cycle 10, day 5: sperm, always sperm

after a rather uneventful couple of weeks, we have some news and a slight update. well, i got my period last week so i am (obviously, again) not pregnant. but this was no surprise and no disappointment this time around. but in more significant news, we finally got the results back from the hubby's sperm dna test. we had quite a hassle trying to obtain this information; the lab had the results last wednesday, but gave him the runaround with return phone calls. finally this afternoon a urologist called him back to discuss the results.

the doc said that the dna results were fine. 2/3 of his sperm are normal, which apparently is... normal. so -- no big awfulness with the sperm, they just don't quite do what they're meant to. it was nice to have a pro look at the results of his first semen analysis also; this doc said that he wasn't really concerned at all about the motility, and that while the morphology percentage is bad, since the sperm count itself is high it's not as bad as it seems. he mentioned a couple of things that could be going on, things i've read a bit about on the internet -- varicose seals and whatnot, but the hubby is convinced all of this is just a plot to get him to come into this guy's office and spend a ton of money. bottom line is the doctor told him he should be taking male fertility supplements (he has been for a couple of weeks now) and that there's really no reason we shouldn't be able to conceive. he also suggested Interuterine Insemination (IUI), which i thought was interesting because from what i'd read online i didn't think it would be a helpful method for us with a morphology issue. but this guy said yes. i feel that i must use a direct quote from the hubby to describe the IUI process, because i just can't say it any better:

"He said that procedure is only a few hundred bucks and would involve me looking at a nudie mag, them "washing" the sperm, then shoving it up your yeehaw."

clearly we'll need to learn a bit more about it, but it sounds promising (and slightly terrifying).

but... i think we have a gameplan for the next couple of months. we'll keep trying as we have been this cycle and next, now that he's on the fertility supplement and we've read a bit of other pieces of advice: that i should lay down for at least 30 minutes after sex, that we should have sex in the morning whenever possible (a.m. sperm is better than nighttime sperm), that he should be exercising more and eating healthy (we'll see how far we get with that!). by january, after 12 tries on this crazy adventure, we'll consider trying IUI if it seems like a good plan.

i like plans.

oh, and we also read that he should be... ahem, expelling sperm every 48 hours or so consistently throughout the month to keep the sperm as fresh and healthy as possible. apparently if they sit around in there they get funky. i thought this could be the key to all of our problems, and told him that we needed to have sex a lot more often. he said, "no... that hasn't been the problem." i paused, knowing full when when we've been having sex and that there have been some big gaps in between my peak times. he repeated, "that hasn't been the problem," and smiled. so i guess he's been taking care of the sperm. sigh. well, he'll have to keep that up!

can you believe this silliness of all of this??? what a riot.

mid-week update

finally talked to the doc today. life has been way too crazy lately... i completely forgot to call him when he was back in the office on monday and then i did not have a single free second yesterday. but, in the end, the conversation wasn't all that earth-shattering anyway. my hysterosalpingogram results were totally normal, everything seems to be working exactly as it should be as far as my body is concerned.

fancy that.

the hubby had the sperm dna fragmentation test yesterday, and we'll get the results next week. in the meantime, we received a copy of the semen analysis, mailed from my doc's office, and have been trying to decipher it. based on the percentages, his motility is "low" (40%, when it should be 50% or more) and his morphology is "poor" (16% when it should be 30% or more). the lab that did his analysis uses the traditional World Health Organization numbers, but my internet research shows me that there is little agreement these days on the morphology breakdown. it seems that all kinds of newer research in the past couple of decades indicates that a much lower percentage of "normal" sperm is still totally average and viable. in fact, some sites i've found say that normal morphology is 15%, and that most men rate much lower (around 5%!). but i'm not sure if what they're looking at or counting as "normal" is different under those conditions, so... it's a little confusing. we're not sure how to react to this information, exactly. could it be that he actually is "normal?" or is this new perception of "normal" just plain silly, as this doctor: http://infertilityblog.blogspot.com/2006/05/sperm-morphology-mythology.html thinks? i really don't know. his results do say that 72% of his sperm have "head defects," which doesn't sound promising, and from my completely non-medical opinion, morphology seems harder to overcome with fertility "assistance" measures than motility. if all we had to worry about was his little guys getting up to the egg, we could do some kind of insemination, i'd imagine... but if, once they get there, they still can't get the job done because their heads are messed up, well... that's not so hopeful.

so we're still at a standstill for the time being, but i am really enjoying the break from the obsession/insanity. next week we'll have more results, another new cycle of mine should start by the end of the week, and it'll be a brand new day! ... one way or another.

a nonchalant Round 9! and other stuff.

so... we decided to TTC again this month. to heck with it, right? by the time the 24-hour waiting period following my procedure had ended, it was the night of my first peak fertility day, so we hit that day and the morning following my ovulation window. but i have to say that i don't think this was as much an attempt to TTC as it was just us... getting busy. our sex life has been constrained by rules lately, even more than usual. we had a mandatory abstinence period prior to his first semen analysis, and by then i had my period, and then we weren't allowed to in between when i got my period and the hysterosalpingogram. so... it had been awhile. i don't think this will be a tremendously hopeful cycle, since we're fairly confident now that this whole thing will be pretty damn difficult. but... as least we had some fun, right?

i've also done some non-researchy research about adoption the past few days. since we're in the information-collecting stage. i have a friend from high school who's in the process of adopting a four-year-old girl from russia, and a former colleague/friend from north carolina who adopted a newborn over the summer. both of them have been more than forthcoming about their experiences and have provided me with a lot of food for thought. much like conception has been for us, the reality of adoption is much less romantic than one thinks before learning something about it. of course it's a risk anytime someone decides to become a parent, but the risks with adoption scenarios are kind of terrifying. but. we're not there yet, so i'm just taking in some details and saving them for a time when i might need to process them further.

in the meantime, the hubby and i had a wonderful weekend setting up the house and just generally enjoying one another's company, which was so needed and so appreciated. i feel dramatically better than i did a week ago today, and for the moment am perfectly content to take things as they come and not get caught up in over-dramatizing, over-planning or over-thinking. for once.

sperm test #2

i stayed home today to fully recover from the stupid hystogram yesterday. i slept in and was planning to go in to work late, but i still had some cramping and bleeding so i decided to go back to bed. by the afternoon i felt mostly normal. the spotting seems to have stopped, and i only have an occasional cramp... but then, i'm also ovulating today, so who knows from whence these cramps come?

we also haven't quite decided what to do about this ovulation situation this time around. we're allowed to have sex now that it's 24 hours after the procedure. but... i dunno.

we made an appointment today for the hubby to go in on tuesday for a much more detailed sperm analysis. it's called a sperm dna fragmentation test. basically, it's been shown that the most important factor in the sperm's ability to impregnate an egg and create a successful pregnancy is the amount of damage to the dna of the sperm, or the fragmentation of the actual shape of the dna chain (remember all those twisty ladder-looking things from biology class?). the basic semen analysis only measures quantity, shape, and movement, and sometimes these factors aren't indicative of the sperm's potential. lots of men who have totally normal semen analyses still can't impregnate their partners because of damage to the sperm's dna itself, and men who have abnormal semen analyses find out that even the use of in vitro or other reproductive assistance doesn't help because there is too much dna damage to sustain a pregnancy. the fragmentation test looks for any of those underlying imperfections. if you care to learn about the scientific details, here you go: http://malereproduction.com/male-infertility/scsa/

we've decided if these results aren't favorable, then we won't try to conceive on our own anymore. it's both nice and sad to have that kind of finality. but it makes sense. and we're still not really thinking about anything further than that. and we've actually had a really nice few days. we joke around about adoption, trying to suss out how we both feel about it... and i don't think we know yet. there will be decisions to make in the near future, but as we don't know what they are we've been trying not to dwell on them. he does a much better job of this than i do, but i have to say i've been staying pretty positive. here's hoping i keep it up!

procedures & tests & decisions... oh, my

i had the hysterosalpingogram procedure today, and at a glance it looks like all of my parts are working right. my doctor will get a more detailed report from the folks who did the procedure once they've looked closely at the x-rays, but the doc i saw today said both of my tubes are open and everything looks fine.

right now i'm feeling pretty crappy, physically, but not so bad emotionally. i've been feeling slightly better since therapy on monday, and trying to be more optimistic and focused on the good parts of my life... of which there are many. i was super anxious all day today about having this "hystogram" thing, so i'm psyched it's over. it wasn't all that bad, either. here's how it went, in case you're curious about such things.

i went to a radiology center, you know -- a place where people get mammogams and MRIs and CT scans and all kinds of other tests that allow docs to take pictures of stuff inside you. it was a nice facility and the people were quite friendly and pleasant... a rarity in medical offices in new york. the hubby went with me (at my request), which was helpful because i was all hyped up about it beforehand, and feeling really gross afterwards. the thing i didn't expect is that he actually went into the room with me. i'd imagined him sitting in the waiting room, bored, checking work email on his phone... but he voluntarily came back with me and stayed with me throughout. there are serious perks to this marriage thing -- who knew?

so, after i'd stripped from the waist down, they took me into a room and set me up on a huge table with an x-ray machine suspended above it. it started out very much like a regular gynecological exam: legs propped up, knees covered, etc. there were two doctors (i assume one was a resident... can't imagine this was all that complicated that it required two doctors) who told me how it would work. basically they used a balloon to keep my cervix open so that they could insert a catheter and fill me up with an iodine-based dye. after they'd done that, i had to scootch up on the table and put my legs down flat so that my lower body was right under the x-ray machine. the dye moved through my tubes and uterus so that they could see how if there were any blockages or other abnormal things. the image was projected on a screen next to me (which i checked out when i could) and they snapped a couple of pictures of things. at one point i had to roll my hips to one side so that they could see the other side better. it took less than 10 minutes from start to finish.

it didn't hurt, but i could feel the pinch of the balloon being attached to my cervix (i mean, you can't really miss that) and then a lot of cramping and general discomfort. because my uterus was inflated by a balloon. definitely not something i feel every day. eventaually the balloon deflated itself and came out, which also felt weird. and since then i've just had cramps and bleeding. the bleeding has actually been heavier than i expected; the technician? nurse? said i'd probably experience some spotting, but this is clearly more than spotting. of course it could be that i left immediately after and commuted home by subway, with a husband who walks way too fast for me. probably not ideal. now that i'm stationed on the couch, where i plan to stay for the remainder of the evening, hopefully i'll feel better and the bleeding will stop.

in other news, the hubby and i have been talking about our next steps in light of our newly found knowledge that most fertility treatments aren't covered by insurance. we decided that we wouldn't spend the money to see a specialist right now, because we think we know what we want our next step to be regardless. we want to know if there's something genetically messed up with his sperm, other than the fact that they don't move or look the way they should. i did some research about this and found out that the test we want to have done is called a sperm DNA fragmentation test. i contacted the lab where he had the initial semen analysis done and they said they can do that test, so i think we're just going to schedule that appointment and then make any other decisions from there. because that information will be enough for us to know if we want to keep trying or not. period.

so that's where we're at. i plan to enjoy a night in sweatpants on the couch with takeout leftovers and TV, and see if i feel well enough to go into work in the morning. tomorrow i will call my doctor for the results and to talk to him about our decision about the sperm DNA test. i'm not thinking any further than that yet. one day at a time, right?

dazed & confused

well, it's been a rough week. to be expected, i suppose. as much as i try to rationalize and intellectualize all of this, there comes a point when the denial is no longer possible. and, in my world, that pretty much means that i am on the edge of either tears or a temper tantrum at all times. luckily for those around me as well as my fragile personal possessions, it's mostly been tears so far.

or maybe i was in better psychoemotional health when i used to scream and break things. i seem to be really good at swallowing down my rage as an adult, but who knows how productive that actually is.

the hubby finally talked to the doc today. he never got ahold of him last week due to what seems to be a combination of busy and conflicting schedules as well as a general sense of either apathy or avoidance on his part. somehow, regardless of how busy my days are, i manage to fit in phone calls that are important, but perhaps he operates differently than i do. in any case, they talked this morning. again the doc said we could just wait 60-90 days because that's how long it takes the sperm to go through a complete cycle and totally re-generate, so we might get different results. the hubby said he isn't comfortable waiting because it's been quite some time with us having unprotected sex (which we called "not trying but not trying not to"), 8 months of planning and actually trying, and also his wife is an anxious basketcase. so the doc recommended a specialist... whom we promptly learned does not take any insurance.

no worries, right? we'll just go onto the insurance website and find a urologist that takes our insurance. easy. except that there aren't any within the entire city limit. not a one. so we can either switch to a different insurance plan that we can't really afford, or go to this "highly recommended" guy and spend $425 for the initial session and $275 for every visit thereafter, with tests and procedures extra, of course. meanwhile, i'm still going in for the hystogram on wednesday, which will mean missing work and being uncomfortable at best and (more likely) in a bit of pain and discomfort for a couple of days. PLUS we can't have sex until that procedure is over for at least 24 hours (likely longer since it seems i will feel like utter crap afterwards) and it seems that's precisely when i'll be ovulating this month! so even if we WANTED to TTC and take advantage of the fact that they say you're more likely to conceive after having one of these hystogram thingies, we won't be able to. awesome.

this is the kind of shit it's come down to, which is creating a good portion of my general instability at the moment. money and hassle. i don't want our sex life to be monitored and prescribed. i don't want to spend hundreds or thousands of dollars or take drugs or go through procedure after procedure just to get pregnant. oh, and adoption? by the way, did you know it runs you about $20-30k to adopt a newborn? my insurance will cover a whopping $5k of that. nice, right? and it still takes years, and you have to deal with home inspections and background checks and who knows what else. any old jane schmoe can get knocked up and have a baby and no one gives a shit, but to adopt one that needs a home they put you through the ringer. where's the justice in that?

but honestly... back to the intellectualizing and rationalizing again... i don't even feel as comfortable with the prospect of adoption as i thought i would. of course i'm open to it. but right now it's a disappointing second choice. and i would never, ever want to bring a child into my life while i'm feeling that way. i didn't used to want to have my own children, it's true. i used to entertain the idea of adoption as a wonderful possibility. but i seem to have conveniently forgotten that what made me change my mind about wanting kids was meeting someone with whom i wanted to have kids. plus it's so... complicated. adopting a newborn is difficult and expensive. adopting an older child is difficult in totally different ways. i don't think i'm ready to have a toddler or a young child walking around my house. the idea of having a tiny infant first and growing and changing with that baby seems so much more logical and so... natural. of course it's how everyone imagines it.

it just seems so unfair that it is so hard. which is what has me walking down the street spitting mad at everyone i see who's pregnant or has kids, particularly those that look pissed off about it or are -- gods help them -- yelling at their kids. i have come close to grabbing people's arms and shaking them for being so ungrateful. and the number of freakin' adorable babies and little kids on halloween? torture. positively awful. i didn't realize that i used to look at them and somewhere subconsciously imagine having my own one day. now it's like a stab in the heart every time. trying to unpack and set up our new house when i've always had -- somewhere in the back of my mind -- the vision that it would be the place where we raised a kid or two is like constant, repetitive heartbreak. i sat down in the hallway and sobbed last night when we brought upstairs the bookshelf that has always held my children's books... the collection that i've used for work but have been adding to deliberately the past couple of years for the purposes of my own future family.

i know on some level that it is still possible that things will work out. but i also have to make myself accept that there's a chance that it won't. and i'm just so angry. and so sad. and there's nothing that anyone can say or do to change that, which is why i find myself not wanting to talk to or see anyone other than the hubby. while i don't think he knows exactly know what i'm going through, he is experiencing something similar, i imagine, and is somehow able to understand how upset i am (and when to walk away, lest he get something -- say, a drill -- thrown at his head when i'm having an irrational outburst about curtain rods). i can't expect anyone else to be able to handle me right now.

except my therapist. thank the stars for mondays.