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Step Two: Bring in the Experts

Step One: Admit you have a problem

According to the World Health Organization, infertility is defined as “the inability of a sexually active, non-contracepting couple to achieve pregnancy in one year. The male partner can be evaluated for infertility or subfertility using a variety of clinical interventions, and also from a laboratory evaluation of semen.” (Semen manual, 5th Edition).

who-laboratory-manual-for-the-examination-of-human-semen-and-spermcervical-mucus-interaction-1-728Yes… there is a semen manual…

Step one: CHECK. On to Step Two, because we can drive ourselves crazy with Dr. Google (according to google we’re infertile or dying of cancer). We decided to see Dr. Heber Dunaway, who has an absolutely incredible resume in the field of reproductive medicine, and the clinic as a whole has positive success rates.

Today we had our first appointment at the Fertility Institute. It wasn’t exactly what we were expecting, but overall it was a positive experience. You walk into the clinic and sit in the waiting room with all of these other people. You can’t help but wonder, “so what’s your issue?”, “how many times have you been here?”, or my favorite thought “do you get to give a ‘sample’ today?”.

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When you go into any fertility appointment, the focus will be on the female, regardless of your diagnosis. Apparently women are more complicated, go figure? We had twelve pages of new patient paperwork, nine of which were solely dedicated to female questions. I get that – but what many people don’t realize is that male factors count for HALF of all infertility challenges.

But honestly, I’m not sure why you fill out the paperwork at all, because they ask you the exact same questions in person. For a consultation, you don’t go to the examination room, you go sit in the doctor’s actual office. You know, the kind you see people sitting in when they’re talking about serious medical decisions. Those chairs have got to be $400 a piece (so that explains why fertility treatments are so expensive).

Our first 15 to 20 minutes was with the nurse, who was wonderful. Very kind, and empathetic. Next came in doc. I’ve got to say, any nervousness that I had previously experienced, was gone when he came in and told us that he had no doubt we would be pregnant one way or another. He looked at Taylor’s numbers and he was happy with 2/3.

There are three main factors that are analyzed for male fertility: count, motility, and morphology. Count is the concentration of sperm in a sample, generally given in sperm/mL. Motility is given in a percentage, and is a percentage of the sperm that move forward normally. Morphology is the shape of the sperm, also given in the percentage of the sample that are normal.

sperm

So for us count is fantastic, motility is fantastic, but definitely not shooting off fireworks to celebrate morphology. Taylor likes to describe it as there is a ton of people packed into a small bar, but when they leave they are too drunk to know where to go (I love this man’s sense of humor).

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Our most recent SA results

Doc said it was interesting, because if morphology is low then typically all three factors will be low. So this is a very positive sign for us. Our next step forward is to try at least two rounds of IUI (Intrauterine Insemination). Luckily for me I do not require any more testing, for now. Positives for IUI: MUCH less expensive than IVF, it will cost us about $1,300 per round instead of $20,000 per round, less invasive, less risky. So, why not?

I will call the office on CD1 (cycle day 1) to schedule a baseline transvaginal ultrasound and confirm I do not have any ovarian cysts cooking for CD3. I will then begin taking a low doses of Clomid, which stimulates an increase in the amount of hormones that support the growth and release of a mature egg, i.e. it will likely make me produce more than one egg. We will have periodic ultrasounds to check follicle growth (where the eggs mature) until about CD12-CD14, and when the eggs are cooked JUST RIGHT I’ll get a trigger shot of hCG (Human chorionic gonadotropin) to make me ovulate… yes, this is the shot in the butt. Can’t wait. We will come back the next day. While I am being poked and prodded and having doctors use a speculum to make my vagina into a real life archeological dig site, Taylor gets to give another sample (are we starting to see a trend?).  Doc will inject the swimmers directly into my uterus to give them the best chance possible.

iui-picture

Sounds simple enough, right? It is reassuring having a plan to move forward. Which is further than we were when we woke up this morning.

One day at a time.

 

Fertility Treatment Running Cost:
Ovulation Kits for a year: $80
Pregnancy Tests for a year: $100
Vitamins: $300
GYN Apt: $50
Semen Analysis: $175
Semen Analysis w/Urinanalysis: $250
Fertility Institute Consultation: $166 ($250 without insurance)
TOTAL: $1,121

 

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