Dunderheads

As I was saying...BJ followed through with his semen analysis (SA).  The nurse told him they would call him with preliminary results and then we would have a follow-up with our reproductive endocrinologist (RE), Dr. D.  So, we waited, and waited...and waited.  This should have been a clue.  They probably do not call if they don't have anything positive to say.  Nevertheless we were anxious (OK I was dying, BJ could have waited months) to hear our results.  We were relieved when they finally called to set up an appointment nearly 10 days after BJ had his test. 

On our first trip to the fertility center we learned that there is apparently an etiquette when you are in the waiting room of a fertility clinic.  Don't look anyone in the eye, attempt to look more pitiful than the woman/couple next to you, and don't talk.  I'm not sure why...I mean, hell, bottom line is none of us are making babies.  You'd think we fertility challenged folk would want to have somebody who could relate to talk to.  Not so, apparently...we just prefer to wallow in our own misery.  If you're not miserable, well, just give yourself some time in the waiting room, and you'll get there.   

Once we were looking appropriately pitiful enough, BJ and I were taken into Dr. D's office. Dr. D went over the results with us.  He told us there were three things that they look for; count (the number of sperm), motility (how well they swim and amount of "forward progression"), and morphology (shape).  BJ's count was fine, not outstanding, but fine.  BJ's motility was normal, but his Kruger's Strict Morphology, was 6%.  Normal is considered to be above 14%.   Sperm should have 1 head, a reasonably sized tail, and the head should be more oval in appearance.  BJ's sperm tend to be too round on top, which makes it difficult for them to penetrate my eggs.  I liken them to being shaped like Stewie Griffin's head from Family Guy.  The unfortunate thing about having poor morphology is that unlike having a low count or poor motility, you cannot treat morphology. What you've got is what you've got.

(From webdesign.org)

My immediate reaction was 'oh, no we're going to need a sperm donor'.  Dr. D started drawing out a chart for us.  He told us that with our set of conditions, we had less than 2% chance of conceiving on our own.  He went on to say, that less than 2% is as low as he will tell people because it's embarassing when they walk in 9 months later with a baby.  So basically less than 2%, is 0% with built-in error. That was hard to swallow.  He said that if BJ had between 10 & 14% morphology, we had a great chance to conceive with intrauterine insemination (IUI).  With 6-9% range, Dr. D said we would have a 9-12% chance with a combination of clomid and IUI. (A "normal" couple has a 20% chance in a given month.)  With injectable medication we would get a 10-13% chance. He recommeded we try 3 or 4 cycles of the Clomid/IUI protocol.  If BJ had 5% or lower morphology, they would have immediately recommended in-vitro fertilization (IVF).

This is when I started bawling...but they're pretty used to this at the clinic.  They have boxes of Kleenex everywhere.  Tons of nurses to hug and pat your back...they've got quite the system.  Dr. D asked BJ if I had been taking Clomid and BJ told him I had.  Dr. D whispered to him that a lot of my reaction could be contributed to the Clomid.  MEN!  OMG...as if being told that  you have practically no chance of having a baby without intervention is not upsetting if you aren't taking Clomid.  I immediately hated both of them...which probably meant that, yes, it was the Clomid, whatever. Still pisses me off...The one good thing he did say was, "Nothing in your chart scares me.  It's not a matter of if you can get pregnant, it is a matter of what will it take."  I have since repeated these words almost daily.  I even considered a tattoo in Latin, but it's pretty long...

We then met with a financial coordinator who told us what our insurance would cover, which is not much, however I still consider myself pretty lucky.  They will cover anything that doesn't directly potentially create a pregnancy.  All the monitoring before the IUI or IVF would be covered, which is a huge help, and I'm very thankful, but it still leaves many procedures and most of the medications up to us.  It is a good idea to set a budget with your partner, because there is the potential to shell out tens of thousands of dollars.  It's clearly a personal matter, but you have to start thinking about how much you want to spend on treatment and if you want to save some to potentially adopt with.  Adoption is awfully expensive too, and often is more expensive than an IVF cycle.

BJ and I had a lot to chew on and a lot of decisions to make.  I called Dr. B, my gyno, to let him know the results of BJ's SA.  Dr B. was very encouraging, but said that since we were dealing with dual factor infertility, that sticking with an RE would be his recommendation. I would recommend that for anyone else, too.  Fertility clinics are set up to help you around the clock.  An OB/GYN usually has to stick to regular office hours which can make the timing of everything rather difficult. With that as the plan, I filled my new script for Clomid.  What did we have to lose?     

TTFN,
MK