I went in for my second IUI on Sunday morning. The procedure was the same, but they kept me waiting a really long time instead of whisking me in and out like they did the first time. I also had Dr. Sparrow in person instead of the physician's assistant. He explained that Mark's numbers should really be above 10 million viable sperm after the wash, while they were actually at 7.5 million the first time and something around 6.8 million the second. So, we're not doing all that well.
But since I've decided I don't really believe in IUI for us, no matter. If it works, great. If not, I won't be terribly surprised.
It's going to be quiet days around here for a while - really nothing new to report.
New financial update:
Initial Visit with Dr. Sparrow: $280.00
Bloodwork for Me: $23.29 (insurance actually covered a lot of the bloodwork costs)
IUI: $175.00
Semen Analysis: $100.00
Sperm Wash: $225.00
IUI v2: $175.00
Sperm Wash v. 2: $225.00
Total: $1203.29
Showing posts with label iui. Show all posts
Showing posts with label iui. Show all posts
Wednesday, March 3, 2010
Tuesday, February 16, 2010
As Expected
Every month when I find out that I'm definitely not pregnant, I just say I flunked. I flunked again this month, as expected.
To be honest, I really, really don't think IUI works much better than no intervention at all (especially without medications - but I don't want the medications either). That said, it's a lot cheaper than IVF and just in case it does work it seems like it's worth a try. Since Mark's numbers were up this past month, we'll do another IUI round this month and then evaluate whether to do a third and then a fourth.
I'm getting better about not buying ten zillion pregnancy test kits and starting to test a week and a half before anything could even show up. I only went through three tests this cycle. Believe it or not, that's a huge, huge improvement!!
Speaking of money, we've just received our first official bills so now I can really break it out. Here's how it looks so far for one round of IUI:
Initial Visit with Dr. Sparrow: $280.00
Bloodwork for Me: $23.29 (insurance actually covered a lot of the bloodwork costs)
IUI: $175.00
Semen Analysis: $100.00
Sperm Wash: $225.00
Total: $803.29
Adds up quickly, doesn't it? The next round won't be as expensive since we won't need bloodwork, an initial visit, or the analysis. Just the IUI and the wash.
So far this process isn't all that stressful. It's pretty sobering to think that we just spent $800 for essentially nothing. Also, now that I've been through the IUI once, the novelty of having the new experience is definitely wearing off and it sounds more like a tedious errand to me than anything exciting, probably also because I have absolutely no confidence that it's going to work. When we get to the IVF part (assuming we do) I think I'll be a lot more excited because I think the statistics for IVF are so much better for us.
To be honest, I really, really don't think IUI works much better than no intervention at all (especially without medications - but I don't want the medications either). That said, it's a lot cheaper than IVF and just in case it does work it seems like it's worth a try. Since Mark's numbers were up this past month, we'll do another IUI round this month and then evaluate whether to do a third and then a fourth.
I'm getting better about not buying ten zillion pregnancy test kits and starting to test a week and a half before anything could even show up. I only went through three tests this cycle. Believe it or not, that's a huge, huge improvement!!
Speaking of money, we've just received our first official bills so now I can really break it out. Here's how it looks so far for one round of IUI:
Initial Visit with Dr. Sparrow: $280.00
Bloodwork for Me: $23.29 (insurance actually covered a lot of the bloodwork costs)
IUI: $175.00
Semen Analysis: $100.00
Sperm Wash: $225.00
Total: $803.29
Adds up quickly, doesn't it? The next round won't be as expensive since we won't need bloodwork, an initial visit, or the analysis. Just the IUI and the wash.
So far this process isn't all that stressful. It's pretty sobering to think that we just spent $800 for essentially nothing. Also, now that I've been through the IUI once, the novelty of having the new experience is definitely wearing off and it sounds more like a tedious errand to me than anything exciting, probably also because I have absolutely no confidence that it's going to work. When we get to the IVF part (assuming we do) I think I'll be a lot more excited because I think the statistics for IVF are so much better for us.
Monday, February 8, 2010
For those who wonder...
I am getting close to five days post-IUI and I don't feel pregnant in the least. Not a single symptom.
I don't think most women do get symptoms this early, but if you do a search on google of pretty much any physical malady followed by "early pregnancy symptom" you'll come up with a ton of links. Seriously. Try it.
So, I don't expect that I should be getting any pregnancy symptoms, and I'm not getting any. Whether that's because I'm just not pregnant or if it's because it's too early for symptoms remains to be seen.
I don't think most women do get symptoms this early, but if you do a search on google of pretty much any physical malady followed by "early pregnancy symptom" you'll come up with a ton of links. Seriously. Try it.
So, I don't expect that I should be getting any pregnancy symptoms, and I'm not getting any. Whether that's because I'm just not pregnant or if it's because it's too early for symptoms remains to be seen.
Thursday, February 4, 2010
A couple things I forgot to mention...
I forgot to mention that I was able to go straight back to work with no problems whatsoever as soon as I was done at the clinic. In fact, it was like it had never happened. I felt maybe a tiny bit different inside, but that might have been because I had KFC for lunch. Similarly, I'm feeling a little bit weird on my left side tonight, but it could be just ovulation or it could be something I ate. Hard to say.
Also, we've got an update on expenditures:
Clearblue Easy OPK - $29
Sperm Wash - $225
IUI - $175
Current Total: $429
Also, we've got an update on expenditures:
Clearblue Easy OPK - $29
Sperm Wash - $225
IUI - $175
Current Total: $429
First IUI
I left that last post at 12:45 in the morning, so I think everyone was thinking that the first IUI is scheduled for Friday, but it actually took place today.
I was half-right about the procedure starting later than 8:30. They had me wait until 8:45 and then brought me into the exam room and had me wait another five minutes. So, they started before 9:00, but not much! It was okay though - it went really quickly so everything worked out.
Mark went to work very early this morning in order to get through a lot of his work before rounds started at 7:30. He left work and went to the clinic at 7:00 am to give his sample. Then, he dashed back to work in time to start rounds with his team.
After he left the clinic, the lab took his sperm sample and put it through a wash. They put the sperm in a container that I imagine as a cylinder. The container has a few filters in it along with some kind of liquid. The sperm are inserted in the bottom and they have to try to swim to the top, through all of the filters. Sperm with no tails don't make it. Sperm with large heads don't make it. Slow, lazy sperm don't make it. They started with 23 million sperm and after the wash they had 7.5 million left. Those 7.5 million were put into a little syringe.
I showed up just before 9:00. I was shown into a regular exam room, just like you would go to for an annual exam. The procedure was done by a physician's assistant who came into the room and explained everything before she began. She showed me the syringe and it appeared to be connected to a catheter that I couldn't see because it was still wrapped in a bag - from what I could tell it was pretty long, but very thin.
The procedure started out just like an annual exam, with the speculum. She checked my cervix to make sure it was all healthy and ready for ovulation. After she determined it was, she inserted the catheter. I could tell when she had inserted it, I could sort of feel it moving up inside me. She then injected the sperm using the syringe/catheter. Around this time she told me the sperm were going in, but I couldn't tell a difference from just the catheter. I started feeling a little crampy, but nothing terrible. Then she just pulled it out and the procedure was over. The whole thing probably took less than five minutes once she started.
At this point, she told me to just lay there for 15 minutes and give the little guys a running start. So, I grabbed my iPhone and looked up my horoscope. It was this:
LEO (July 23-Aug. 22). You just got home, so you're not anticipating another trip. But you might have to adjust your activity forecast when an interesting invitation arrives. When have you ever turned down a new adventure?
I was half-right about the procedure starting later than 8:30. They had me wait until 8:45 and then brought me into the exam room and had me wait another five minutes. So, they started before 9:00, but not much! It was okay though - it went really quickly so everything worked out.
Mark went to work very early this morning in order to get through a lot of his work before rounds started at 7:30. He left work and went to the clinic at 7:00 am to give his sample. Then, he dashed back to work in time to start rounds with his team.
After he left the clinic, the lab took his sperm sample and put it through a wash. They put the sperm in a container that I imagine as a cylinder. The container has a few filters in it along with some kind of liquid. The sperm are inserted in the bottom and they have to try to swim to the top, through all of the filters. Sperm with no tails don't make it. Sperm with large heads don't make it. Slow, lazy sperm don't make it. They started with 23 million sperm and after the wash they had 7.5 million left. Those 7.5 million were put into a little syringe.
I showed up just before 9:00. I was shown into a regular exam room, just like you would go to for an annual exam. The procedure was done by a physician's assistant who came into the room and explained everything before she began. She showed me the syringe and it appeared to be connected to a catheter that I couldn't see because it was still wrapped in a bag - from what I could tell it was pretty long, but very thin.
The procedure started out just like an annual exam, with the speculum. She checked my cervix to make sure it was all healthy and ready for ovulation. After she determined it was, she inserted the catheter. I could tell when she had inserted it, I could sort of feel it moving up inside me. She then injected the sperm using the syringe/catheter. Around this time she told me the sperm were going in, but I couldn't tell a difference from just the catheter. I started feeling a little crampy, but nothing terrible. Then she just pulled it out and the procedure was over. The whole thing probably took less than five minutes once she started.
At this point, she told me to just lay there for 15 minutes and give the little guys a running start. So, I grabbed my iPhone and looked up my horoscope. It was this:
LEO (July 23-Aug. 22). You just got home, so you're not anticipating another trip. But you might have to adjust your activity forecast when an interesting invitation arrives. When have you ever turned down a new adventure?
Tomorrow - First IUI
Day 2 and 3 of the ovulation predictor kit were much more successful than day 1. Today the test indicated that I have a surge in my luteinizing hormone and am therefore about to ovulate. To explain that more fully, when your egg is developing each month it is held in a protective follicle. As the follicle matures, your estrogen level rises. Once your estrogen level has risen to a certain point, it triggers a surge in your luteinizing hormone. That prepares the follicle for ovulation (the release of the egg) and conversion of the follicle into a corpus luteum. This conversion takes place while the egg is traveling down the fallopian tube in search of a willing sperm. If the egg is fertilized, then the corpus luteum secretes progesterone which helps thicken the lining of the uterus to assist in implantation of the egg.
So. Today my body had the surge in the luteinizing hormone and an egg should be released in less than 24-48 hours. This is where the scrambling comes in. After receiving the test result, I called Joy and she said we have to go in tomorrow for the IUI. Mark has to give a sample tomorrow morning at 7:00 am, and I'm supposed to go have the insemination done at 8:30. Officially they don't do inseminations until 9:00 am, but I've begged them to let me in early because I have a meeting at work that I do not want to miss for one of my youth clients (it's already been rescheduled once.) They say they'll let me in, but they sound very dubious, so I have the feeling they're going to let me in to sit in the waiting room until 9:00. All I can do is try, I suppose.
I'll post tomorrow about the whole experience.
So. Today my body had the surge in the luteinizing hormone and an egg should be released in less than 24-48 hours. This is where the scrambling comes in. After receiving the test result, I called Joy and she said we have to go in tomorrow for the IUI. Mark has to give a sample tomorrow morning at 7:00 am, and I'm supposed to go have the insemination done at 8:30. Officially they don't do inseminations until 9:00 am, but I've begged them to let me in early because I have a meeting at work that I do not want to miss for one of my youth clients (it's already been rescheduled once.) They say they'll let me in, but they sound very dubious, so I have the feeling they're going to let me in to sit in the waiting room until 9:00. All I can do is try, I suppose.
I'll post tomorrow about the whole experience.
Monday, February 1, 2010
New Characters and Little Blue Lines
First - I've named some new characters:
Dr. Sparrow - my reproductive endocrinologist
Joy - his medical assistant
The first step in doing one IUI cycle for us is to monitor this month's ovulation. I've been monitoring my ovulation cycle for seven months using a ridiculously expensive (yet pretty darn accurate) fertility monitor. Unfortunately, Dr. Sparrow prefers to have his patients use Clearblue Easy Ovulation Predictor Kits. I was given instructions to use the first test on day 10 of my cycle, and today is day 10.
Most of the kits tell you to use the test first thing in the morning. However, Dr. Sparrow prefers his patients to use the tests on the second trip to the powder room of the morning (can everyone tell I'm trying to be as delicate as possible about this? Is it actually making it worse?!) Dr. Sparrow's method means that I actually have to take a test to work with me and try to take it in the bathroom with no one noticing.
So, at about 10:00 this morning, I used the trick one of my high school friends taught me for sneaking to the bathroom with a tampon - pay attention all you riveted teenagers - I slipped the test stick up my sleeve and held it in place by just holding the sleeve next to my wrist with my fingertips and then casually sauntered to the restroom.
After doing what I had to do to take the test, I looked at the results window. I was supposed to be able to see at least a control line to show me the test was working. And then, there was supposed to be another line and if it was lighter than the control line I was not ovulating. If it was darker, I was ovulating. It wasn't there. No line. No control line. Blank.
So I waited. I waited for several minutes. Blank. Maybe a little smudge of blue, but really no line at all. Then, horror of horrors, one of my co-workers walked into the bathroom.
I was standing in the stall doing nothing at all and was certain my co-worker was going to notice. I don't know why that matters, but it does. It also matters that I had no desire to be caught with an ovulation predictor kit test stick at work. So as soon as she closed the door to her stall, I grabbed the stick and zoomed out to the sink to wash my hands. I tossed a paper towel on the counter, then the stick, and then another paper towel on top to cover it up (because *that* won't look suspicious). The girl apparently really didn't need to go to the bathroom at all, because before I could even finish washing my hands at hyper-speed, she was out and fixing her hair at the mirror - with my stick sitting on the counter between us covered up by a measly paper towel. We did the obligatory greetings and I carefully watched for her to have a convenient difficult-hair-adjustment moment. She finally started working on putting a clip in to pull her hair up and I quietly slid the paper-towel-and-stick package off of the counter while she focused on shoving a bunch of hair in the clip. I then found myself walking down the hall back to my office with this strange package in my hand.
Once back at my desk, I peered at the stick again. Nothing. A blue smear in one corner. I tossed the stick in a desk drawer and decided to just focus on work for a while. About an hour later, I looked again - two lines. Both blurry. Was the left line darker than the right? Couldn't tell. Were they the same? Not sure. They were both kind of just smeared lines.
I called Joy.
Joy suggested that I go in and do an ultrasound. This sounded like a silly idea to me. After all, we aren't expecting this cycle to work at all. Going in to do an ultrasound would set us back several hundred dollars in addition to the cost for the IUI itself. I am not excited about spending $1,000 on a useless cycle. I called Joy back and she agreed with me that the ultrasound wouldn't make sense. Instead, she instructed me to try the stick test again tomorrow.
At work.
Total Costs Thus Far:
$29 - One box of Clearblue Easy Ovulation Predictor Kit Tests
Dr. Sparrow - my reproductive endocrinologist
Joy - his medical assistant
The first step in doing one IUI cycle for us is to monitor this month's ovulation. I've been monitoring my ovulation cycle for seven months using a ridiculously expensive (yet pretty darn accurate) fertility monitor. Unfortunately, Dr. Sparrow prefers to have his patients use Clearblue Easy Ovulation Predictor Kits. I was given instructions to use the first test on day 10 of my cycle, and today is day 10.
Most of the kits tell you to use the test first thing in the morning. However, Dr. Sparrow prefers his patients to use the tests on the second trip to the powder room of the morning (can everyone tell I'm trying to be as delicate as possible about this? Is it actually making it worse?!) Dr. Sparrow's method means that I actually have to take a test to work with me and try to take it in the bathroom with no one noticing.
So, at about 10:00 this morning, I used the trick one of my high school friends taught me for sneaking to the bathroom with a tampon - pay attention all you riveted teenagers - I slipped the test stick up my sleeve and held it in place by just holding the sleeve next to my wrist with my fingertips and then casually sauntered to the restroom.
After doing what I had to do to take the test, I looked at the results window. I was supposed to be able to see at least a control line to show me the test was working. And then, there was supposed to be another line and if it was lighter than the control line I was not ovulating. If it was darker, I was ovulating. It wasn't there. No line. No control line. Blank.
So I waited. I waited for several minutes. Blank. Maybe a little smudge of blue, but really no line at all. Then, horror of horrors, one of my co-workers walked into the bathroom.
I was standing in the stall doing nothing at all and was certain my co-worker was going to notice. I don't know why that matters, but it does. It also matters that I had no desire to be caught with an ovulation predictor kit test stick at work. So as soon as she closed the door to her stall, I grabbed the stick and zoomed out to the sink to wash my hands. I tossed a paper towel on the counter, then the stick, and then another paper towel on top to cover it up (because *that* won't look suspicious). The girl apparently really didn't need to go to the bathroom at all, because before I could even finish washing my hands at hyper-speed, she was out and fixing her hair at the mirror - with my stick sitting on the counter between us covered up by a measly paper towel. We did the obligatory greetings and I carefully watched for her to have a convenient difficult-hair-adjustment moment. She finally started working on putting a clip in to pull her hair up and I quietly slid the paper-towel-and-stick package off of the counter while she focused on shoving a bunch of hair in the clip. I then found myself walking down the hall back to my office with this strange package in my hand.
Once back at my desk, I peered at the stick again. Nothing. A blue smear in one corner. I tossed the stick in a desk drawer and decided to just focus on work for a while. About an hour later, I looked again - two lines. Both blurry. Was the left line darker than the right? Couldn't tell. Were they the same? Not sure. They were both kind of just smeared lines.
I called Joy.
Joy suggested that I go in and do an ultrasound. This sounded like a silly idea to me. After all, we aren't expecting this cycle to work at all. Going in to do an ultrasound would set us back several hundred dollars in addition to the cost for the IUI itself. I am not excited about spending $1,000 on a useless cycle. I called Joy back and she agreed with me that the ultrasound wouldn't make sense. Instead, she instructed me to try the stick test again tomorrow.
At work.
Total Costs Thus Far:
$29 - One box of Clearblue Easy Ovulation Predictor Kit Tests
Monday, January 25, 2010
Argh. One step forward, two steps back.
We got my labs back today and they don't look so great. Here's how they came out:
Estradiol – Normal – 58.3 (normal is 80 or less)
FSH – 11.6 – slightly elevated (11.3 or less is necessary to be considered fertile, below 9 is best)
TSH – 1.55 - normal - (between 0.4-4.0 is normal)
Prolactin 17.3 – normal (25 or less is normal)
So, things aren't looking so rosy. The FSH means that my ovulation is probably messed up, or my eggs are, or I'm not ovulating properly. I have to research that more. In short, the RE is now recommending that we do just one round of IUI, mainly to see if Mark (new name picked!) has had any improvement in his counts. If he has, then we can still do the four IUI's. If he hasn't, then we're doing one IUI, then straight to IVF. The only weird thing is normally estradiol is high with FSH, so it's strange that the estradiol is normal.
Oh, the journey. Got upset about it for the first time today. But then I ran through little things I've learned through reading books by Pema Chodron and pulled myself out of it. Onward.
Sunday, January 24, 2010
First Official Step - Bloodwork
Today I took the first official step to either IUI or IVF - I had my blood taken. This had to be done on day 2, 3, or 4 of my cycle. Day 3 is the goal, but since today is not a work day, I opted to go in today (day 2). The clinic I'm going to is open weekend mornings for just this sort of thing.
Giving the labs themselves was very simple - just like giving blood for testing at a normal doctor's appointment. I was in and out of the office within five minutes. By the way - the flat rubber-ish tourniquet they wrap around your arm before they take the blood makes a wonderful jar opener at home. If you can get your lab technician to give it to you, do it and keep it in your kitchen drawer. Very handy!
The labs they are testing are:
Follicle Stimulating Hormone (FSH) - This is a hormone that is released from the pituitary gland near your brain. It signals your ovary to begin maturing the follicles and eggs. They test this hormone to make sure your ovaries are healthy.
Estradiol (E2) - One of three types of estrogen that a woman produces. Estradiol indicates whether follicles are developing. It should be lower in the beginning of the cycle and gradually increasing. It's a good hormone to measure to see if a woman is entering menopause, because it will be very low in menopausal women.
Thyroid Stimulating Hormone (TSH) - Having an underactive or overactive thyroid can result in fertility problems. If the thyroid is underactive, the hypothalamus and pituitary glands increase levels of TSH and a hormone called thyroid-releasing hormone (TRH). TRH both prompts the pituitary glad to release TSH and to release prolactin. Prolactin is a hormone that can interfere with ovulation by suppressing leutanizing hormone and FSH. This is a common problem with fertility. There can also be a problem with excessive thyroid hormone. It can block estrogen's effects, which causes problem with the uterine lining.
Prolactin - Mentioned above, prolactin is a hormone released from the pituitary gland. It's also tested at this time, and a substantial elevation indicates there may be a pituitary tumor.
So, that's what they tested today. I should get results in the next day or two and will keep you posted!
Giving the labs themselves was very simple - just like giving blood for testing at a normal doctor's appointment. I was in and out of the office within five minutes. By the way - the flat rubber-ish tourniquet they wrap around your arm before they take the blood makes a wonderful jar opener at home. If you can get your lab technician to give it to you, do it and keep it in your kitchen drawer. Very handy!
The labs they are testing are:
Follicle Stimulating Hormone (FSH) - This is a hormone that is released from the pituitary gland near your brain. It signals your ovary to begin maturing the follicles and eggs. They test this hormone to make sure your ovaries are healthy.
Estradiol (E2) - One of three types of estrogen that a woman produces. Estradiol indicates whether follicles are developing. It should be lower in the beginning of the cycle and gradually increasing. It's a good hormone to measure to see if a woman is entering menopause, because it will be very low in menopausal women.
Thyroid Stimulating Hormone (TSH) - Having an underactive or overactive thyroid can result in fertility problems. If the thyroid is underactive, the hypothalamus and pituitary glands increase levels of TSH and a hormone called thyroid-releasing hormone (TRH). TRH both prompts the pituitary glad to release TSH and to release prolactin. Prolactin is a hormone that can interfere with ovulation by suppressing leutanizing hormone and FSH. This is a common problem with fertility. There can also be a problem with excessive thyroid hormone. It can block estrogen's effects, which causes problem with the uterine lining.
Prolactin - Mentioned above, prolactin is a hormone released from the pituitary gland. It's also tested at this time, and a substantial elevation indicates there may be a pituitary tumor.
So, that's what they tested today. I should get results in the next day or two and will keep you posted!
Sunday, January 10, 2010
Decisions, Decisions
Turns out we lost our motivation to go to the gym, so now I have time to write a little more...oh, and I've posted a link to this blog on a support website I've joined as well as emailed the link to close friends and family. Most of these blog entries are intended for people who are going through the same thing, so friends and family may find them boring...or not.
We have a number of choices to consider. We could do the IUI or IVF (with or without ICSI). We could just ignore the analysis and keep trying the way we have been. Or, we could switch tracks entirely and adopt either a child in the foster care system or adopt through a private adoption. Finally, we could just choose not to have children at all. This post is all about the pros and cons of each choice, as I see them.
1. IUI - The best part of IUI is definitely that it's one of the cheaper options and since we don't have coverage for fertility issues in our medical insurance, this matters. I think you can do IUI for $3,000-$5,000 per try (not positive about those numbers). It's less invasive than IVF. The downside is that it's not as likely to result in a successful pregnancy, and we could end up spending a whole lot of money on IUI just to have to switch to IVF anyway. If the problem was mostly motility, IUI would be a lot more enticing.
2. IVF - The best part of IVF is that the success rate is the highest of all of the intervention options (the success rate is still around 30-50%, so not a sure thing). That's pretty much the only benefit to it. It's more invasive than all other options, it's more likely to result in multiple births (which would be cute and all, but it makes the pregnancy higher-risk and as a practical matter I don't know how people handle two babies at once (or 4, in the case of my mother-in-law who had a boy, then twin boys a couple years later, and then a girl a couple years after that!)). The worst part of IVF is the financial hit - well, and the potential repeated disappointments.
3. Natural Pregnancy - We could just keep trying. This would be the cheapest option, but it's also the one that is a complete unknown in terms of chances for success. I do frequently read that people in very similar circumstances go through fertility treatments, take a break, and then conceive naturally (just got a note about one today on another website I subscribe to). This would be the best thing we could have happen, and so we are still trying, but I have to admit that my instincts have been telling me for a while that this just isn't going to work that way. That said, I could be wrong.
4. Adoption through Foster Care - Those of you who know my line of work must have guessed that this is an idea that has been seriously considered. I even found a little guy on the Northwest Adoption Exchange website who I think would be a great match for our family. He looks like a miniature version of my husband. Because of my history, I've thought a lot about whether adoption is a choice I would make for myself, and I've gone back and forth. In the last year, I've become more and more open to it, but I'm mainly open to adopting out of the child welfare system rather than a private adoption. My husband would really like to have a biological child and if it ends up that we can't do that, he's open to adopting but would rather go through a private adoption. The best part of this option is that we could quickly have a child (a 6 year old son, to be specific). The scariest part is that we could quickly have a child (a 6 year old son, to be specific).
5. Private Adoption - So I could be talked into a private adoption as long as it would be an open adoption. The drawback here is mostly that my husband would prefer to have a biological child and if we can't do that I would like to adopt out of foster care. So, it's not really the top choice for either of us. However, if we ended up going down this route, the typical drawbacks would likely involve a lot of waiting and some financial outlay as well. The best part is definitely that you end up with a baby!
6. Live Child-Free - This would definitely be the least expensive of all options! We could travel and be independent. However, I can't imagine not having a child at all and I can't imagine growing older and not having any family following behind.
In writing out these options. I ended up putting them almost in the order in which we've thought of them. I guess we could move natural pregnancy to the beginning since we thought we originally were going to go that direction. The plan is currently IVF. Current concerns about IVF are:
1. How will this treatment protocol effect my job?
2. How long or how many cycles are we willing to try?
3. Should we do genetic testing and if so, for how many genetic disorders and should we do gender selection?
4. What are the medications going to do to me?
5. Are IVF pregnancies more likely to result in miscarriages?
6. How many embryos should we have implanted?
7. What if I end up pregnant with triplets?
8. Am I being too obsessive about all of this? (I already know the answer to this one)
Next post will be on how this treatment protocol may effect my job.
We have a number of choices to consider. We could do the IUI or IVF (with or without ICSI). We could just ignore the analysis and keep trying the way we have been. Or, we could switch tracks entirely and adopt either a child in the foster care system or adopt through a private adoption. Finally, we could just choose not to have children at all. This post is all about the pros and cons of each choice, as I see them.
1. IUI - The best part of IUI is definitely that it's one of the cheaper options and since we don't have coverage for fertility issues in our medical insurance, this matters. I think you can do IUI for $3,000-$5,000 per try (not positive about those numbers). It's less invasive than IVF. The downside is that it's not as likely to result in a successful pregnancy, and we could end up spending a whole lot of money on IUI just to have to switch to IVF anyway. If the problem was mostly motility, IUI would be a lot more enticing.
2. IVF - The best part of IVF is that the success rate is the highest of all of the intervention options (the success rate is still around 30-50%, so not a sure thing). That's pretty much the only benefit to it. It's more invasive than all other options, it's more likely to result in multiple births (which would be cute and all, but it makes the pregnancy higher-risk and as a practical matter I don't know how people handle two babies at once (or 4, in the case of my mother-in-law who had a boy, then twin boys a couple years later, and then a girl a couple years after that!)). The worst part of IVF is the financial hit - well, and the potential repeated disappointments.
3. Natural Pregnancy - We could just keep trying. This would be the cheapest option, but it's also the one that is a complete unknown in terms of chances for success. I do frequently read that people in very similar circumstances go through fertility treatments, take a break, and then conceive naturally (just got a note about one today on another website I subscribe to). This would be the best thing we could have happen, and so we are still trying, but I have to admit that my instincts have been telling me for a while that this just isn't going to work that way. That said, I could be wrong.
4. Adoption through Foster Care - Those of you who know my line of work must have guessed that this is an idea that has been seriously considered. I even found a little guy on the Northwest Adoption Exchange website who I think would be a great match for our family. He looks like a miniature version of my husband. Because of my history, I've thought a lot about whether adoption is a choice I would make for myself, and I've gone back and forth. In the last year, I've become more and more open to it, but I'm mainly open to adopting out of the child welfare system rather than a private adoption. My husband would really like to have a biological child and if it ends up that we can't do that, he's open to adopting but would rather go through a private adoption. The best part of this option is that we could quickly have a child (a 6 year old son, to be specific). The scariest part is that we could quickly have a child (a 6 year old son, to be specific).
5. Private Adoption - So I could be talked into a private adoption as long as it would be an open adoption. The drawback here is mostly that my husband would prefer to have a biological child and if we can't do that I would like to adopt out of foster care. So, it's not really the top choice for either of us. However, if we ended up going down this route, the typical drawbacks would likely involve a lot of waiting and some financial outlay as well. The best part is definitely that you end up with a baby!
6. Live Child-Free - This would definitely be the least expensive of all options! We could travel and be independent. However, I can't imagine not having a child at all and I can't imagine growing older and not having any family following behind.
In writing out these options. I ended up putting them almost in the order in which we've thought of them. I guess we could move natural pregnancy to the beginning since we thought we originally were going to go that direction. The plan is currently IVF. Current concerns about IVF are:
1. How will this treatment protocol effect my job?
2. How long or how many cycles are we willing to try?
3. Should we do genetic testing and if so, for how many genetic disorders and should we do gender selection?
4. What are the medications going to do to me?
5. Are IVF pregnancies more likely to result in miscarriages?
6. How many embryos should we have implanted?
7. What if I end up pregnant with triplets?
8. Am I being too obsessive about all of this? (I already know the answer to this one)
Next post will be on how this treatment protocol may effect my job.
What We've Learned So Far
As I mentioned in the introduction, our urologist recommended IUI, while the nurse practitioner at my ob/gyn has recommended IVF. Here is what we've learned about these two different techniques - please keep in mind that I am not a doctor and a lot of the information I have is still kind of sketchy. In other words, it may be somewhat inaccurate or it may be completely wrong. Please don't rely on it for your own purposes!
My understanding is that IUI is a process by which sperm are collected, washed, and then injected into the woman's uterus. I think it's primarily used when the sperm are having a tough time making it all the way to the egg. The urologist recommended this method, and I think he did so because it's a less expensive and less invasive method than IVF. It does still involve the woman going through injections and Clomid medication in order to make sure she is ovulating at the time when the insemination of the sperm through a catheter will be made.
IVF is a more invasive and much more expensive method. In IVF, the woman first takes a series of medications (oral and injection) to stimulate the growth of extra follicles in order to try to harvest numerous eggs. After she starts taking the medications, she goes in for ultrasounds and blood tests to see if the medications are working and to track potential ovulation. The hope is to get a lot of eggs, so the woman's ovaries may grow from the size of a walnut to the size of a human fist with the medications. When it is determined that it is the right time, the woman goes in to the doctor and has the eggs extracted. At that point, the eggs are either placed in a petri dish with a bunch of the sperm to allow fertilization or the eggs are individually fertilized by a specialist in a process called ICSI. The eggs are then monitored for several days to determine which ones successfully were fertilized and which ones are growing into blastocysts or embryos. Once the successful embryos are identified, they may be tested for genetic disorders (this is optional) and then the woman will return to the doctor to have between 1 and 3 embryos implanted. Two weeks after the embryo(s) are implanted, the woman returns to the doctor for a pregnancy test.
We think we're going to end up doing IVF plus ICSI because the problem for us is that our sperm don't have good morphology. Morphology describes whether the sperm are shaped properly for fertilization. When the sperm have the wrong shape, it may be difficult for them to fertilize an egg. Our sperm count is at 15 million sperm per milliliter. In order to be considered to be officially fertile, you need to be at about 20 million per milliliter, so we are low but not terribly low. Similarly, our motility (the movement of the sperm) shows that 30% are moving fast enough. Again, low, but not terrible. The bigger problem for us is that our morphology is only 2%. That means that only 2% of our sperm are shaped properly for fertilization. To be considered fertile, you need to have at least 14% shaped properly. Therefore, our best chance at a successful fertilization may involve locating the healthiest sperm and injecting them straight into the egg via ICSI.
Tomorrow (or maybe later tonight if I'm motivated), I'll talk about the financial differences and challenges and the other options we have.
My understanding is that IUI is a process by which sperm are collected, washed, and then injected into the woman's uterus. I think it's primarily used when the sperm are having a tough time making it all the way to the egg. The urologist recommended this method, and I think he did so because it's a less expensive and less invasive method than IVF. It does still involve the woman going through injections and Clomid medication in order to make sure she is ovulating at the time when the insemination of the sperm through a catheter will be made.
IVF is a more invasive and much more expensive method. In IVF, the woman first takes a series of medications (oral and injection) to stimulate the growth of extra follicles in order to try to harvest numerous eggs. After she starts taking the medications, she goes in for ultrasounds and blood tests to see if the medications are working and to track potential ovulation. The hope is to get a lot of eggs, so the woman's ovaries may grow from the size of a walnut to the size of a human fist with the medications. When it is determined that it is the right time, the woman goes in to the doctor and has the eggs extracted. At that point, the eggs are either placed in a petri dish with a bunch of the sperm to allow fertilization or the eggs are individually fertilized by a specialist in a process called ICSI. The eggs are then monitored for several days to determine which ones successfully were fertilized and which ones are growing into blastocysts or embryos. Once the successful embryos are identified, they may be tested for genetic disorders (this is optional) and then the woman will return to the doctor to have between 1 and 3 embryos implanted. Two weeks after the embryo(s) are implanted, the woman returns to the doctor for a pregnancy test.
We think we're going to end up doing IVF plus ICSI because the problem for us is that our sperm don't have good morphology. Morphology describes whether the sperm are shaped properly for fertilization. When the sperm have the wrong shape, it may be difficult for them to fertilize an egg. Our sperm count is at 15 million sperm per milliliter. In order to be considered to be officially fertile, you need to be at about 20 million per milliliter, so we are low but not terribly low. Similarly, our motility (the movement of the sperm) shows that 30% are moving fast enough. Again, low, but not terrible. The bigger problem for us is that our morphology is only 2%. That means that only 2% of our sperm are shaped properly for fertilization. To be considered fertile, you need to have at least 14% shaped properly. Therefore, our best chance at a successful fertilization may involve locating the healthiest sperm and injecting them straight into the egg via ICSI.
Tomorrow (or maybe later tonight if I'm motivated), I'll talk about the financial differences and challenges and the other options we have.
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