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.