miscarriage?
  • What are the common complications we need be aware of?
  • Is it possible that our future bloodwork and/or tests could change our eligibility for IVF treatments? Are there key tests we need to be aware of?
  • Are there any genetic defects and/or development disorders that have been associated with / attributed to IVF?
  • Given our inclination to move straight to IVF, do I need the laparoscopy, or can we wait?
  • I have recently gained about 15 pounds (normal weight is 160-165lbs). Is there benefit to waiting a couple of months to lose the weight prior to starting treatment? I am concerned about being too heavy during my pregnancy.
  • Is there weight gain associated with the fertility drugs I will be taking?
  • Are there any lifestyle modifications that might help my condition and increase my chances of getting pregnant? What role do the following play in getting pregnant: weight, exercise, prescription drugs, stress, acupuncture, etc?
  • What is the full array of programs/services the Center for Reproductive Health offers?
  • Will any of our fertility conditions worsen over time, improve, or remain constant?
  • What further tests do you recommend? Are there any risks associated with the testing? Does my hubby need additional testing?
  • Follow up: In your practice, how often does this/these treatment(s) result in pregnancy? How many of these pregnancies result in live births, miscarriages, etc. (percentages?)
  • How many cycles of treatment on average does it take to see positive results?
  • Can we begin treatment immediately? Do you tailor treatment to individual couples, or is there a set protocol?
  • What type of monitoring and interaction can I expect from the center? Ultrasounds, blood work, general communication? How available are people for consultation and questions via telephone?
  • What are the benefits to IUI v. IVF? What makes a good candidate for each treatment? Can we improve our candidacy for IUI?
  • At what point do either or both of us need to consult a reproductive endocrinologist? Does your center offer that service?
  • Do you provide fertility and ob/gyn, or fertility only? Do I need separate ob/gyn?
  • What does treatment cost? Does my insurance cover any of the medications, hospital charges, or doctor’s visits? If I must pay out-of-pocket, do you offer any special payment plans?
  • What is the procedure for getting questions answered between appointments? Can I call, fax, or e-mail and expect a prompt reply?
  • What is the standard callback time, and does it vary depending on the urgency of the call?
  • I understand that many of my questions can be answered with a callback from a nurse, but if I need to speak with a doctor how do I make that clear?
  • What do I need to know about scheduling weekend procedures?
  • What is the phone number for off-hours problems?
  • Is there a directory of phone numbers for office staff and doctors? (numbers for contacting a nurse, getting lab results, discussing billing issues, etc)

THE DECISION

By default, we decided to just go to the upcoming IVF orientation. We were pretty clear that IUI was not going to work for us. Had it simply been an issue of my husband’s sperm motility, it may have made sense. However, with my follicle count and FSH levels “drifting upward” we knew we needed additional help. At this point, I think it was really more a question of whether or not IVF would work for us.

MONDAY, FEBRUARY 9, 2009

Today is the day. We have our big appointment with Dr. Victor Fujimoto at the UCSF Center for Reproductive Health. I have been counting down the days. Like Christmas. Remember when you were little, and it seemed like time stretched on and on and on? Then you get to the day and you wonder, what is in store for you?

I had been preparing for weeks. I wanted to know as much as I could as to speak intelligently to the doctor. I didn’t know if he would be the God Complex type or the compassionate type. Would we have much time with him? Or would this just be a quick meet and greet and then he would send us off for more testing. Having most of the preliminary testing done beforehand was a good idea, I thought. {In the end, Dr. Fujimoto was pleased with that as well.}

My husband has a completely different approach. He prefers to hear what the doctor says, then ask questions based on results. This does make me a bit nutty. I think we should have questions prepared for all the options. We STRONGLY disagree here. What a learning lesson for me. I have to remember that we don’t have to think alike, or be the same. And I can’t expect him to act and think like I do. You know, it is probably better that we are different that way…he may be more open to hearing things I don’t since I have everything written down. I tend to get stuck in what I have in my mind.

We arrived for our appointment a few minutes early. I was happy my husband was ready on time, and we were there with time to spare. My husband likes to breeze in at the last moment, rarely thinking of the details that need to be taken care of when we arrive places-is there paper work to fill out…do we need to bring a gift or wine to a dinner party…will we be checking bags at the airport? This is how we ultimately compliment each other.

The women at the front desk were so kind, and knew us both by name. This made me feel so easy, like we were not just another name in their book. The offices were very nice, and well kept. When we walked in, and I was filling out the paperwork, I noticed my husband seemed a bit distant, glassy-eyed. I think the full weight of what was happening hit him at that moment. We had talked a lot about it, but you can never really prepare until you are in a situation, I think. And, he has so much going on at work right now, I know he hasn’t really had the bandwidth to process all of this. He has told me time and again how much he has wanted a “natural baby.” He wants a family so badly, he will do what it takes. And, we will adopt if we can’t have out own. But I know that the idea of the petrie dish makes him sad. Being the romantic that he is, the clinical nature of this knocks the wind out of him.

The nurse called me in to do my initial vitals…weight, blood pressure, temp…and I wonder, why do I wear boots, jeans and a heavy sweater? My weight shows a solid 5-7lbs more than normal. What a chub. I have gained about 15lbs since our wedding. Most people like to say, oh, married life. Really, I have just felt so ill this year that I have not made it to the gym much lately. I promised myself in that moment I would do what I could to drop some weight before we began a cycle. It would be at least 8 weeks. I can do some serious damage in that time! It really just takes focus on my part, and discipline on my husband’s part. He doesn’t like to eat his ice cream alone, so I really have to get him to promise not to tempt me.

Dr. Fujimoto came out to invite us to his office. I love when the doctor comes himself to the waiting room for you. They just seem more accessible to me that way. We went directly to his office, where Dr. Fujimoto had our file, preliminary testing and initial intake form. Prior to our visit, we were required to review and complete a LENGTHY packet of information. Dr. Fujimoto had clearly reviewed our packet, studied our test results and was well-prepared to meet with us. We came prepared with a list of questions and a calendar charting my menstrual cycle, LH surge, estimated ovulation and intercourse dates.

We spent about 15 minutes discussing our previous results with Dr. Fujimoto. At this point, he suggested we move into the ultrasound room where he would perform a vaginal ultrasound. Again, my husband would be with me, with a man I did not know prowling around my coochie! My husband is actually very cool about it, I am the one who is mortified. I am hoping the more we do it, the better I will feel.

Off we went, and I undressed from the waist down. At least this time the table had some cushion, was on an incline and had stirrups. HOWEVER, there was NO MODESTY with Dr. Fujimoto. I had the paper drape over my lap, and when I lay down on the table, he essentially threw it up over my waist. ohhhkaay! This was also the first time that I had a vaginal utlrasound where I did not insert the probe myself. He was not rough or anything, I was just a bit startled…my first meeting with a male doctor I didn’t know, and he was probing me! Like I said, I think it will get easier. And I think I will HAVE to get over it by the time we go in to birth the baby. I have heard that you just CANNOT care at that moment.

During the ultrasound there was a female nurse in the room (who did not introduce herself to me, huh?). Suddenly, Dr. Fujimoto became quite serious and very professional. The casual and friendly atmosphere redirected and my husband and I became silent. I was worried. And, to be honest, I was terribly sad. Heavy news was to come. Dr. Fujimoto began dictating notes to the nurse, describing the number of antral follicles found in each ovary. He gently removed the probe, asked me to get dressed, and invited us back to his office.

When we sat down with Dr. Fujimoto for our second discussion, the air in the room felt a bit dark to me. My husband and I were holding hands, we were determined to be optimistic. This was our first fertility visit, and had the idea that we would be sent for tests and take a few steps at a time towards a diagnosis and getting pregnant. We were so wrong.

For better or worse, Dr. Fujimoto was extremely candid with us. It was hard to hear, we were stunned. BUT, to say we were appreciative is an understatement. His ability to understand complex issues and explain them to people outside the medical profession is unmistakable.

Dr. Fujimoto’s assessment was:

  • My FSH level, at 9.8 units/liter, was high, and drifting upward. This was a surprise as my ob/gyn had reported all my blood work to be in the normal range. Normal range is actually 4-7 units/liter.
  • I had a significantly low antral follicle count of 8 follicles. A normal follicle count would be 40-50.
  • My husband has a borderline low sperm count at 20million.

What did all this mean? Could we proceed with IUI? This was the recommendation from our ob/gyn. This was also the preference of my husband, it seemed the most natural option.

No. With a drifting FSH level, my ovaries and egg quantity are likely compromised. I have a low ovarian reserve, and, like most women, am shedding close to 1,000 follicles per month. IUI would provide us less than a 10% chance per month of conception. IVF would provide us a 35-40% chance per month of conception. Dr. Fujimoto strongly recommended us to move straight to IVF. Indeed, he said that if we wanted to have a family, this was our time. In fact, we had no time to waste.

We left with a handful of cards for the IVF team…the coordinator, the nurse, the billing team, the urologist…I’m sure there are more I can’t remember right now. We all agreed we would spend the weekend deciding what to do and contact Dr. Fujimoto the following week with a decision and/or any follow up questions.

My husband and I walked into the elevator holding hands in complete silence. It is not like me to not start chatting right away. I like to know what he is thinking. I usually need to pry it out of him. I was in shock, though, that we had to move to the most drastic fertility procedure from the get-go. As we walked outside, my husband ran his hands through my hair, rubbed the back of my neck, and kissed the bridge of my nose. I always know how much he loves me when he does this. I couldn’t have married a better man.