Warning: This page could very well contain WAY MORE INFORMATION THAN YOU NEED TO KNOW, and much of it could also fall in the category of TMI (which while literally meaning the same thing as I just said, carries the connotation of being slightly personal/'icky' information you could have done without). I only want to lay it all out because I myself find it very helpful/informative to know other couples' experiences and protocols when it comes to infertility treatment. This way you'll be able to know exactly WHAT we done/experienced and what we haven't, so you'll know what I can offer personal advice/commentary on. Or maybe you're just nosy and wanna know what kinds of exciting things go on in IF-land. That's cool, too.
I'm gonna give a stab at doing this "timeline"-style. We'll see how it goes.
First, a few common infertility (IF) abbreviations you might not know:
TTC= trying to conceive
BD= baby dance...the euphemism for *ahem* the act of trying to get pregnant. Get it?
BBT= basal body temperature...many women do some hardcore temperature tracking and charting while they're TTC in order to determine ovulation and many other things. Google this one if you wanna know more.
BFP/BFN= Big Fat (or another F word, your choice) Positive/Negative. The results on your pregnancy test.
SA= semen analysis
IUI= intra-uterine insemination (Google it)
IVF- in vitro fertilization (Google it)
September 2008: Decide we want to start TTC in January 2009, so I stop taking birth control pills. Switch to another form of birth control so that my body will start doing its thing again. Read Taking Charge of Your Fertility.
October-December 2008: My body seems to do exactly what it's supposed to. Cycles are extremely regular. Decide that since my cycles are so regular, I won't initially bother with all the temperature-tracking, etc., from TCoYF. We'll just see what happens.
December 2008: Happy birthday to me! We decide to start TTC a little early. Yay!
December 2008-November 2009: Faithfully TTC. I still have extremely regular cycles and (in our humble opinions) well-timed BD. No BFPs. We even took a cruise in September, trying the "just relax and take a vacation" approach. Decide to begin BBT charting when we reach our one-year TTC anniversary.
January 2010-April 2010: BBT charting reveals that I am absolutely ovulating and everything about my cycle appears normal. I have a short-ish luteal phase, so we decide to go ahead and schedule a doctor's appointment to get the IF workup. Luteal phase defect (LPD) is typically fairly easy to detect and has a fairly easy solution. This is what we were hoping for.
April-May 2010: BBT charts in hand, we head off to the first of many appointments. My doctor doesn't seem concerned about LPD, and a P-21 test (progesterone) reveals my P levels remain high throughout my LP, so she rules that out. Actually, ALL of my tests come back normal. They test Matt. Much to our disappointment, we find the reason we are unable to conceive. The SA reveals extremely low sperm count and motility (morphology is okay) and low volume. Diagnosed with severe male-factor infertility (oligozoospermia). Repeat analysis reveal the same results. In layman's terms, we have a really really small swim team...that can't swim. Bummer.
May 2010: I had an HSG. Because there is really no cure for MFI, one of the primary strategies is to make sure the female partner is in TIP TOP CONDITION. That way, if ANY sperm has a shot at success, there's nothing else compounding the problem. My HSG results were normal. Matt has begun taking a ridiculous regimen of vitamins and supplements. Future SAs (in months down the road) will reveal a slight increase in count, but not enough to take us out of the "extremely low" category.
June 2010-November 2010: (sorry if times start overlapping here) Matt has many appointments with a urologist specializing in MFI. Unfortunately, they cannot find a "cause" for the low counts/motility, and there isn't anything they can do to help them get higher. He has an ultrasound (yes, before me-- how unfair is this) that reveals a tiny varicocele. His doctor thinks this varicocele is so small that it is probably not much of the problem, if any. We could choose to have it repaired, but his doctor told us openly that even if it were repaired, there was about a 50% chance we would see minor improvement in sperm quality/quantity. Most likely not even enough to give him 'normal' numbers (IF it improved it at all). Since the surgery would be upwards of $8,000 (out of pocket, of course!), we opted to decline. Doctor says there is really nothing he can do and gives us a referral to an IVF clinic.
August 2010: Decide that IUIs may be our best chance at getting a sperm into the vicinity of an egg. Embark upon IUI #1 (unmedicated). It is a miserable failure before it even begins, and it is cancelled due to technical difficulties in the office.
September 2010: IUI #2 (unmedicated). We're doing these unmedicated (that means no Clomid/other ovulatory stimulating drugs (OSDs)) because it is already established that I ovulate on my own. It can be risky to take OSDs when you don't need them because hyperovulation can have bad side effects. Therefore this (and the previous) IUD was timed according to BBT/CF tracking. This IUI (read that blog for more info) goes slightly better (although as usual, we did it against the doctor's advice because of the abysmal post-wash sperm count), but because of an uncooperative cervix, turns into an ICI (intra-cervical insemination).
October 2010: IUI #3 (medicated). I described this cycle in great detail in the blog I just linked to. This time I did 50mg Clomid on days 5-9, had an ultrasound revealing excellent follicles, had the trigger shot, AND had a cooperative-enough cervix to complete the IUI. Continued extremely low post-wash counts lead our doctors to suggest kindly that IUIs are a waste of our money and would still require a miracle to succeed. They recommend IVF.
November 2010: No IUI, but I take another round of Clomid 50mg. I figure-- if it'll take a miracle anyway, we'll skip the $300-500 IUIs...but if I can get a nice handful of eggs releasing, maybe a few sperm can find their way at home and make me a baby. Instead of getting pregnant, this cycle ends with two ovarian cysts rupturing. This is evidence that my ovaries are being hyperstimulated and it's enough to make my doctor cut off the Clomid. Additionally, you are "supposed" (in quotes because most doctors appear to ignore this guideline) to be limited to six cycles of OSDs in your LIFE (due to increased risks of ovarian cancer, etc). I've already used up two, and my doctor recommends saving the rest for the future, in case I decide to undergo IVF (which will require OSDs).
December 2010: No Clomid, no IUIs, no nothing. Have another ovarian cyst rupture. Am somewhat concerned I have permanently damaged my poor ovaries. Both Matt's and my doctors again tell us that there is nothing else they can do for us and that IVF and/or a miracle (their words) are our only medical hope.
January 2011-December 2011: Focus our efforts on saving money and praying. We also continue BBT charting, timed BD, a variety of vitamins and supplements, and periodic check-ups. Every month we hope for a miracle. We also explore and weigh our other options as far as family-building is concerned. Viable options (for us) include: donor sperm, IVF (probably with ICSI), embryo adoption, and independent/private adoption. We are on a constant emotional rollercoaster regarding which option is truly the best for us. Since we can currently afford none of them (except donor sperm), it doesn't really matter that we can't decide. We pray that when the time comes, God will make clear which option is the best for us. But we mostly pray that we can experience a miracle for free, at home.
September 2011-December 2011: Matt does acupuncture. He goes weekly for about 4 months and also takes a new variety of herbal supplements and teas.
December 2011: We decide to pursue private adoption. Read about our journey to that decision: Part 1, Part 2, Part 3. Future adoption-related blogs will be filed under the Adoption label.
December 2011-present: More waiting. For a successful adoption referral, or an at-home miracle.
June 2012: I am diagnosed with endometriosis. This now drops us into the really lucky category of couples with both male AND female-factor infertility. Yippee. We are still planning to pursue adoption, but will also be treating the endometriosis.
August 2012: I undergo laparoscopic surgery (as well as a hysteroscopy and D&C) to remove endometriomas from both ovaries as well as adhesions located throughout my pelvic cavity. Surgery reveals Stage 3 endometriosis and fairly severe damage to both my left ovary and Fallopian tube.
November 2012: After extensive testing and evaluation with a new male infertility specialist, we discover that Matt's sperm issues are caused by dilated veins in each testicle (more details here). Surgery to correct the veins should restore his ability to create functional sperm.
December 2012: Matt has surgery. It will be three months before we can expect to see any difference in sperm quality/quantity.
March 2013: Matt's surgery follow-up.
June 2013: Matt has another round of testing and analyses, this time with less encouraging results.
August 2013: Matt's third post-surgery follow-up. This time we got better news! His numbers were good enough that our RE said he would consider letting us pursue another IUI. We begin thinking about starting cycling again in the fall.
September 2013: We are chosen by a birthmother! All thoughts of infertility treatment fly out the window as we prepare for a baby to join our family via private domestic adoption in November.
November 2013: Our daughter is born. Three days after her birth, her birthmother changes her mind and chooses to parent the baby. Our adoption has failed.
April/May 2014: We are chosen by J, an expectant mother with a baby girl due in early August. We begin meeting with her, her family, and our attorney as we prepare for a private adoption.
August 2014: Our daughter, Camilla Ann, is born and joins our family. We feel blessed beyond measure.
Feel free to join us in praying. If you have any questions about any of this, feel free to contact me.
Also, I file most of my infertility-related blogs under the category Infertility. Adoption-specific posts are filed away under Adoption. Creative, right?
*You can find me (and a lot of other awesome adoption/loss/infertility bloggers) on the Stirrup Queen's List of Blogs- check it out!*