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Archive for March, 2009

you don’t say

I had my regular annual with my GYN yesterday. She asked what was new; I told her we’re planning to start IVF later this spring. She’s in the same hospital network as our RE, so she already knew. “I thought the problem would be with me,” I added, “but it turns out it’s male factor.”

“Yes,” she confirmed. “Severe male factor.”

Huh. Okay. Dr. S never mentioned the “severe” part. Of course, she gave us all of The Boy’s test results and numbers, but didn’t really qualify them other than to tell us that IVF/ICSI would give us our best chance at conceiving.

Omitting the descriptor could have been an oversight, but my guess is she wants to keep us positive and optimistic rather than stressed out about things we can’t control. Still, it does make me wonder: how much do REs keep from their patients? What’s been kept from you that you’ve learned later? And how do you feel about it?

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I’ve been reading infertility blogs for years. I don’t remember when or why I started, or why — as a then-single 20-something woman with no gynecological problems to speak of — I stuck around.

Now I find myself wondering: eerily prescient, or self-fulfilling prophecy?

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the whole truth

I wasn’t entirely truthful with my RE at our first appointment. She asked how long we’d been trying. Honestly? It hadn’t been very long. I just had a gut feeling that something was wrong, and I wanted her to take my concerns seriously. So I told her we hadn’t been using birth control since last April.

As it turns out, something was — is — wrong. It’s just not what I thought. The increasingly weird cycles, the ever-more-frequent spotting … I was sure these things meant we wouldn’t be able to get pregnant without help. So I fudged the dates in order to get seen by the RE.

I don’t like to lie. But if I hadn’t, we’d still be trying … and for who knows how long. We’d be losing precious time, with the clock ticking towards my 37th birthday, all the while having no idea that MF would make it highly unlikely we’d ever get pregnant on our own.

So my gut may have only had it half right, but I’m grateful to have trusted it.

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Got the recommendation today: IVF with ICSI. If we really wanted to get our “feet wet” (i.e. if The Boy is too freaked out to jump straight to IVF), we could try a cycle or two of IUI. But Dr. S said chances are very, very slim that it would work. And personally, I don’t want to put myself through that emotional wringer if our odds are that bad. So The Boy and I need to sit down and make sure we’re on the same page in terms of going directly to IVF, and then figure out when to start.

Of course, this is all pending preauthorization from our insurance company. Without that … well, everything changes.

But I’m not going to go there today.

What I already have in front of me is enough.

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So, on top of the male factor issue, I’ve got a blocked fallopian tube, according to the HSG that was performed on Friday.

And this morning came the call that I’ve tested positive for one copy of a genetic mutation called Mucolipidosis Type IV.

Now I’ve got an appointment with a genetic counselor and The Boy needs to be tested for the mutation to make sure he’s not also a carrier. (I don’t even want to think about what it would mean if he is.)

But the bottom line is, it looks like we’re heading for IVF.

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Just got a call from the nurse at Dr. S’s office. The parameters of The Boy’s semen analysis were “a little low.” When pressed, she said the count was low, as were the motility and morphology.

Obviously this is not what I wanted to hear. Not by a long shot.

Next step: a consult with a urologist, along with a repeat semen analysis. The nurse mentioned treatment (ICSI with IVF), but said it’s premature to talk about that now.

Now how to suppress the roiling panic?

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I’ve been reading these pregnancy/infertility/babyloss blogs long enough, guess it’s time I start one of my own.

Of course, my greatest hope is that this winds up being a blog of the first type, rather than the second or third.

Only time will tell.

Appointment #1 at the reproductive medicine clinic this morning. The doctor is wonderful: warm, friendly, enthusiastic. Her nurse equally so. They did a full blood work-up, including the Ashkenazi panel; a pap; a culture; and an ultrasound. The ultrasound showed a “beautiful” uterine lining and one cyst, which I’m fairly certain she said was on one of my ovaries. She deemed it “fairly common.” Six small follicles on one side, four on the other. She said that’s “pretty typical” for someone my age. (I hate being my age.) During the pap, she saw plenty of evidence of the mid-cycle spotting about which I’m always complaining. At least they know I’m not making it up.

The Boy will go in for bloodwork and a semen analysis, then we’ll both go for a follow-up appointment in four weeks.

Step one on a journey I’ve been waiting to make for a long, long time.

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