Gametes In Love

Well… it’s official. We’re trying IVF!

Some of you will feel saddened when you read that. Please, don’t be! I, for one am really excited about it. It’s good for a change to have a diagnosis and a path forward. As I’ve said before “It’s the engineer in me: find the bug, troubleshoot it and move on”.

We had our follow-up test review with our RE today (that’s Reproductive Endocrinologist for you non-baby obsessed types… also fancy speak for Infertility Doc). It was to go over the results of my blood test, hubs’ sperm and blood work, and my HSG exam.

We know that I have a good egg reserve (yey), I am clean of STDs (double yey) and my tubes aren’t blocked. From previous nine months worth of charting we’re also pretty certain that I ovulate. It doesn’t mean that there couldn’t be anything else going on, but the most obvious causes have at least been examined. We also know that HE is clear of STDs and has a good number of swimmers. Unfortunately, the motility (how long they live) and form (the shape) of said swimmers is not quite in range of what will help us naturally conceive. When the doc went over this I couldn’t help but think “Are you OK hearing this?”. Some guys don’t like to hear it. Luckily HE isn’t one of them, but I wonder if deep inside it bugs him.

We went over treatment plans. We have the following options:

1. Put me on Clomid and partner it with an artificial insemination attempt. The Clomid could help me ovulate more than one egg, which would increase the number of targets for the little dudes. The artificial insemination (or IUI) would take the good and strong sperm and deposit it close to the eggs.
2. In Vitro Fertilization (IVF) with ICSI. IVF includes taking medication to force my ovulation. It actually over-stimulates ovulation so I’ll produce multiple eggs (hopefully). These eggs will later be harvested. HE will also be making his deposit. The ICSI portion of the procedure would select a single sperm and inject it into the egg to increase the chances of fertilization. If the egg(s) fertilize, they’re reinserted.

… and we’re going with option 2. Here’s the reasoning:

• Success rates. Success rate with IVF is higher. I really don’t want to go through cycles of IUI only to continue being disappointed and end up at IVF anyway. Also if we need ICSI (implying that just surrounding the egg with sperm is insufficient), wouldn’t it imply that IUI will also be unsuccessful? Maybe it’s my rationalizing.
• Cost. I don’t think the people at Aetna are as clear on what they cover. We’ve heard two separate stories from them. Story A has Aetna covering 6 IUI attempts and then 15K towards IVF. Story B has Aetna covering a total of 15K, where the IUI attempts and Dr visits are part of the 15K. Given that a single IVF round will be around 15K, I really would like to have the insurance company cover as much as possible.
• Twins. For years it’s been my wish for the longest time to have twins. Yes, some people think I’m nuts, but I can’t help my fantasies. Given that I’m not the right age group, family predisposition or ethnic background I’ve known its almost impossible and I’ve become quite accepting of a single healthy baby, but a girl can still dream 🙂 In a weird way I feel that knowing that we’ll have to go through treatment, this is Nature’s way of at least giving me a glimpse of hope to see a dream realize to makeup for months of unsuccessful trying.

The Dr. didn’t advise us against IVF. She really wasn’t suggesting one approach over another (I think their office explicitly asks them not to), but hubs and I both walked away thinking that if she didn’t think we needed to consider that option yet she would’ve said something.

So… on Monday we go back to talk about the IVF cycle. I will need to have another test of my uterus this time to check how big it is and see where the eggs would need to be re-inserted. If it’s anything like the HSG test (which I expect it will be) it won’t be pleasant. Then I go on birth control for 2 weeks, then start the injections. If all goes to plan, we’ll be doing the egg retrieval late November, early Dec. Wouldn’t it be a great Christmas gift to know we’re pregnant? Ok, now I’m getting ahead of myself. Let’s get through Monday first!

So between now and then I need to start making a list of detailed questions about the process: Can I still work out with my trainer? Do I need to stay away from certain foods/drinks? How much weight will I’ll be gaining through the meds, and will it go away? How do I store the medication? Ugh… I really need to start writing these down!

And that’s that — for now at least 🙂