Awkward

I have a new boss at work and I had the chance to meet him this week. After introducing himself, he asked us if we had any questions for him. One of the directors shouted out "what do you like to do outside of work?" He mentioned he has a wife and two children and that somehow turned into asking anyone who has children to raise their hands. Everyone at the table except one other woman and me raised their hands. He then went around and asked the ages of the kids.

Now if you read my post about jealousy, you'll wonder why this bothered me so much and to be honest, I'm not sure I understand why myself. But it did. Part of the frustration was that we only had a small amount of time and it was spent discussing kids when I think there are many important questions that could have been asked. But then the other part is probably that I couldn't raise my hand. And I wish that I could.

Sharing the truth

I told my mom about our fertility issues. I mean, I told my mom.. everything. Before I gave her the details, she said "I thought you said when you got married that you'd try naturally until you were 30." And yes, at some point, before I knew everything I know now, that is what I said. But then I explained to her that we have issues we didn't know about. She seemed really sad. I'm pretty sure the sadness was for me. And god.. that makes me even more sad. I don't want her to share my pain. I just want to be able to talk to someone about everything that is going on.

She was really supportive of everything though and it felt good to get all of this off my chest. I told her I didn't want her to ask me anything after the conversation in terms of updates etc. For some reason, my biggest fear is the added stress of someone asking questions about appointments and procedures and how they went. I want to talk on my own terms, when I'm ready. Anyway, just typing this entry puts tears in my eyes.

Guilty Pleasures

I have to confess that one of my really guilty pleasures is watching “16 and Pregnant.” If we have children and our teen daughter becomes pregnant with a baby, I would never encourage her to have an abortion and I would certainly never be behind adoption. I would definitely make sure that she could continue on with high school and graduate from college while we hired someone to watch the child. However, I am pro-choice and if my teen daughter felt strongly that abortion was her best option, I would stand behind her regardless of how much it would pain me. Anyway, I have no doubts that teen pregnancy is difficult, but I do question why our society looks down on it so much. If a family has financial stability and realizes the importance of education and is able to support their child/grandchild, I don’t think it’s as terrible as people make it out to be. Of course, this situation is probably not the norm.

I think some of my feelings stem from my sister-in-law’s experience. She had two kids at a young age, but by the age of 27, she was diagnosed with cancer and had to have her uterus removed. She can’t have any children now but she was blessed to have two at a young age and she is very thankful for that. I know that this is a unique situation. Not everyone loses their ability to have children at 27. But in her case, everything worked out in the way that it was supposed to.

When I married my husband at 22 (he was 29) I think a lot of people thought we were too young. However, now I am more thankful than ever that we got married when we did. If we waited 4-5 more years to get married and then we tried naturally for a few years, I’d be at least 30 before we’d seek out fertility help and go through what we are doing now. Fertility begins to gradually drop in your late 20’s. That is certainly not a reason to get married young, but if you know you are with the person that you are going to marry, perhaps that should be a thought in your mind.

In hindsight, I wouldn’t have tried naturally for a few years to get pregnant based on the theory that we were young.

Sharing Happiness

Now this may sound really bad, but one of the things that I am really looking forward to is a baby shower. We had a really small wedding (immediately family only) so you know I am not typically one who likes a lot of attention (and I’m certainly not one who just wants gifts). But, the baby shower is going to have special significance to me and I just really want to celebrate it. I want to gush over baby things and anticipate the arrival of our baby. And yes, I know you need to have a baby on the way to have a baby shower. I’m just saying that I can admit to the fact that if I become pregnant, I want a really special shower.

I’m also not the kind of person to go clothes shopping (I may spend a couple hundred on clothes/shoes a year, if that) but you better believe that I am going to spend my tail off at the maternity store. I may just be the happiest pregnant woman that you have come across. As a matter of fact, you may hear me yelling in my apartment, at the top of my lungs, to anyone and everyone that we are pregnant.

Yard Sale

Over the next couple weeks, we are going to prepare for a yard sale and I am going to get rid of as much “stuff” as possible from our spare bedroom. Right now the spare bedroom has a convertible sofa, bookshelves, and an amazing, old, and colorful Middle Eastern rug. I’m not planning on removing those items or any of the paintings on the walls. I just want to make room for a crib and a dresser/changing table. I don’t think the room will be a typical baby nursery by any means. I guess I should explain that we live in a 2 bedroom apartment (in the city) that doesn’t have a ton of room. Maybe I’m still not confident that we’ll be able to have babies for years and when/if I do become pregnant, I’ll change my mind and make the room into a typical nursery. But for now, I completely picture the room staying as is (for the most part) with the addition of some baby furniture.

A friend of mine struggled for years with infertility. Throughout those years, she prepared a nursery in anticipation that she would become pregnant one day. I always thought that was kind of odd. Maybe I’m the odd one though. I would definitely find pleasure in creating a nursery, but I think I’d lose it if I had to pass by that room every day.

Dreams

I had a dream we adopted a baby last night. It was a beautiful, tiny baby girl. I just remember that in my dream, I was so incredibly smitten by this sweet little girl as soon as she was in my arms. Everything just felt so right. For a dream, everything was so vivid and I could really feel each emotion.

Anyway, I wonder what kind of parents we will be. The one upside to not being able to conceive for a long time is that you get to see a lot of your friends and family members start their own families. And you learn (at least in my case) what kind of parents you want or don’t want to be. Their challenges become your lessons. Of course, it’s easy to think you won’t to do this or that, but in reality, who knows what you will be like when you are actually a parent.

It’s been interesting to see how our friends/family “cope” with having a new baby. Some of them continue on with their lives and others seem to be trapped in their houses, afraid to take a baby out for fear that it will cry or misbehave. I really hope that we are going to fall into the first category. I don’t want to be the kind of mother that tries to one up other mothers, or the one that doesn’t let her baby be a baby. I hope I’m laid back enough to go with the flow.

Anyway, what kind of parent are you hoping to be?

My Guilty Pleasure

One of the things that I know I will need to give up sooner rather than later is caffeine. As stupid as it sounds, I could inject myself, undergo surgery and take medications, but I really, really don’t want to give my morning cup of coffee. For years now, I’ve had migraines. A surefire way for me to get a migraine is to miss my morning cup of coffee. I’ll give up wine, I’ll give up sushi, but please just don’t take away my coffee.

Giving up my coffee probably means that I will need to take my prescription migraine meds more frequently, which also makes me wonder if they are safe. My nurse did mention recently that you could have caffeine throughout pregnancy but in limited quantities. And with my migraines in mind, it may make sense for me to continue having my morning cup of coffee. But at the same time, I don’t want to take any risks. So what’s worse? Migraines (and then possibly having to take medications with caffeine) or having the morning cup of joe? I’ll be sure to ask my doc when I see him next.

The "What Ifs"

The “what ifs” are always in my head. What if we take advantage of everything our insurance has to offer and we still don’t have babies? Are we going to pay tens of thousands of dollars out of pocket or are we going to resign to our fate? My initial thought is that if insurance stops covering any of the procedures or we hit a fertility dead end, we are going to go to adoption. The way that I see it is if we funnel tens of thousands of dollars into fertility treatments, it’s for a chance to have a baby and that chance may or may not work out. But if we put the money toward adoption, we’ll end up with a baby. Sure there are options in between: surrogate mothers, donor sperm and eggs etc etc. I just don’t see us going down any of those roads.

Of course, adoption has its own difficulties. I read somewhere the other day that 35% of couples experience false starts with adoption. However, I’ve never met someone who wanted to adopt and wasn’t able to. I have met people who went through years of infertility and never had kids.

Anyway, I’ve always wanted to adopt even if we were able to have biological kids. Maybe that is our fate.

Fertility Challenged

Being fertility challenged puts you in a weird position socially if you are a private person. I don’t share our fertility challenges with anyone (including family or friends for the most part). Anyone that does know we are having difficulties has very limited information without any specifics. Of course, when you have been married for 4 years, you cannot stay away from the “when are you going to have babies?” question. My response is typically “we’ll see..”. If someone presses me for more information, I try to change the subject at all costs.

Luckily for us, our families have never pressured us to have children. However, the societal norm is that a couple gets married and the next step is to have babies. These poor people who question couples like my husband and I have no idea they could be touching on a very raw subject. I don’t blame them, but I am much more aware myself that the subject is personal and I never ask anyone when they are having children for fear that they may be going through the same thing as us.

The truth is I don’t know if we will ever have children, and that isn’t by choice. So is honesty the best policy to make the questions go away? I certainly don’t want to be pitied by them either.

SA x2

The nurse called my husband back today and said his SA results were the "same." That bothered me. I asked my husband to call back and ask for the exact results. I think there may have been some confusion but apparently his morphology went up from .5% to 1%. However, the nurse told me that the results of the first test were 1% morphology. Anyway, it bugs me that they can use words like "same" when every bit matters. Not sure if this nurse gave the results the same way because this one told my husband "50% were moving" but the first nurse said the motility was 13%.

Anyway, they referred him to a Urologist. I just hope nothing is seriously wrong. Give me something minor/fixable and I'll be happy. I just can't deal with more bad news.

SA

In my husband’s case, he is measuring low in all three areas by either the WHO or the Kruger scales. The blanket “rule” at the bottom is concerning. My husband’s motility and morphology measure lower, however, his sperm count is higher.

It’s amazing that a medical policy can be such a wealth of information. I spent countless hours looking at various websites when all I had to do was pull up the medical policy to find all of the information that I was looking for. However, I do question the date of the research that they are referencing. 2000 was more than a decade ago and it seems to me that they should be referencing more recent information, even if it is still the same data.

Health Insurance

I contacted my health insurance company and requested that they direct me to their medical policy on infertility. By far, this was the best explanation of all of the facets of infertility and all of the procedures that come along with them and why/when they are offered. The IVF and ICSI section reads as follows:

ICSI and IVF for:

 ICSI is covered for severe male factor when at least 2 unprocessed semen analyses show < 10 million total motile sperm or ≤ 2% strict Krueger normal forms or post processing semen analyses show ≤ 3 million total motile sperm. IVF is covered for moderate male factor when at least 2 unprocessed semen analyses show < 4% strict normal forms or post processing semen analyses show >3 and ≤10 million total motile sperm. 22 (hysterosalpingogram is not a prerequisite test in couples who present with male factor who require IVF and/or ICSI.)

Note: 2 semen analysis requirement for the diagnosis of male factor (Effective 4/2008)

 ICSI is covered on the day of IVF if the post processing semen analysis of that day meets the ICSI coverage criteria noted immediately above. Retrospective authorizations will be allowed.

As it stands, we qualify for both of those procedures based on my husband’s first SA. Now we just need to wait and see what the second SA will show. So here’s my question: if there is one irregular SA and one regular SA, what conclusion can be drawn from that? Or is there typically a third SA at that point?

Decisions

It’s sad to read some of the infertility stories online. While some of them end up with positive news, a lot of them detail difficult, painful journeys that do not always necessarily have happy endings. Without knowing how our journey will shape out, each time I read about someone’s experience, I wonder if that will be us.

Recently, I was on the mothering.com board and I was reading about egg and/or sperm donation. Someone posted that due to male factor issues, they decided to use donated sperm and were able to have children. The woman went on to say that she and her husband made the decision not to tell anyone, including their children, that they were the product of donated sperm. I have heard about this same predicament with those who adopt. Should they tell their children they were adopted? I have always been of the mind that they should. But I have never thought about donated eggs/sperm and whether or not I feel that children should know. My gut reaction now is that I would want to tell my children when they were old enough to understand because I would want to know. If for nothing else, it is honest and forthright and everyone deserves to know where they came from.

Interestingly, I told my husband about this last night and he thought that it would be better to not complicate things for the children and to not tell them. This just goes to show how hard it is to make decisions on these matters. Nothing is cut and dry.

Vacations

We had a vacation booked and planned for Feb 2012. For whatever reason, I got into my head that I would be pregnant by the time we went on hat tvacation but that was before I found out about my husband's SA results. Now I wonder if I will be pregnant by our 5 year wedding anniversary. We have decided that if we aren't pregnant by that point, we are going to take a huge vacation somewhere. The kind of vacation that you don't normally splurge on, but that takes away a little bit of the pain inside for a little while. Traveling rejuvenates me in a way that not much else does. It's sharing time with my husband and experiencing new places, new foods and creating new memories. Traveling grounds me in a special way while also lifting my spirits.

So where should we go? We'd only be able to take 7-10 days off from work so it can't be too far away as I don't want to lose that much time traveling back and forth from our destination. I'm thinking Italy or France or maybe something much more obscure.

Finances

Talking about money is tacky, but talking about money anonymously is justifiable if it's in regard to infertility, right? We're lucky that we live in a state that mandates that health insurance cover fertility treatments. Unfortunately, my company's health insurance is self insured so they can get around that and they don't cover fertility services. That leaves us with my husband's health insurance as an option which is significantly more expensive. Each month we pay over $400 to cover us, knowing that we will need to use it for fertility services. Meanwhile, my jaw drops each time I see the rates at my work which are more than 4 times cheaper. But that's the sacrifice that we make to have the chance to have kids.

If the fertility treatments fail, however, and we decide to go the adoption route, I just don't know how we will be able to afford it. The thought stresses me out. We are no longer talking about $400 a month for health insurance but tens of thousands of dollars. How come foster parents receive a stipend but those who would make a child extremely happy are shuttered out of being able to adopt due to financial reasons? If I had the funds, I'd start an organization to help parents adopt. An adoption philanthropist - giving parents the opportunity to adopt a child and giving children a home. Win/win.

Jealousy

I've wanted kids for years. I've watched my siblings have babies and I've watched some of our friends have them. I've gone to baby showers and I've thrown baby showers. And I have to tell you that when I read people venting that they are upset at the sight of other people who are pregnant around them, I can't relate. It's not that I don't wish I was also pregnant. It's that I'm still happy for these people and I don't think everyone else has to pay for our situation.

A colleague of mine has had fertility issues for years. Recently, she ended up adopting a baby. She's really the only one that I have even slightly opened up to about our fertility issues but I have always been really vague. Anyway, one morning she came into my office with a really sad expression on her face  and said "were you okay yesterday?" I had no idea what she was talking about. "What was yesterday?" I asked her, thinking she was confusing me with someone else. "Mother's Day" she said with a pout, "was it hard .for you?" Realizing what she was talking about, I explained to her that I hadn't even thought about it. She then told me she bawled every year on Mother's Day and this was the first happy year for her now that they had their son.


I guess I just don't get it. My pain doesn't need to be anyone else's pain. I wouldn't wish this upon anyone.

Positive Visualization

Dr. Google is a wealth of knowledge but boy can that doctor make your head spin when there is something wrong. Personal experiences, articles, and information from medical professionals themselves fill pages upon pages of materials. Googling “low motility and morphology” I am able to pull up a wealth of information on what those in comparable situations went through. It seems most ended up going the IVF/ICSI route. And then I start looking at their decision points. How many cycles? One embryo or two? Out of pocket or will insurance cover it?

Maybe I’m a planner with stuff like this or maybe it’s natural to imagine yourself in their shoes, but I start asking myself those questions just in case we will have to answer them. And naturally, because I know that I won’t be making any of these decisions alone, I start asking my husband. One or two embryos? He looks at me as if I’m losing my mind. He hasn’t even done the second SA and I am already leaping 10 steps ahead. But I can’t help it and hey, if it helps me feel better to do some positive visualization, then it’s fair game. “Two” he says and the excitement bubbles over. I know twins are difficult, but if they take and it’s meant to be, it will be right for us. Deep inside, I have a feeling we will have twins. I know it’s just a feeling, but it’s a strong feeling.

Speaking of planning and positive visualization, what would daycare cost for twins out here?

Rational vs. Irrational

My husband and I have been very happily married. For years now while I have wondered about my own fertility, I have always been of the mind that if I do end up being infertile and can’t have children after reasonably trying with intervention, I will not let it devour me… or us. Easier said than done, right? But, I am still doing my best to stick to that and this is coming from someone who has wanted to be a mother her entire life. I won’t let our fertility journey devastate our relationship.

Finding out that you are fertility challenged certainly doesn’t boost your spirits. This is probably one of the most difficult things that we have faced in our time together, but I wouldn’t want to go through this with anyone else. It certainly stings to have to be in emotional pain with my best friend, but it would be worse if he wasn’t by my side.

From an analytical perspective, it is interesting to look at the various facets of infertility. There is the emotional piece, the physical piece, the coming to a consensus on many important decisions piece, and there can certainly be a financial component. As much as my irrational self wants to go to any lengths to have a baby even if it means bankrupting us, the rational part understands that this is a challenge that cannot ruin us. We must come out of it as a team and be ready to face the future together. Chin up!

Background

About us: I'm in my 20's and my husband is in his early 30's. We've been blissfully married for 4+ years, together for 7+. By today's standards, in our area, I married young. Immediately after we got married (realistically, it was for many years before), I knew that I wanted to be a mother and we tried to see if we could conceive naturally. Since I was young, there was no concern. Time was our friend and we figured that my irregular periods were the culprit. Three years into the marriage, I started to wonder if there was something more that was preventing pregnancy and went to a highly recommended doctor. He performed a series of tests and a laparascopy and determined that I have PCOS and mild Endometriosis. The doctor remarked that he was happy that I had come in at a young age and that he didn't recommend that we wait to start getting serious about our fertility. He said that as soon as we were ready to try to get pregnant with intervention, he would put me on Clomid and Metformin. An optimist at the time, I figured we could wait a little while before we turned to the meds.

Recently, we decided it was time to get really serious about having a baby. I scheduled an appointment and went in. The fertility doc requested genetic tests and they all came back with no issues. The doctor mentioned my husband needed to come in for a sperm analysis and then we could start trying the Clomid. Before we got the Clomid, we got my husband's results: 16 mil sperm, 13% motility and 1% morphology. So this is where we are at currently. My husband has to go back in for another SA to make sure the results are accurate. The Clomid is on hold. Our follow-up appointment is in late August and I am finding it really hard to wait. I want to know what his results are now, and I want to have a conversation with our doctor right away. I hate the wait.

I've read up on hours and hours of research and it looks like the morphology and motility are very concerning and IVF/ICSI may be our best option. Now, I'm not a doctor and this is a guess. Who knows what his recommendation will be. In the meantime, all sorts of thoughts are going through my head. Are we ever going to be parents? How many times will we be able to try fertility treatments before our insurance won't be able to cover them or before we tire out and give up? Are we going to end up adopting?

I do have to say though that I am glad that one thing is still on my side: time. I'm young and I'm certainly thankful that I'm not getting this news much later in life.