Doin’ it and Doin’ it and Doin’ it well.

My husband had his varicocele surgery April 17th. The sperm was supposed to be tested four months later. A week or so ago, my husband went to his pee pee specialist who said it’s too early for the Supersonic Sperm test (not sure why), but…he did a regular one. His count was lower (which, apparently, can vary from sample to sample), but his motility had improved by something like 300%. The doctor said this was a sign that the varicocele surgery MIGHT have been effective. He will officially give him the supersonic test at the end of September.

Meantime, I’ve been tracking my cycles and they have definitely regulated, ranging between 32 and 36 days long. I am taking something called FertilAid, which a friend recommended, in order to get them to continue to be regular and maybe even make them shorter. I’ve been taking it for a month and so far all seems fine. Last month, I ovulated on day 17.  Today is day 13, so I started peeing on sticks.

We have decided to make baby-making our priority. It can be very easy to let jobs and school and other obligations take over one’s mental space, and we’ve decided we can no longer afford to do that. I am starting a new job in a couple weeks and have taken a leave of absence from school so that I can just focus on what matters right now: making a baby and paying the bee-ulls. My husband thinks that if we don’t get pregnant the old-fashioned way by December, that we should consider IVF. Personally, I don’t think that gives us enough time with the good sperm (only four months), but we will cross that bridge when we come to it.

Making baby-making our priority, by the way, does not mean that we plan to sit around wishing for something we don’t have. We are very careful right now to appreciate our free time, our ability to be spontaneous, to stay up late and enjoy quiet time.

Sex has been good lately too. Even though friends tell me “getting pregnant” sex is rarely sexy, enjoyment seems to me to be important for conception.

That’s all for now.

Phoebe

Husband’s Junk Update

How’s my husband’s junk, you’re wondering?  I know you are.  It’s OK.  And I’m here to tell you his junk is healing fine.  He went back to the doctor on May 8 for a follow-up appointment.  The doctor told him everything was coming together just right and that he should come back in 3.5 months for his first semen test.  He was a little surprised at 3.5 months when we had thought he could be tested 3 months from the date of his surgery, which was April 19.  But oh well.  He also told him he can go back to exercising, but has to wear a jock strap.  Sad!

Here’s something odd.  The doctor also sold him a fertility supplement, which is basically an overdose of anti-oxidants.  It’s a supplement that’s like, HIS OWN PRODUCT.  Weird – no likey.  And it was like $110 for the bottle!  WTF?  The doctor said I could take it too.  My husband let him know that I am already taking pre-natal vitamins.  The doctor said that it was OK, that I could also take the supplement.  Yeah, so then we’ll use it up twice as fast and buy another $100 jar of the shit.  I know I sound bitter, but knowing that crackheads are getting pregnant left, right and center, it’s hard for me to believe a supplement is going to make the difference in my situation.

Oh, also – we bought a house in the ‘burbs and I chopped off my hair.  So now I really have the mom-mobile, the mom haircut and the mom house!  Just need to fill it with chillun’s now.  The timing is right.  By the time they come, we’ll be all settled in and ready to party…

Phoebe

Phoebe: Pee Pee Update

Husband was doing great back at work until he forgot he couldn’t run and ran down the hallway and thinks he pulled something.  He says it feels “hernia-ish.”  Again, he was fine until he stepped off of a stair and felt a shooting pain up in his left groin.  Now he describes it more like a ruptured a blood vessel.  I told him to contact his doctor.  The doctor emailed back “it’s probably nothing.”  NICE PERSONAL ATTENTION!

We did the nasty last night for the first time since his surgery, which seemed awfully soon to me (it hadn’t technically even been a week). I was afraid he was going to break something so I just laid there. As if I normally do it any other way. Har har har…

Phoebe

Phoebe: Varicocele Repair Post-Op report

My plan to seduce my husband the night before his surgery went horribly awry. I needed his help putting together a video for school and we didn’t finish it until 3am. He was so tired and done with me and nervous about his surgery after that (we had to be up at 7am to take him), that he was in no mood for sex. The good news though, is that my temperature spiked yesterday, which means that I definitely ovulated ON MY OWN. I am not sure whether that means I don’t have to go back on the Clomid or what, but I guess I have a few months to track it and see if the ovulation continues to happen on its own and in a reasonably timely fashion.  I ovulated around day 19 or 20 this time.

Anyway, this is about the surgery. So I picked up my husband at 11am on Friday and put him into bed. He slept and watched movies all day Friday.  He had to work Saturday and Sunday, and just went in there with an ice pack and worked away. He even went out to dinner with friends both nights and he was fine.

As far as how the surgery went, the doctor said that the veins he found in the left testicle were much bigger than what he’d seen on the ultrasound. The good part about that is that the results we see should be marked. The bad part about that is that there could be veins in the right testicle that did not show up on the ultrasound. However, when the doctor “listened” for the veins in a previous exam (a poor man’s ultrasound, done using a microphone and a pair of earphones), he heard nothing going on in the right testicle. So hopefully there is nothing there.  Let’s hope this is the one and only time the poor guy will have to go under the knife. He’s been up and at ‘em since the surgery, but even so, it was nerve wracking and I believe he has been in more pain than he lets on.

In three months, he gets his first sperm test.

Woo to the hoo,

Phoebe

Phoebe: Ovulating on my own! That’s right. On my own. Woo hoo!

First of all, I got locked out of my blog for days. It was so sad. I visited it, but couldn’t get in. It was like being locked out of my own house, but still being able to look in the window. WordPress wasn’t all that helpful until I figured out myself what the problem was. Anyway, all is well and my three readers must be relieved too. I’M BACK, GUYS!

So even though my husband is having his varicocele repair surgery on Friday and we aren’t really “trying” at the moment, I decided to continue taking my temperature and sort of loosely charting.

Side note: I went back on caffeine, and then acted like a heinous douche to my husband several times – where something triggered me, a small annoyance, and I had to turn it into a HUGE, monumental situation that I couldn’t get over. So despite the fact that we’re not “trying” at the moment, I am back off of caffeine.

Anyway, I started to sense my “fertility signs” picking up a couple of days ago and today I decided to pee on a stick. Sure enough, there was a surge! I am going to do it with my husband tonight.

This is meaningful for a number of reasons:  First of all, I am ovulating on my own. Secondly, I am ovulating around day 17, not day 45 or whatever is typical for me.  Third, wouldn’t it be amazing if we got pregnant au natural the night before his surgery?

I don’t want to get too worked up about it – our chances are nearly nil, but what the hell? I am going to use some Preseed to help his swimmers get through and then leave it up to biology from there… I haven’t told him about this plan. I just intend to seduce him tonight.  Penises  seem to work better that way:  aroused and unsuspecting.

Phoebe

Phoebe: Fertility Musings/Melatonin for Reproduction?

Now that I have quit the IVF birth control pills (wtf?) mid-cycle, I am starting to feel better.  At around 3pm on Tuesday, all of a sudden something shifted and I suddenly went “oh, right” and just started to feel better.  I think the jet lag from Asia is finally wearing off (this is the worst case of jet lag I have ever had), and the hormone roller coaster is calming down.  Between the Clomid and the birth control pills, I was on a ride I wasn’t even aware of.  Now that we are doing the varicocele repair surgery, I’m not going to lie:  I am glad I don’t have to take any more hormones, at least for a while.  That, plus gnarly jet lag, seriously f**ks one up.  In ways one never expected.  For the past couple of weeks, I have felt despairing, self-pitying, self-flaggelating and melancholy.

Another thing I realized about it all is that once we really decided to embark on this baby-making thing and not just “not try to not try,” something shifted in my identity.  I started changing from hot mama to mom.  Not that moms can’t be hot (MILFs, anyone?), but there’s a shift in mindset that begins when you start thinking about motherhood.  As a superficial example, it just so happened that right around January, my sexy, sporty manual transmission Audi was getting to that point where it was sucking up more dough than it was worth, so we decided I needed a new car.  We figured I may as well get a mom car since we are the type of people to keep cars for a long time (like ten years long).  Certainly within the next ten years, there will be baby seats in the back of that thing!  So I got a Honda CR-V.  OK, so now I am driving around the mom car, which is big and cozy with an automatic transmission.  I have the mom car, but I am not the mom.  Also, when we were in the midst of our IUI cycles, the doctor told me to stop working out so much.  I normally go four days a week; he told me to cut down to three.  So I did.  But I kept eating the same amount (which is a lot, which is why I work out so often), and started to grow a little tummy.  I was OK with it thinking, “I am preparing my body for motherhood.”  But again, mom body and no baby.  I got a “sensible” shoulder-length haircut.  Mom haircut and no baby.  We’re looking at houses and worrying about school districts.  Mom mentality and no baby.  Now that my husband is getting his surgery, we won’t be trying again for around six months.  So now I am back to working out when I want and drinking caffienated coffee and eating sushi and all that – the old me.  I know a baby will come eventually, but in the mean time it’s like I’m between identities and it’s uncomfortable!  Of course the lesson in all of this is to enjoy the present tense, no matter what it is.  A couple of days ago, feeling really down, I went to yoga and the teacher read this quote:  “Once you realize that the road is the goal and that you are always on the road, not to reach a goal, but to enjoy its beauty and its wisdom, life ceases to be a task and becomes natural and simple, in itself an ecstasy.” It was just what I needed to hear.

In other exciting news, for the past few nights, I have taken Melatonin to fall asleep and I think it’s been making me unable to wake up in the morning and has given me weird dizzy spells.  I was looking up the side effects on the internet when I came across this on the University of Maryland medical website:

Melatonin also helps control the timing and release of female reproductive hormones. It helps determine when menstruation begins, the frequency and duration of menstrual cycles, and when menstruation ends (menopause).

Anyone heard of this before?  Should I continue with it to regulate my irregular cycle while we are waiting out the results of my husband’s varicocele repair?

Also, in all of my research and whatnot and thanks to all of your fabulous comments, I have come to the conclusion one always comes to in a medical situation:  NO MATTER HOW GOOD YOUR DOCTOR IS, YOU MUST TAKE CONTROL OF YOUR OWN MEDICAL CARE.  Our doctor is very competent and a professor in Reproductive Endocrinology at UCLA, meaning he has access to all of the latest information as well as technology.  And still, without us asking the right questions and asking for a referral to a specialist, we may still have been wasting money and time doing IUI after IUI rather than getting the detailed analysis of my husband’s sperm that determined there to be a severe male factor infertility there and the IUI’s to be 100% pointless!

That’s all for now.

Drinking ‘caf and yoga-fying to my heart’s content,

Phoebe

Phoebe: My RE Wrote Back!

While he didn’t answer any of my questions about IVF, he did respond to a few of my queries.

Regarding the CGH test, which is a new DNA test I read about in the Fertility Advocate blog, a test that one clinic feels so confident in that they are offering a refund plan based on it:  CGH is still experimental.  Not of proven benefit yet.

Regarding IVF Refund Programs:  Most “refund programs” have a catch – they profit by charging more up front.

Regarding why the supersonic semen analysis is not done on every patient (ostensibly saving them time and money):  The SCSA test is a newer sperm test.  “How” it is used in reproductive medicine is still being established - which is why it is not ordered initially in all patients.  It does not predict outcome in all patients.

I asked him what we would do next if my husband’s varicocele repair was effective.  He said we’d try a couple more IUI’s.  I assume that if the varicocele repair isn’t effective, we’ll move on to IVF, in which case dude will have to get around to answering my questions.

Emotionally, I am feeling really down.  Don’t know why, other than it all feels very overwhelming, what with other things that we are doing in our lives right now.  Job, school (both of which I am really not into and yet they are a big portion of my life), buying a house, bad economy, etc.  And my poor husband has such a good attitude about the surgery, but we were reading about the aftermath and whatnot and I can tell he is worried about the pain.  Wouldn’t it be nice to just f**k and have a baby like normal people?

Phoebe

Phoebe: IVF Refund Plans. Really?

I have been doing a lot of fertility research lately.  Thank god for my meaningless job and the internet and all of you amazing people out there spouting off about this stuff.  One of the things I heard on the Twin Peas podcast is that fertility clinics are suffering in the economic downturn.  You wouldn’t know it from walking into mine, but if this is the case, isn’t it time they started offering discounts?  One of the myths that was dispelled on this podcast is that doctors can’t negotiate prices.  It turns out doctors are the only people who can negotiate prices.  In fact, a friend of mine had two failed IVF’s with a doctor and after she switched, he offered her a free one if she was willing to come back.  Sounds like they have some pull after all.

On a blog called The Fertility Advocate, I read about a clinic called SIRM that has offices all around the US and is offering a risk-sharing plan “for qualified patients.” In other words, they don’t make you a baby, you don’t pay.

Here is the link: http://www.thefertilityadvocate.com/wpblog/?p=753

Can anyone speak to the legitimacy of something like this? It seems too good to be true. Like, they’ll get you in the door and then figure out “oh gee that’s so funny ’cause you’re not qualified.”

I contacted this SIRM joint to see what they had to say. Here’s how it went down:

Hello,

I have had two unsuccessful IUI’s and we recently learned from a fertility urologist that my husband has pretty severe male factor infertility. He has a varicocele that is likely the cause of 57% of his sperm having damaged DNA. I am about to turn 37, so we feel we cannot wait six months to see if the varicocele repair surgery will be effective. We are in the process of beginning an IVF cycle now that will involve taking the sperm directly from the testicle, rather than from the ejaculate. I start Lupron injections on Monday, 3/30. I read about your CGH risk-sharing plan, and would like more information on it. It would be nice if our fertility clinic shared in some of the risk we are taking on. Especially in these times, $20k is a lot of money. Please contact me at xxx xxx xxxx.

Thank you,

Phoebe

The prompt reply:

Dear Phoebe,

Your timing is great in inquiring about risk sharing because we released another program that screens all embryos for chromosomal problems and if you have normal embryos and don’t become pregnant you get 100% of the medical fees refunded. I would highly encourage you to call Jennifer at the front desk tomorrow and set up a free consultation with me. Once we determine the specifics of your case, you can talk to our office manager, Linda, and get all the details of the full refund program. Additionally, there are other programs such as the two-cycle program or the outcome based program, which re the most popular programs. All of the programs are much less than the amount you’ve mentioned below with up to 100% refund.

Hope to speak with you soon.

Aykut Bayrak, M.D.

Medical Director

SIRM – Los Angeles

1520 E Chevy Chase Drive, Ste. 101

Los Angeles, CA 91206

Tel: (818) 291-1985

Fax: (818) 291-1986

www.haveababy.com

I got online and starting asking other advocates if they had heard about such a thing. One woman who is an attorney specializing in fertility asked me if I had read the contract associated with the risk-sharing plan.

Dr. Bayrak,

Thank you for your prompt response. Would you be willing to show me the contracts involved with the risk-sharing plans you mentioned in your previous email?

Thank you so much,

Phoebe

Again came the prompt reply:

Let’s evaluate you first to determine which type of treatment and plan would best work for you. The we can give you the specifics. Please contact us at the number below for a consultation.

Aykut Bayrak, M.D.

I am somewhat suspicious, but now that my husband and I have decided to get his varicocele repaired, I am thinking it might not be a bad idea to go in and get the consultation. What harm can it cause?

I also sent a long email to my RE with a litany of questions about the consent forms and the IVF procedure. My final question was about the risk-sharing plan and how he felt about such things. I have not yet gotten a reply. I am glad that I decided not to start Lupron injections TODAY. They asked me to sign their consent forms promptly. Ironically, one of the things they want me to sign says that I HAVE BEEN COUNSELED BY MY DOCTOR.  They really expect me to spend $20k and sign my life away without being counseled?  I won’t get an oil change without talking to someone.

Now that we’re going the varicocele repair route, I have at least three months if not more to chill and figure things out.  In that time, I’m glad I can drink ‘caf coffee again and exercise whenever I want. I am also thinking about fertility acupuncture. Anyone know whether it’s covered by insurance and/or whether or not it is effective?

Please advise, ya’ll…

Phoebe

Phoebe: Decisions, Decisions. Now it’s Varicocele Repair.

After much back and forth and back and forth and back and forth and back and forth (seriously, people, make up your frigging minds), my husband is calling today to schedule his varicocele repair. The doctor said that we could see changes as soon as three months from now and we’ll definitely know something in six months. At my age (37 in April), that’s not too long to wait, according to most everyone we’ve talked to. The procedure is covered by insurance (we think), and we can always do IVF if it’s not successful. Going to email my doctor’s office now and tell them we’re holding off on IVF. They will have to wait to get my $24k. Let’s hope we don’t have to go there!

Later today update: the varicocele repair surgery is scheduled for April 17.  BTW, the reproductive urologist pointed out that DNA fragmentation is more important than morphology or motility in predicting pregnancy, and yet it is not part of the initial semen analysis given by most clinics.  I realize the test is expensive, but people should be given the option, for Chrissakes.  Had we done that “expensive” test, we wouldn’t have lost more money and time on pointless IUI’s.

Just sayin’,

Phoebe

Phoebe: Back from Asia, Leaning Toward IVF

The pregnancy test, as suspected, was negative.  Before my trip, the doctor gave me a prescription for birth control pills just in case we wanted to start IVF right away this upcoming cycle.  Why do they give you birth control for IVF?  I have no idea.  Anyway, my husband and I are going back and forth trying to decide whether to get the varicocele repair surgery, which is 90% covered by insurance, or just go for IVF, which is going to come in at around $20,000, actually $24,000 with the added procedure of taking the sperm directly from my husband’s testicles.

While I was in Asia, my husband was trying to get an opinion from our doctors in time for me to either start taking the pills (day 2 of my cycle) or not.  This didn’t happen.  He still hasn’t gotten an opinion from his urologist, but our RE said basically we could go either way.  On one hand, we could get the varicocele repair and wait six months.  The risk is that a) my eggs could be degraded by then, although it’s not super likely (as far as age is concerned, 37 is kind of on the bubble) and b) the varicocele repair might not even do the trick.  In fact, my husband showed his test results to his dad’s friend, a urologist, but not a fertility urologist, who said the varicocele doesn’t look big enough to make a difference even if it is repaired.  We’re still waiting for a reply from the fertility urologist about this.  The RE also said that if money were no object, he would suggest going to IVF right away.  We do have the money in savings, only it was for a house.  But if that’s the case, we could just buy a cheaper house.  So basically, the RE left it up to us.  Either way, he told my husband I should start taking the pills regardless so that we could have the choice of doing IVF this cycle.  I started the pills on day 5 or 6 of my cycle (hard to tell since I was 15 hours ahead), and I hope that’s ok!  I just put in a call to my nurse at my RE’s office to let her know the latest.  Tomorrow I am supposed to go in for “Lupron Injection Lessons.”

Before I left for Asia, I talked to a nurse who said that if I were to go to IVF I would start taking injections two weeks after starting the pill.  The RE said I would take them one week after starting.  So I have a message into their office to clear that up.  And if it is all good, I gotta talk to the husband to figure out whether we’re IVF-ing it this cycle.  I have a feeling we are.  The odds of success with the ball slicing are like 66%.  That sounds pretty damn good to me!  Also, who knows?  We could have twins.  Two for the price of one…  That makes the bargain hunter in me all tingly.

Later today update:  OK, we’re IVF-ing.  It’s official.  Apparently, it’s OK that I didn’t start my pills until day 5 of my cycle.  My doctor’s office just sent me a shitload of consent forms that have to be witnessed by a non-family member.  I am now officially overwhelmed.  I will start my injections on March 30th and the “retrieval” will take place around April 20th.  Freaked out!

Phoebe