Archive for April, 2008

While this is not really an infertility blog, I figure at some point google is going to send people this way with all the mention of fertility related things going on in so many of my posts. And I know that when I am reading someone’s infertility blog, I really want to know what their situation was/is so that I can figure out if the lessons they are learning (about meds, treatment, etc) might apply to me too. In the spirit of providing people with questionable medical information, I figured I would chronicle our test results and treatments in a way that might be helpful for others who need to obsess.

The Lady of the House: Never had an irregular cycle. In fact, I have such regular 28 day cycles that I’ve started on a Sunday every cycle for the last year. Bad cramps but nothing that can’t be controlled by ibuprofen (the elixir of the NSAID gods). I haven’t had a lap to see if there is endometriosis, but this is not a concern at the moment. There is also no concern of a luteal phase defect/progesterone deficiency based on cycle charting and a progesterone level I had drawn last year that I can’t remember but was good. I know all these things can change or be proved wrong later, but for now they are assumed good.

Hysterosalpingogram: Looks great! Our RE did our test and I think the consensus is, if you can, have your RE do it and not the radiology tech. I have known several radiology techs and they are awesome people but not trained at reading HSGs.

Day 3 Fsh: 4.9

Day 3 Estradiol: 36

Day 3 Prolactin: 12

Ain’t nuthin’ wrong with the lady’s hormones.

The Gentleman of the House:

Semen Analysis #1 – 3 Days of Abstinence

Volume: 2.5 ml; Concentration: 18.5 million/ml; Total Count: 46.3 million; Motility: 55% (45% rapid, 10% slow); Morphology: (WHO criteria) 1% normal, 14% Slightly Abnormal, 85% Severely Amorphous Heads; PH: 8.1; Viscosity: grrrrreat!.

In between SA #1 and SA#2 Chad gave up alcohol and caffeine (oh my god the coffee??!!! Will no one think of the coffee??!!) and started taking Centrum total/complete/something or other that the doctor recommended.  There were about 6 weeks between #1 and #2.

Semen Analysis #2 – 5 Days of Abstinence

Volume: 3.55 ml; Concentration:20.5 million/ml; Total Count: 72.7 million; Motility: 45% (35% rapid, 10% slow); Morphology (WHO Criteria): 2% normal, 34% slightly abnormal, 66% severely amorphous; PH: 8: Viscosity: grrrreat!

So as you can see, SA#2 is a good bit better than #1. SA #1 was categorized as Moderate Male Factor Infertility (MFI) and we were okay with going straight to IVF if everything stayed the same. SA #2 is Mild MFI and so we are going to try IUI. For anyone who is trying to find information on what to do with bad morphology let me just say good luck. The field seems to be split pretty much down the middle as to whether or not you should try IUI or IVF first. One study I read said that slightly abnormal sperm are just as good as normal sperm at penetrating the egg, so I think its good to know what you’ve got going on with your slightly effed up guys. For us the decision came not from one parameter but multiplying the total count by morphology (eg .36) and motility (eg .45) to get an idea of how many guys we might have for IUI.

We have it planned but we’re not telling anyone when its going down because frankly I don’t want to talk about it. The actual procedure, not infertility or wanting a family. In the way that we all learn things the hard way, after last year’s miscarriage I know that I don’t want to tell a lot of people things that I may have to take back later.

I will tell you my protocol and I’ll even tell you how much stuff costs because just as much as we want to know if something works, we want to know how much its going to cost.

Cycle Day (CD) 1: baseline scan ($320)

CD 3-7: Femara (2.5mg/2xday) ($20 if my insurance will cover it – which they might since its label use is not as a fertility medication)

CD 6-11: Follistim 50IU/day ($235 through online pharmacy)

CD 12: Follicle Scan ($246)

CD ?: Ovidrel – HCG trigger ($60)

CD 14-ish: IUI ($366 – procedure/office visit/sperm washing)

CD 15-28: agonizing wait (Totally Fucking Free)

We get 20% off of everything but meds since we have no insurance  coverage for this and we’ll be paying cash (10% if we used a credit card). This means the whole thing we’ll probably run us just over $1000. So there you have it folks – that’s what you can expect to spend on a low dose injectable/trigger IUI in central Indiana.

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Pictures?! You think I promised you pictures?! Surely you’re mistaken.

Its been a busy couple of weeks. Fun weeks, filled with visits from older brothers and getting back test results that are markedly better (Chad’s second analysis) and reassuringly good (my FSH, estradiol, and prolactin). Its funny – for years I thought that any anxiety and depression I experienced was the result of hormonal imbalances but so far my hormones are not in the least imbalanced. I’m coming around to the opinion that all that angst might have been due to low self esteem  and that it was a sort of learned behavior. A bad habit. I still think there’s some sort of predisposition to the whole thing because anxiety just comes so naturally to me, but I’ve come to have far more control over it than I used to. Therapy helps. Everybody should go to therapy. Chad helps, too.

Does anybody give their animals greenies or their generic equivalent? We’re trying different dental chews for the dogs because they’re not so hot on having their teeth brushed and they all seem to cause their own unique stinky gas. So much of my world has to do with the gas of loved ones.

It’s my bed time.

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