IUI #2.2 - My Husband is a Rockstar!

I had IUI#2.2 today, and am so happy to report that my husband's sperm finally came to the party! :) His motility shot up to 60% (progressive)!! Yesterday it was only 4%, so that is a huge difference! His concentration was decent (28 million per ml), and his volume was the best it has been yet (2ml). Overall, awesome result! We had 13 million motile post wash! :)) I am so so relieved. Even if this doesn't work this cycle, I have a little more hope now, as there is evidence that his boys can put on a good showing. :)

I think the difference might actually be the lack of abstaining this time. His motility has been consistently higher when he doesn't abstain for more than 24 hours, and substantially lower when he does (for example, he abstained for 3 days before the 4% motility yesterday). His count is higher when he abstains, but frankly, who gives a fuck if we have 100 million immotile sperm? So, no more abstaining for us. It's more fun this way anyway! ;)

As for me, the jury is out on whether I had already ovulated. The ultrasound technician said definitely not, but the nurse said maybe/probably based on my bloodwork (progesterone went up, estrogen fell slightly). The doctor was adamant that I would not ovulate until 36 hours after the trigger, and that my bloodwork was normal for right before ovulation. Dr. Google is, of course, inconsistent - some sources say progesterone starts to rise immediately before ovulation, and some say it only rises after (and no, I am not consulting Yahoo answers!). I did get one positive OPK the night before trigger, but I got a negative within hours, and my bloodwork has not shown an LH surge. Perhaps it was a short surge, and maybe it was a false positive. Who knows. Either way, it was at least close. With multiple follies and 13 million swimmers, I can't help but hope!

IUI #2.1 - 4% Motility, WTF??

I had IUI #2.1 today (ie. the first of two back-to-back IUIs this cycle). It did not go very well. There is good news and bad news. The good news is, the collection condoms really did do the trick - my husband's sample volume trippled to 1.5 ml! His concentration was great, at 70 million per ml. The problem, and the bad news, is his motility. It was a whopping 4%! :(. We knew it was low, but we were not anticipating a number like that (it has previously been 26% and 17%). The extremely low motility made a big difference. Notwithstanding that we had upwards of 100 total sperm, only 3 million survived the wash, with 85% of them being motile. Dammit!. If it's not one thing, it's a-fucking-nother. Of course the doctor also could not get the catheter past my stupid cervix again either, and so she had to use the foley balloon method again.

This is so frustrating.

On the plus side, to the extent that it even matters at this point, I had an awesome response to the Gonal-f! Even at the low dose of 87.5, I had three perfect mature follies, with two that were very close (1.6 cm each), and another three at 1.5 cm! The odds of any more than the three most mature follies containing an egg are about 50/50, according to my RE. Of course, none of that matters if we don't have enough good sperm to work with. *sigh*

I guess we will try again tomorrow. My bloodwork and ultrasound today showed that I had not yet ovulated, so there is still hope. We really need to get to the bottom of this motility bullshit though. My husband has an initial appointment with a urologist in July, which can't come soon enough.

Someday...

I have never had a blog before.  I have certainly thought about it, and in fact kept a journal for many years (hardcopy - yes, I am old).  I have always enjoyed writing. Frankly, I don't know what has held me back... but in any event, here I am. I have finally decided to give this blogging business a chance. 

So, what will I write about?  I'm not sure yet.  For now, I think I think it makes sense to start with what has become the major focus of my thoughts and attention as of late - trying to conceive with diagnosed fertility issues. 

I won't go so far as to say that I am struggling with infertility - I frankly don't think that I am there yet, and I believe that to adopt that label at this point would be insulting to the many women who have been trying for far longer than myself, and whose strength and spirit are both humbling, and inspiring.  My husband (MH) and I have however been diagnosed with a number of fertility issues - low progesterone, low ovarian reserve, low motility, and a varicocele (further testing pending).  All but one of those diagnoses came as a shock to both of us.  We are still reeling from, and trying to come to terms with, this new reality.

MH and I have been trying to start our family since September 1, 2011.  By that time, we had been together for more than 8 years.  My husband was 35, and I was 31.  We had finally decided that it was time.  We were both excited, and nervous.  It never occured to either of us that we might encounter any difficulty in starting this new chapter in our lives.  We both (very naively) assumed that if we had unprotected sex, then I would be pregnant within a month or two (at the most).  After all, wasn't that we had always been told?

We have always known that we wanted children, but we were never in any hurry to get there.  I was in university until I was 24, and then at the beginning of a very demanding career in a male-dominated profession.  I wanted "prove myself" and establish my career before turning my mind to children.

We thought we had all the time in the world.

Whenever someone asked when or if we were going to have children, our response was always to say that of course we wanted to start a family "someday", but "not just yet." 

Fast-forward to September 2011.  We finally decided to take the plunge and so, I began charting my temperatures and tracking my other fertility signs.  I quickly discovered that I had a painfully short luteal phase (LP).  My concerns were dismissed by everyone, including my family doctor, who did not know what a luteal phase was (!).  I finally convinced him to refer me to a specialist.  My goal of course was to simply have my progesterone tested at 7 days past ovulation (DPO), in order to determine whether I needed to be taking progesterone supplements in order to stave off my period and sustain a pregnancy, if one were to occur.  This process took several months. 

In the meantime, I became pregnant in December 2011.  I actually did not know that I was pregnant until mid-January 2012, when we were in the midst of trying to time our sex during what we thought was a new cycle.  I had begun bleeding at 8DPO in December, right on time.  I bled for 7 days, as usual.  I also had a negative pregnancy test that day (way too early to test, I know!).  I therefore assumed that I had my period, and went on with my life.  It was only after I had positive ovulation tests four days in a row in January, nausea and extremely sore breasts that I thought "okay, I know this is crazy, but I am going to take a test."  Lo and behold, I was knocked up.  We were so excited!

Unfortunately, our excitement turned to apprehension within hours as I realized that what I thought was mid-cycle spotting in January could in fact be indicative of a problem given that I was pregnant.  Our fears were confirmed via numerous betas and ultrasounds (in which I heard the heartbeat, twice) and ultimately, I miscarried naturally at home over the course of several days.  I was 8 weeks, 3 days pregnant.

Around the same time, I began a new job with a great company.  We decided that we would take a short break.

We started trying again in April, and finally met with a specialist and had testing done in May 2012.  My only concern was my progesterone, but my RE insisted that I have full testing done before she would treat me.  I anticipated that I had low progesterone so I was prepared for some bad news, but I frankly did not expect there to be any other issues.  Unfortunately, I was wrong.  In addition to low progesterone, I was diagnosed with low ovarian reserve (!).  My husband was diagnosed with low motility at 26% (should be at least >40%).  He has also now been diagnosed with a vericocele.  He will be doing further testing, and is scheduled to see a urologist soon.

Because of MH's low motility, we have been told that our chances of conceiving with timed intercourse alone are not great.  We are therefore proceeding with IUIs.  Our first cycle will be natural.  I will thereafter be taking increasing doses of Gonal-F.

So, there you have it.  We are continuing on our journey to start our family via the world of fertility treatments and procedures. 

While I am still confident that we will have children someday, I now realize that "someday" may just be a little farther off on the horizon than I had anticipated, and our path might not be as straight and flat as I had hoped.    Hopefully though, we will still get there soon.