Strength and Vulnerability

I'm in a weird place right now. It's been over 3 years, and I'm not going to say it gets easier. In fact, as time passes I find myself having to make tougher decisions. Decisions that I thought I would never have to make. But I'm making them. I'm weighing the pros and cons. I'm asking myself "am I okay with this?" and my answers surprise me.

When I first started this journey, the idea of seeing a fertility specialist scared me. I didn't want to admit that I was in the minority of couples that would need a doctor to help us conceive a child. But I got over that. Next I was very anxious about doing an IUI. I had to give up the idea of conception as the magical moment between husband and wife, and instead accept it as something that happens in a doctors office, laying on a table with a nurse all up in my nether regions. But I accepted that too.

And now that we've decided to do IVF, I have surprised myself yet again. A year ago, I thought that IVF was the ultimate resignation from my dream of conceiving a child with my husband. Instead, it will happen in a lab, in a petri dish. That idea still bothers me to some extent. No girl dreams of conceiving their first born in a lab. Most of us dream about it happening on our honeymoon, or on a dream vacation, or even in the comfort of our home while wrapped in the arms of our husbands.

The moral and ethical dilemma of "playing God" still plays out in my head. But I can't help but feel that this is the path we are meant to take. I know in my heart that Daniel and I are meant to be parents, and that may not happen on it's own. We are lucky to live in a society where fertility treatments are available, and to live in a city where we have an abundance of clinics that we can research to find the best fit for our needs.

I'm happy with our decision, and even excited. I think that IVF will probably be one of the hardest things I will ever go through, both emotionally and physically. But it will be SO worth it. To finally have a baby with Daniel, I would give up just about anything.

And it's that strength that has surprised me in the last month. The ability to make that hard decision to move forward with something that will force us to make some sacrifices. We are sacrificing the idea of having a natural conception, as well as our finances. But at this point on my journey, those are sacrifices I am willing to make, just for a chance to have a child.

But at the same moment, I find myself completely vulnerable. What if IVF doesn't work? There are no guarantees and I know several women who have walked away from this journey empty handed and grieving for the loss of a dream. I remember how heartbroken I was after our first IUI failed. I little piece of me died that day. It was terrible. And I think to experience that same heartbreak after a round of IVF will multiply that feeling of devastation ten fold.

It's that vulnerability that defines this struggle, because nothing we do is ever guaranteed to work. We are taking a risk with every treatment. We are gambling our finances, hope, and even our sanity that a healthy baby will be the outcome. And with odds around 50%, we have an equal chance to fail as we do to succeed.

But I'm still going to do it. Because moving forward is the only option for me. I will do whatever it takes. And this is what the journey of infertility is all about. Discovering how badly you want something, and what you are willing to give up to get it.

My IUI Experience

I was VERY nervous for my IUI this morning. I just wasn't sure what to expect; I've read about it of course and I know how the procedure is done, but since it was my first time I think it's natural to feel anxious about it. Plus we didn't know what to expect with the semen sample since Daniel has been taking Clomid. We assumed it would improve somewhat but we were prepared to see between 5-10 million post wash.

Daniel went in for his appointment at 8:00 and once he provided his "sample" we left to get some breakfast. We drove to a restaurant just a mile from the doctor's office and I had eggs and potatoes. I couldn't eat much since I was so nervous! We were done with that by 9:00 and drove back to the clinic since my appointment was scheduled for 9:30.

There were 4 other couples in the waiting room, which surprised me since it was a Sunday morning. But I assumed all of us were either IUI or IVF patients. 9:30 came and went and I figured they were running a little behind which was fine. By about 9:45 we finally got called back by a nurse named Karen. I hadn't met her before but she was very friendly. She took us to a little exam room and I was surprised not to see an ultrasound machine there. For some reason I thought they would be doing an ultrasound at the same time as the IUI.

The nurse showed us Daniel's sample in a vial and we both had to confirm that it was his by the label. She told us that we had 84 million total motile sperm! I was in shock! The Clomid must have really helped him. Then she put the sample in a syringe that was attached to a long catheter. She explained that she would insert the catheter through the cervix and that I would probably feel some cramping since the uterus isn't used to having that much liquid inserted in it.

After inserting the speculum the nurse had a hard time reaching my cervix so she "adjusted" things so she could access it better. Then she inserted the catheter and blew up a small balloon against the cervix to prevent the liquid from spilling right back out. I was cramping a lot at this point and very uncomfortable, but this wasn't nearly as bad as an HSG. It lasted about 5-6 minutes. After the nurse removed the catheter and the speculum I was still cramping a bit but not as much as before. She set a timer for 20 minutes and put a pillow beneath my hips and asked me to rest until the timer went off. After that we were free to go!

After getting home I have been laying on the couch relaxing. I still feel crampy but it's slowly getting better. So overall it wasn't a bad experience and Daniel and I were both very happy with the sperm count. I am hoping and praying that we'll get pregnant from this so the next 2 weeks I'm going to believe that we did and try to surround myself with positivity. I'll be testing out my trigger and I'll know whether the IUI was successful by the end of September. Fingers crossed I finally get my BFP!!!

Patience!

Today I had a follow up with my RE, Dr. T. The past few weeks I've been feeling really down and gloomy about our TTC situation and I was hoping to get some hope or at least a plan of action for the next few months. I've been especially occupied with deciding whether or not to have another surgery to fully remove my septum.

First off, Dr. T said that in his opinion I do not need a 2nd resection surgery on my septum. He said he will do it if I really want it, but he believes my uterus to be in an arcuate configuration now which is considered a "normal variant" of the uterine shape. He reminded me that the septum is not why we haven't gotten pregnant yet, but I'm still worried about miscarriages since I still have a higher risk for them. I'm worrying about a hypothetical situation, but that's what this whole TTC journey is about...what if I never have a baby? So I'm trying my hardest to focus on one thing at a time; let's just try to get pregnant and see how it goes.

I then asked him about IUI and what our chance would be if we went that route, and he said about 5-10% per cycle. Because of Daniel's low morphology he said an IUI would not increase our chances by very much.

Remember, only 2% of Daniel's sperm are "normal" but he has plenty of them, over 115 million total. Eggs will only allow normal sperm to penetrate them because they have special sensors that can tell if a sperm is defective. With so many abnormal sperm crowded around the egg, the strong healthy sperm have a hard time reaching it and therefore conception hasn't occurred. Dr. T said its like at a concert, if you are in the back it will be very hard making your way to the stage, you have to get past all those people first. Same goes with the sperm, there are just so many that are abnormal, they are blocking the path for the normal ones.

Dr. T recommends we wait and see if Daniel's weight loss makes a difference with the morphology. If not, we can continue trying naturally and hope it happens that way, or we can move forward with IVF (which is really expensive!)

So for now, we're just going to wait it out. Daniel has been working REALLY hard to lose weight and he's already lost 15 lbs! I'm so proud of him for working so hard and trying to get healthy. His next urology appointment is mid-June and hopefully I will be able to go with him since I tend to ask all of the tough questions :) I really hope we don't have to resort to IVF, but Dr. T assured me that I WILL be pregnant someday, it's just a matter of when. So for now, I just have to be patient! But man, that's easier said than done.

Urologist Update!

Daniel went to his first urology appointment today. Unfortunately I couldn't go with him, but I made sure he had all of the appropriate paperwork and forms he needed, including a copy of his Semen Analysis (SA). Daniel told me that the urologist was pretty quick to suggest after reviewing the SA that he could have high estrogen levels, which are often caused by (and a symptom of) being overweight.

Both men and women produce estrogen and testosterone from the pituitary glands. So we all have both in our system, but in women the estrogen is dominant thanks to our ovaries, and in men testosterone is dominant thanks to the testes. Fat can actually turn testosterone into estrogen (who knew?!). Too much estrogen can damage sperm. This would explain why his count and volume are good, but the  motility is low. We will need blood work to confirm this of course, but I think it makes sense. I still need to do some research to see if this could impact morphology as well.

The urologist also examined Daniel's "fellas" and didn't really find anything concerning there, which is good. We were both worried about a varicocele but it sounds like that's not the issue. So no surgery! The urologist suggested that Daniel lose about 30 lbs and hopefully that will help decrease estrogen levels.

I'm curious to see what the blood work shows and if weight loss is the answer. It sounds simple to me but I'm not the one who has to lose weight, so I hope Daniel can stay motivated and make a commitment to getting healthy and losing weight to better our chances of conceiving. I know he wants this as badly as I do so I will try my best to support him and even work out with him if needed.

I'm so happy that we didn't get bad news today! I really feel like this is something we can work with. Like I said, we don't know for sure if the estrogen is the issue but after reading up on it I think it fits. We'll find out in about 3 weeks when Daniel gets the blood work done. I'll keep you all posted!