So many people have been asking what is happening now, when am I going to update the blog, what is going on. Welcome to IF. It is a whole bunch of planning, planning, planning and then waiting. Waiting for the next cycle, waiting for test results, waiting for meeting with the doctors, waiting. So while we are in this waiting process, I thought I would write a blog about how IF is determined and what testing goes into it.
If you saw the video I made, you know that it can take a perfectly healthy couple up to a year of well timed intercourse to get pregnant. Some people get pregnant right away, others it takes almost a whole year. You have a 20% chance each month. Some people may think that there is a problem or it's infertility after a couple of months, but it's really just them being impatient. After that year, or six months if the woman is over 35, a couple can make an appointment with the reproductive endocrinologist (RE), or a fertility specialist. I always advocate for using an RE over your OB/GYN because REs specialize in getting people pregnant and spend years training in this field. OBs, even ones who "specialize in fertility" only received about a month of training in fertility. Usually the first meeting is just a history gathering, a planning session, and question answering.
The RE will usually ask about family history, if a woman has regular cycles, if she is been tracking her temps each morning or using ovulation predictor kits to check her ovulation, and about a million other questions. If that woman has short cycles or long long cycles, doesn't know if she's ovulating, or has other symptoms (painful periods, short luteral phases, etc), it will play into what testing is done. I am no expert at all tests out there so I can only tell you my experience, others have different ones.
The first step is for the man to have a semen analysis. So Jeff gave a sample (guys have the easy part ;) ). When looking at a sample, they are looking for a few things including count, motility, morphology, and defective sperm. Count is the overall number of sperm, motility is how well they swim (both speed and direction, no swimming in circles!), morphology is their size and shape (helps determine if they can get into the egg), and defects could range from having two heads to no tail and more. Jeff's test came back great, with the exception of morphology. He saw urologist who was not worried at all and neither was our RE. The RE basically said morphology is like soldiers who didn't bring all their gear, they may still get in and win, but it will be much harder and more may die in the process. Yep, I can never get away from military comparisons. They said that this was most likely not our problem. So Jeff gets a pass and just has to take vitamins to maintain his health.
My testing was not quite so easy. The first thing I did was went in on day three of my cycle and had around six or seven tubes of blood drawn. The testing included looking at levels of testosterone, FSH, LH, thyroid hormones, estradiol, and a genetic panel done. Most of my levels came back within a fairly normal range, except my thyroid. That was high and so I was started on a medication called levothyroxin to hopefully bring it back down to normal levels. I am not a genetic carrier for anything so that is pretty awesome to know too. At that same visit an ultrasound done to look at my ovaries and uterus. My uterus was perfect but my ovaries (along with some other symptoms) showed that I have a condition called polycystic ovarian syndrome (PCOS). I'll write about that another time, because that is a whole post by itself. About a week later I went and had an HSG done. This is a test where they essentially check to see if your Fallopian tubes are open and functioning. If you want to read more about it, click
HERE. This site include descriptions, tube pictures, and some facts. My left tube has no problems but my right one is inconclusive. As of right now it's considered blocked but the doctor said that he didn't feel comfortable stating whether it was open or blocked because the test was somewhat inconclusive. So we are treating it as blocked. There's nothing that can be done for this except surgery and even surgery has no guarantees. They could perform the surgery, we would be benched for a few months, and within a few months the tube could be blocked again and so it is really not beneficial.
What a normal HSG looks like
Since many times PCOS can be caused by insulin resistance, my doctor also had me do a two hour glucose test. This consisted of drinking a bottle of highly concentrated sugar water, tasting very similar to the orange drink at McDonald's, and then waiting two hours. They drew my blood both before and after and tested the levels to see if I was at risk for diabetes or potentially had diabetes. That test came back that I was fine and not insulin resistant. Thank goodness for small victories! I have now started referring to the lab people as vampires though, because I see them so often and they take bunches of blood! They laugh when I do. :)
After getting all the results we had another meeting with our RE. It was determined that the cause of our infertility was most likely the PCOS causing weak and sometimes no ovulation, high thyroid, and the morphology didn't exactly help. So our plan is to take a medication called Femera (Letrozole) on days three through seven of my next cycle, and hope that that brings on a stronger ovulation than I've been experiencing. Hopefully this will be enough to help us meet cutie pie Humphrey. Time will tell!
