Test Results

We had our $50, 5 minute phone consult on Friday and it was not good :(

The semen analysis results indicated that the male factor infertility is worse now. The test didn’t look at morphology, which was our only male issue on the last semen analysis from a year ago. This tested looked at count, motility and ability of the sperm to swim around to find an egg. While motility was still great, there was a dramatic drop in count. This means that there are not enough sperm getting to the fallopian tubes to try to fertilize an egg, so there is pretty much no chance of natural pregnancy occurring and that IVF + ICSI will be our only option for pregnancy. This result was a bit confusing for us because count was great on the last semen analysis and for all 3 IUIs we did last year. It could just be a fluke result, or something could be going on that has impacted the sperm production. We could do a repeat semen analysis or other testing to try to figure out what’s going on, but this could just add more time and cost more money and not change our treatment plan or success rates, so we are going ahead with the plan to freeze a semen sample and do IVF + ICSI.

My test results were a little confusing. Everything came back in the normal range, but my AMH, which is a measure of ovarian reserve and potential response to the fertility drugs came back on the low side of normal. The RE mentioned that my AMH is closer to what he would expect for a woman that is 38 not one that is 30, which could mean nothing or could mean I am at risk for having diminished ovarian reserve. I didn’t ask for my FSH so I don’t know if it’s on the high side of normal, which would be another indicator of low ovarian reserve, and have not had an antral follicle count down, which is why we don’t know if my lower AMH means anything. Nevertheless, it’s not great because it means that I’m less likely to get a lot of eggs produced. The RE said that a normal response to the fertility drugs would be 5-14 eggs retrieved, but that they would expect me to be on the lower side so maybe 5-8 or 10 eggs, and that I would likely need to take higher doses of the drugs to get these eggs. The fewer eggs, the fewer embryos. In a “typical” IVF cycle it is expected that ¾ of the eggs will fertilize and about 1/3 of those will make it to 3-5 days and be suitable for transfer. Now, ICSI should ensure that all eggs are fertilized, but if we get 5 eggs we are likely looking at 1-2 embryos produced.

This low anticipated result now changes our plan. Ideally, we want to have 3 children, but really more than 1 would be great. When we were expecting a 10-15 egg result we should be able to get 3-4 embryos from 1 retrieval cycle, so unless the first 2-3 didn’t take then we wouldn’t need to do another retrieval cycle. Now that we are looking at 1-2 embryos that changes things, especially based on the AMH and semen analysis results. Now the plan is to “bank” at least 4 embryos so we should hopefully have enough healthy embryos to have 2 kids. We talked a little about doing this because then my eggs would be 30/31 instead of 33+ if I got pregnant from the first round and had to do another retrieval later. Now, we are concerned that my ovarian reserve is dropping or the amount of healthy sperm is dropping so we went to get a bunch of embryos now in case something happens and we don’t have that option in the future.

On hold

One of the worst things about infertility is the feeling like your life is on hold. It’s hard to make plans for the future when you don’t know how treatments are going to go, how many rounds you’ll need to do, how much it’s all going to cost you, and if you’re actually going to get a baby at the end of all this.

We’ve already had to make the IVF or job decision, which was incredibly difficult. It felt like an impossible choice – do I turn down my dream job and go for IVF when there is no guarantee I’ll have a baby at the end AND no guarantee that I’ll be able to get another great job offer? Do I accept the job and have to go through another year of heartbreak while waiting for IVF? Watching all of my family and friends have kids while I sit here with next to no chance of getting pregnant, and dealing with constant symptoms of my infertility.

As you know, I took the job and we postponed IVF. We will hopefully be able to schedule our first cycle for late spring, but now this opens a whole new set of problems. I need to travel for work but it’s hard to schedule these work trips when I don’t know when my cycle will be starting because I am so sick of waiting and don’t want to postpone it for another month. My husband’s family wants to take a vacation together but we can’t commit because we don’t know when we will be cycling, and how tight money could be. I can’t commit to going to my aunt’s wedding in late summer because I don’t know if we’ll be cycling then AND I have a lovely family member that likes to rub it in that she has a kid and I don’t, and I couldn’t handle that if we had a failed IVF cycle. We want to buy a house but are hesitant to put down so much money on a down payment when we don’t know how much IVF is going to cost us. In addition, what if we buy a house and then have something big happen like the furnace dies or we need to replace our car and then we don’t have the money to continue with IVF. We have the money for a downpayment and an IVF cycle with a couple of frozen transfers without having to drain all our savings, but what if we need a second cycle? Or a surrogate? Or donor eggs? Furthermore, what we even need in a house is going to differ if we aren’t going to have a baby. Like, right now we want 3 bedrooms on the same level and a finished basement area, but if we end up being child-free-not-by-choice, then 2 bedrooms or a master on a different floor would be fine. Heck, even something like buying a new pair of jeans is on hold because I don’t know how long I’ll be able to wear them during cycling or if I get pregnant.

Infertility has pressed the PAUSE button on my life and I really wish we could unpause.