Worrying while TTC

From even before the moment we decided to pray about whether or not it was time to time to start trying to start our family, I worried.

I worried about money, how I was going to continue running my company with kids running around, how Mr.E would be able to study (he’s still in school), if we would have trouble trying to get pregnant (nah! That will never happen to me!), my other medical conditions and how pregnancy would affect them, and so on.

And then we never got a BAM! revelation that it was time to start trying. It was just that one day we felt more confident in our abilities and the worries seemed less relevant. So I made the appointment to get my IUD removed.

Then a new worry started. Did it work? Did we time it right? Are these stupid OPKs and HPTs working???

By the time the second month of TTC ended, I knew there was something wrong. Call it crazy, or woman’s intuition, or whatever you want. I knew that something wasn’t right. So for the third month I found a doctor to test my basic levels during my cycle. They seemed ok. But I still just knew something wasn’t right. I could feel it. And I worried about it. A LOT.

After talking to an RE, he suggested getting Mr.E’s sperm count checked. Just in case. And to put my fears at rest.

So, on September 11, 2012 we went to get the semen analysis. I truly did not think anything would come of it, other than some reassurance that all was well. Imagine my surprise when I got that phone call on September 18, 2012. I will never forget that.

Whatever I used to think “worrying” meant was so lame compared to the way I felt then. And I haven’t stopped worrying since! Oh I’ve tried to stop. There have been times I’ve felt at peace and confident with our decisions, but for the most part I’ve worried. Even now, I worry about how I’ll explain a sperm donor to our kids.

I wish I could stop. I remind myself of quotes like, “Worry is a misuse of the imagination.”

Today I came across this one and wanted to share it with you all. I hope it helps you make the choice to stop worrying, even if only for a day. Be a little stronger today!

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IVF #3 – 9 Weeks 0 Days

I had a funny dream last night. I dreamt that Mr.E slept with someone else and he had to tell me because she got pregnant. Of course I was very upset and I kicked him out.

As he was leaving I realized all of a sudden, “Wait a minute. She got pregnant? That means he has sperm!!!” So I ran after him trying to catch up to him to tell him to stop and come back.

Now that I’m awake I think it’s funny that I forgave the infidelity so instantly just because he had sperm 🙂

On the TTC front, we don’t get to see the babies again until Friday, 9w6d. That appointment is with a Maternal Fetal Medicine doctor. I hope I like the doctor because I wasn’t thrilled with the regular OB. He has an obsession with just looking at TSH for hypothyroid. The TSH test is a joke.

Anyway, then the following week we’ll have an appointment with the IVF clinic. If things are still going smoothly, we’ll be released and sent on our way!

FDA Regulations for Known Sperm Donors

Before we asked my brother-in-law to be our donor, we had a meeting with the donor coordinator at our fertility clinic. We learned a little about donor sperm and donor embryos.

When we got home I did my own research about the regulations, specifically about FDA regulations about known donor sperm. The major areas of regulation are:
– quarantine period
– communicable disease testing
– genetic testing
– psychological evaluation
– FDA registered facilities

The rules for sperm donation are very similar for anonymous donors and known donors, but there is one major difference that is critical. That rule is about the sperm quarantine period.

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Gratitude in Infertility

I find myself apologizing a lot lately. My husband asks me, “What’s wrong?” and I find myself responding quite often with an apology and, “I’m just an angry, angry person.”

Now that it’s getting closer to IVF #3 and we will almost certainly have embryos to transfer, I’m very angry. I’m so angry. I don’t want to have a baby with some other guy’s sperm. I want a baby with Mr.E’s sperm.

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mTESE Surgery Day

7:40am: Well, today is the day! My mom, our designated driver, spent the night last night because we had to leave at 4am to get to the hospital on time. They just took Mr.E back. Dr. Hotaling said the mTESE surgery would be anywhere from 1-3.5 hours. Obviously I want it to be just 1 hour because that means they found sperm right away.

9:30am: Fortunately my egg retrieval is only 1 mile away. I just woke up from the procedure. I’m having a little cramping. They found 14 eggs, still waiting to hear how many were mature.

These crackers and juice they gave me really hit the spot. I was starving! Now I’m just ready to get the heck out of here and get back up to the hospital to check on Mr.E.

10:40am: Dr. Hotaling came out to tell me that Mr.E is in recovery and they didn’t find any sperm during surgery. Now it is up to Dr. Carrell to finish looking in the lab to see if they can find some there.

12:36 pm: Dr. Carrell called with the bad news. No sperm. He said they couldn’t even find any precursor sperm cells. In all his years he’s never seen a case so black and white.

We are so devastated.

Sperm: Fresh vs. Frozen

I have a fertility app on my phone called iPeriod. Before we found out Mr.E had zero sperm I was using it to track LH surges, morning basal body temperature, pregnancy tests, etc. Now I mostly just use it to track my period.

Anyway, I was looking at it several weeks ago and realized that Mr.E’s mTESE is scheduled for exactly 6 weeks after my next period is supposed to start. Six weeks is exactly the minimum for how long it takes to do an egg retrieval cycle. So I thought, “Is this a sign? Should we try to do a fresh-fresh cycle?”

What do I mean by “fresh-fresh”? I mean fresh (not frozen-then-thawed) eggs and fresh (not frozen-then-thawed) sperm. What difference does it make?

First we have to define what “success” means. For most, if not all, infertility patients, success would be considered taking home a healthy baby while success in the laboratory might be considered making lots of grade A embryos or simply surviving the freeze-thaw procedure. For this post, “success” means taking home a baby.

I think all studies agree that fresh eggs are always better than frozen eggs. So if possible, you always want to use fresh eggs.

Some studies show that fresh sperm is better than frozen sperm. Other studies show that fresh and frozen sperm have the same chance of success. I think there’s even one that shows frozen is better than fresh (think survival of the fittest).

For us, I think fresh-fresh is going to be the best option. Why?

– not 100% guaranteed that all/any sperm will survive the freeze-thaw
– only 80% of subsequent mTESE procedures are successful (meaning sperm found on the 2nd mTESE)

By doing fresh-fresh, we’ll have the same number of sperm frozen (minus the 8-12 used to fertilize any eggs retrieved), plus we get to do the fresh-fresh. It’s like a two-for-one deal.

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Azoospermia and the Andrology Lab

As you may know, Mr.E has NOA (non-obstructive azoospermia) which means he has no sperm in his semen. The only way to get sperm is with a surgical procedure. We’ve chosen to do mTESE (microdissection testicular sperm extraction). Depending on who you talk to, mTESE has between 50-70% chance of success (finding sperm).

Mr.E’s mTESE is scheduled for January with Dr. Hotaling at the University of Utah. Dr. Hotaling just finished his fellowship with Dr. Neiderberger in Chicago (who is one of the top 3 surgeons who perform mTESE).

We chose Dr. Hotaling for a few reasons:
– U of U is closer to us than Dr. Schlegel in NYC
– the surgery is less expensive in Utah (though truth be told I don’t care how much any of it costs, I just want my miracle babies)
– the U of U has an amazing take-home-baby rate at their reproductive clinic (almost 70% success rate in the under 35 male factor category)
– Dr. Schlegel doesn’t have Dr. Doug Carrell

Who is Dr. Carrell you ask? Dr. Carrell is not an MD, he’s a PhD. He’s the director of the Andrology Lab at the U of U.

I let you in on a little secret: the real stars of the show when it comes to IVF are the people in the lab. If you’ve got seriously low egg reserve, then maybe the star of the show is the Reproductive Endocrinologist that gets your body to produce good quality eggs. But otherwise, the star of the show is the lab.

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Azoospermia and Cancer

Did you know that men who are diagnosed with Azoospermia (no sperm) are much more likely to have cancer? By “much more” I mean 8 times more likely. EIGHT times! Actually, if you’re over the age of 30 when you’re diagnosed, then you’re only 4 times more likely to be diagnosed with cancer. (!!!)

Geez. Kick us while we’re down why don’t ya.

So what does this mean? In my mind it means two things:
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Azoospermia Supplements

One of the first things I did when we received the results of Mr. E’s first semen analysis was look to see what pills he could take to “fix it.” Technically there’s probably not a pill you can take that’s going to magically make your sperm count go from 0 to 20+ million.

But I think there’s lots of supplements you can take and lifestyle changes you can make to increase your chances of finding sperm at your mTESE.

One thing I wish we had done sooner is see a Naturopathic Doctor. If you can find one near you, it’s worth a trip. I wouldn’t take everything they say as gospel, but because they treat the entire body (not just the heart or reproductive organs like a specialist) they oftentimes have insight into additional issues. They might think more outside the box than an MD.
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